No Fault/PIP/First Party Medical States

Transcription

1 Delaware Listed on Policy Primary 15/30 ; Added benefits, up to $100,000 based on coverage purchased Florida -Fault & Owned and insured Medical Payments under the. If after 90 days of "residency" is established, PIP must then be purchased (does not roll on). PIP follows the family. Owned s are first in priority $10,000 Medical paid at 80%. $10,000 only if endorsed in the Hawaii -Fault All s -Fault is primary Basic is $10,000 $10,000 + additional is optional Kansas -Fault All, excluding government s, farm tractors, s operated on the highway merely for crossing and motorized bicycles. Kentucky -Fault All, excluding farm tractors, motorcycles, construction equipment, mopeds Maryland 1.Titled owner 2.Vehicle 3.Household resident 1. Vehicle 2. Injured Party Listed on PIP Primary - Medical Payments secondary $4500 plus $4500 for rehabilitation. Depends on rider: $12,500 to $77,500 Limited by total benefits limit: basic overall limit is $10,000. Depends on Rider: $20,000 - $100,000 Medical Payments can be subrogated 50% of no-fault if special damages awarded If $2000 threshold is met, subrogatable from dollar one If $1000 threshold is met, subro at $1001. PIP primary to everything. (If comp involved, pip will not duplicate anything received from comp). none Work Comp Work Comp $2,500 Workers' Compensation Benefits Verbal threshold state, no fee schedule, extremely litigious providers & attorneys. The entire limit of PIP is $10,000. This is inclusive of meds, wages, services. Extended PIP can be purchased through an endorsement making the meds paid at 100% and the lost wages paid at 80% BI claims are settled for general damages only, which bars no-fault recovery. Fee Schedule applies - medical benefits are paid based upon "medical necessity." Medical payments stacks provided seatbelt in use

2 Massachusetts & Medical Payments Private passenger s. Motorcycles excluded from PIP but allow for MP. PIP pays first $2000 in $8000 PIP. MP up to 8000 up to $25,000 available in MA health insurance none medical bills then $25,000 coverage coordinated with health carrier up to $8000 limit. MP available for expenses not payable under PIP. Michigan -Fault All, excluding farm tractors, motorcycles and mopeds (benefits are offered to motorcycle owners) Minnesota -Fault ALL, excluding motorcycles and mopeds 1. Vehicles transporting passengers as a business 2. Employment 3. Injured party 4. Vehicle owner 5. Vehicle operator Coverage follows insured. 1. Employment 2. Injured Person 3. Vehicle ne other than a cap if a Michigan unlimited Very limited Government required benefits Able to stack x 2 by endorsement ne, unless tortfeasor is a commercial or the loss occurs out of state. Policy may provide for co-ordination of benefits for medical and/or wage loss. W/C primary with offset Tort threshold $4000 in meds ( excluding diagnostic tests) or 60 days lost time from work, or a permanent injury.

3 New Jersey -Fault Insurance follows the person, the household as well as the covered. If the named insured/resident relative is injured in or by a private passenger they are covered. There is no pedestrian pip effective 1/1/04 for anyone other than the insured/resident relative Personal Policy, then Basic $15,000 ; Basic limit $15,000, Commercial by fee schedule The insurance follows the person, the Business Policy; If Standard $250,000; no added medical only if at fault; out-ofstate household as well as the covered workers comp loss, Optional $1,000,000 benefits accident if at. If the named wcomp becomes fault. insured/resident relative is injured in primary. or by a private passenger they are covered. There is no pedestrian PIP effective 1/1/04 for anyone other than the insured/resident relative. New York Mandatory (optional med pay is excess to NF) rth Dakota -Fault ALL, excluding motorcycles and mopeds Follows car but WC primary over NF. NF primary overall everything else. 1. Work Comp 2. Vehicle 3. Injured Party 4. Bus 5. Ridesharing Vehicle $50K basic, optional coverage's up to $150K max. $50K; up to $150 if optional endorsement added. Limited by total benefits limit; Basic limit is $30, weight, taxi / livery, non-covered, XPIP, if injury was "serious" or weight exceeds 6500 pounds. Optional deductible, $200 family Regulation mandated no-fault forms and timeframe exist. Interest penalty of 2% / month imposed (over $5.00 charges).fee Schedule applies - medical benefits are paid based upon "medical necessity."

4 Oregon Motor as - defined in Mandatory endorsement $15,000 Follows the. t applicable. Limits are mandatory Workers compensation Deductibles do apply. Individual limits for and $15,000. or any other similar benefits. Endorsement medical or disability A36024 effective benefit law (excluding 01/04. Benefits Medicare). expire 1 year post Endorsement allows date of loss for reduction of uninsured motorist benefits and allows for reduction of bodily injury settlement. Pennsylvania -Fault First party benefits provided for eligible person(s) regardless of they occupy. Texas For names insured, & any veh occupied or Medical Payments when struck by. *IV, s designed mainly for use on public roadway (i.e.- three wheelers), pedestrian when struck by motor 1. Coverage follows person (insd) 2. Residency Relative 3. Owner of they are riding in 4. Pedestrian - any involved Primary when occupying "your covered auto". Excess coverage when occupying other s. Can be purchased up to a limit of $277,500. Can purchase catastrophic medical that covers $100,000 1 million in medical. Policy Limit Basic statutory amount of medical is $5,000. You may also purchase additional medical benefits up to $100,000. Workers Compensation primary for medical - lost wage benefits excess over work comp $2500 total for Can t subro PIP. Can. Collateral medical and loss wage for PIP. $2500 medical benefit for Med Pay. subro Med Pay Source can be used. Act 6 mandates medical cost containment provisions. Fee Schedule applies - medical benefits are paid based upon "medical necessity." PIP cov is very basic coverage and tracks our Med Pay coverage with the exception that wage loss benefit is available, or, if injured party is not a wage earner, loss of essential services can be paid. Med pay covers reasonable and necessary med expenses only. We now have PIP credit on uninsd motorist and liability claim settlements. Utah -Fault Covered Autos / veh operated by insd NA $3000 ; $5000 / $10,000 / $15000 / $20000 / $ All benefits paid Fee Schedule Fee Schedule applies - medical benefits are paid based upon "medical necessity."

5 Washington Medical Payments (MP) Motor (MP). 3 designed for use year period. mainly on public road. PIP coverage available. School of Insurance Fraud (MP) Stated in (MP) Stated in (MP) PL - (MP) Reduced by any Declarations - declarations, double subrogation is amounts payable to Doubles if wearing if seatbelts worn. applicable. CPL - same expenses under seatbelt on Personal removes right Coverage A or D. Lines. to transfer right of recovery for med pay. Washington (PIP) (PIP) Insured while occupying a motor and while a pedestrian. (PIP) Primary. Pro-rata share if other PIP is applicable based on applicable limits. Excess for eligible injured person when occupying or while a pedestrian through being struck by a temporary substitute or non-owned. KEY: NF = -Fault = 1st party medical and wage loss benefits with tort restrictions (choice, monetary or verbal). PIP = = 1st party medical and wage loss benefits with no tort restrictions. MP = Medical Payments = 1st party medical benefits only. tes: (PIP) Specific for types of benefits as stated in declarations. (PIP) Basic - $10,000; Added - $35,000. (PIP). (PIP) Reduced by the amount paid, payable or required to be provided under any worker's compensation or other similar medical or disability law.