House Bill 381 has been introduced recently in the Kentucky legislature by Rep. Jim Gooch. This is a bill that, if passed, would alter the way no-fault or PIP medical payments are handled in Kentucky auto accidents. The bill is proposing several changes to the No-Fault Statute. These include:
- The statute now presumes medical bills are reasonable when presented by your doctor. The bill would require specific circumstances to be present and met for reasonableness.
- All claims will have to be submitted by your doctors within 45 days of the date of service. If you go to the emergency room for injuries sustained in the auto accident, your PIP insurance has to pay the hospital first. Under the current law, you, the injured person, can direct who gets paid first and have the option to have payments be made for your wage loss claim before anything else is paid. You could direct your health insurance to pay the emergency room once your PIP benefits are exhausted. This right under the statute is being restricted in favor of the hospital.
- Another portion of the bill requires a person injured in an auto accident to submit to a DME (Defense Medical Exam) at the request of the car insurance company. Presently, a court order is needed to require an injured person to submit to this exam. The insurance company now has to go to court and show good cause to have the injured person submit to this exam. Under the present bill you would be required to submit to the exam at just a request by the insurance company.
- There is also a very complicated system being proposed for the review of medical bills to determine if they are medically necessary or reasonable.
Will these changes help the accident victim?
I do not believe any of these proposed changes will help the accident victim. As the law stands, the accident victim has control of the doctor they choose, the treatment they receive and how to direct the payment of the $10,000 in benefits they have available. This bill would place restrictions on this process by:
- Putting in place hoops the injured person would have to jump through while they are in pain and attempting to heal.
- Make it difficult for their providers to get paid as they deal with miles of red tape.
- Discouraging doctors from treating auto accident victims.
There are already procedures in place that sufficiently handle the issues presented. This bill would place restrictions on the rights and ability to get required medical treatment by accident victims. If you would like more information on this bill or any other bill before the Kentucky legislature follow this link: http://www.lrc.ky.gov/.