PIP Payment Enforcement Page
Kentucky Law provides for a no fault system of insurance payments. This means that no matter who is at fault in an automobile accident, there is some money available to pay for basic services such as medical bills and a small amount of lost wages.
In Kentucky there are typically $10,000 in no fault benefits available. More can be purchased as insurance coverage, but $10,000 is the state minimum. These are called Basic Reparations Benefits or Personal Injury Protection Benefits. Most commonly these benefits are referred to as “PIP.”
More frequently, insurance companies are looking for ways to deny benefits to those who are injured. Many insurance companies even deny PIP benefits. This leaves injured people with no way to pay their medical bills. Because the Kentucky Motor Vehicle Reparations Act abolishes tort liability for the first $10,000.00 of medical bills (the portion PIP is supposed to pay), if an injured person’s insurance company does not pay their medical bills, they cannot have those medical bills paid by anyone else including the person who injured them. This is why it important to hold insurance companies accountable. This is done through a law suit, in Kentucky Called a “PIP Suit.”
Kentucky law sets forth the no-fault benefit in KRS 304-39. This statute is call the KMVRA. This statute is a self contained body of law. This means that many of the other statutes dealing with insurance do not pertain to no-fault benefits. For example, the Kentucky Unfair Claims Settlement Practices Act does not apply to PIP benefits, Foster v. Kentucky Farm Bureau, 189 S.W.3d 553 (Ky. 2006). Insurance companies like the fact that bad faith cannot be alleged in a lawsuit to recover PIP benefits. However, the law works both ways. The KMVRA also contains the remedy for an insurer that wants to contest the payment of benefits. KRS 304-39.-270 provides that an insurance company can petition the circuit court to order an examination by a physician. Because the PIP laws are self contained they restrict what a claimant and an insurance company can do.
The KMVRA is pretty liberal in what is covered. Medical bills may be paid, also bills from any religious system of healing are covered. This means if a person is injured, they may seek treatment anywhere they like. Currently there is a lot of debate about he reasonableness and necessity of Chiropractic treatment. Insurance companies have resorted to several gimmicks to limit treatment by chiropractors. GEICO routinely sends chiropractic records to medical doctors to review. While this may seem harmless, it is illegal under Kentucky law (see KRS 312.200). Other insurance companies simply decide to stop paying bills. They often base this refusal on something the injured person has not done. It could be giving a recorded statement or filling out a form. Also, insurance companies like to put claims “under investigation.” Usually these tactics are simply used by insurance companies to keep from paying claims. Under Kentucky law an injured person’s claims must be paid upon submission of the medical bills.
We currently represent many clients who have had their PIP benefits denied by insurance companies. If you have had your PIP benefits denied, or you are a medical provider whose patients have had their PIP benefits denied do not hesitate to contact the attorneys of Murphy & Associates today.
If you are an attorney or legal professional interested in more legal cites for our positions on PIP payments, please see our PIP Suit Brief by clicking here.