FindLaw KnowledgeBasePublished: 2012-04-25
New Jersey drivers can currently purchase up to $250,000 worth of protection for damages in medical expenses and pain and suffering after a car crash through personal injury protection insurance, or PIP. Recently, however, a proposed administrative revision of PIP seeking to lower the amount of protection a New Jersey resident can purchase underwent a hearing on Oct. 6, 2011, in the state’s Financial Institutions and Insurance Committee. On one side at the hearing were insurance companies claiming this high limit reduces their profitability through arbitration on claims disputes; on the other side were medical providers and personal injury attorneys who say that long delays by insurance companies in processing PIP claims brings additional and preventable pain and suffering to their patients and clients.
The New Jersey Department of Banking and Insurance has the final say on the new regulations. In 2009, the DOBI created fee scheduling, which set limits on the amount medical providers could charge for certain procedures. The Superior Court’s Appellate Division upheld the decision, despite doctor complaints that the fees were arbitrary and too low. The proposed regulations would further restrict the ability for doctors to set fees for the cost of certain medical procedures.
The DOBI took comments on new regulations, which have been quite controversial, up to Oct. 17. NJ.com reports that the DOBI received over 12,000 letters between August and October regarding the proposed PIP revisions.
Regulations Still Current — but Likely to Undergo Changes
It is unclear what changes the DOBI will ultimately make to PIP regulations. Several aspects are under scrutiny; for example, the current proposed revisions would only allow an appeal of an insurance company’s denial of a PIP claim within five days of the denial. This means a doctor would have very little time to diagnose injuries, especially for pain and suffering, before filing an appeal on a rejected claim. For patients with injuries that manifest themselves later, such as back pain or brain injuries, these regulations would greatly limit the timeframe under which they can recover.
Speak to an Attorney
For those injured in an auto accident, the bureaucracy involved in getting needed medical treatment and procedures to mitigate pain and suffering can be a nightmare. If you have suffered injuries in a car accident, speak to an experienced attorney familiar with obtaining awards for damages and navigating insurance claims settlements. An advocate can greatly enhance your ability to recover the appropriate amount of costs that resulted from the accident.