Last February, we announced the use of the Personal Injury Protection Medical Benefits Questionnaire, FM-1669 and the procedure for converting policyholders who will be moved from Excess Medical PIP (coordinating) to Full Medical PIP (non-coordinating) for example, drivers older than 65 who may not be eligible for Excess Medical PIP premium reduction.
In addition to these changes, we will be introducing revised forms to coincide with this new workflow. Form 95174, Information About Your Auto Insurance Policy will be revised and FM-1717, Notice To Policyholder – Personal Injury Protection (PIP) Coverage will be introduced with policies effective 8/1/12. Also, starting with the August Agency Renewal Reports, a display will appear indicating a policy has converted from Excess PIP to Full PIP.
Detailed information about the Form revisions is listed below.
Please contact your Personal Lines Field Manager or Underwriter should you have any questions regarding these revisions.
95174, Information About Your Auto Insurance Policy (04-12 to 08-12) – This form was revised in the PIP-Medical Coverage section to describe how individuals may qualify for a reduction in premium for their PIP coverage based on whether they have a coordinating medical policy that would pay for auto-related injuries. The form now suggests that drivers who have Medicaid, Medicare or Medicare Supplement Coverages may not be eligible for the PIP coverage premium reduction. Also, the verbiage explains how the premiums for new business will be calculated based on the assumption that they do not have a “coordinating” policy unless they advise their agent otherwise. Also, when we ascertain that a policyholder does not have a “coordinating” policy for renewals, we will calculate their premium without a reduction to PIP coverage. Similar changes were made to the PIP-Wage Coverage section as well.
FM-1717, Notice To Policyholder – Personal Injury Protection (PIP) Coverage (New 08-12) – This form was created to explain to renewing policyholders how benefits are paid from their PIP coverage and how their premiums are calculated when there is a “coordinating” medical insurance policy in place. It explains to them that we have reviewed their policy and will be calculating their renewal premium without a reduction in premium to their PIP coverage, based on the fact that we ascertained their medical insurance does not provide medical benefits (i.e. all drivers are 65 years or older on the policy, so they likely have Medicaid, Medicare or Medicare Supplement which makes them ineligible for the premium reduction).
