Determining when to choose Full vs. Excess Medical Benefits is important to ensure we are properly writing risks.  To be eligible for Excess Medical coverage, the insured must have health insurance that provides coverage on a primary basis for auto related accidents. 

Statistics show only 30% of health insurance programs provide this benefit.  The PIP Medical Benefits Questionnaire, FM-1669, must be completed whenever Excess Medical coverage is requested.  This form is the insured’s certification their health insurance provides primary coverage.  This information will be verified by the company. 

Everyone in the household must qualify for the excess benefit as it is applied to all vehicles.  If not, then Full Medical should be selected for all.  If the insured’s health insurance is provided by only Medicare or Medicaid, Excess Medical Benefits are not available since Medicare and Medicaid does not provide primary coverage for automobile related accidents.  Also, if anyone has health insurance provided through a county or community plan, they would not be eligible for Excess and would need to choose Full Medical.

Effective 10/1/2012, a $500 deductible (increased from $300) will be applied if, at the time of loss, qualifying medical insurance is not in effect providing coverage for injuries sustained in an auto accident by the Named Insured or any resident relative.  PIP is changed to “Full Med” as soon as Claims notifies us of the discrepancy. 

If you have questions on when to choose Full vs. Excess Medical or any other PIP questions, contact your Personal Lines Underwriter.

Thank you for helping us work toward pricing accuracy in our auto book.