FPCA Auto Division: Emergency Care-Only Personal Injury Protection Coverage Outline

Dec 22, 2011


FPCA Auto Division Members:

The attached summary has been provided to us by the staff of the House Insurance & Banking Subcommittee.  House Legislators and staff are considering drafting a proposal of an emergency care only Personal Injury Protection insurance type coverage based on the attached outline.  House staff would like feedback on this summary, as soon as possible, preferably by Wednesday, December 28.   Please submit your comments on the attached summary to Katie Webb at kwebb@cftlaw.com by Wednesday, December 28.

This proposal would maintain the no-fault system, but significantly restrict the types of medical treatment reimbursable under the coverage. Lost wages and death benefits would still be available. In order to allow for a transition to the new coverage, the proposal would not be effective upon becoming law but effective at some point in the future.

The proposal would revise current law to limit No-Fault motor vehicle insurance to EMS services, emergency services and care, service and care to admitted hospital patients, and follow up care, all subject to certain time-frames and only provided by certain providers. Coverage would be limited to $10,000.

Additionally, the proposal would make additional changes, such as allowing insurers to require claimants to submit to examinations under oath (EUO); create rebuttable presumption that a claimant’s failure to appear for two medical examinations is an “unreasonable refusal” to submit to examination; capping attorney fee awards and barring the use of a contingency risk multiplier in PIP cases; and requiring all insurers to make rate filings based upon the new no-fault coverage.


Should you have any questions or comments, please contact Katie Webb (kwebb@cftlaw.com) at Colodny Fass.