_5_ PAP Medical Payments Coverage

The limit of liability provision specifically states...

"no one is entitled to receive duplicate payments for the same elements of loss under Part B - Medical Payments, Part A - Liability, Part C - Uninsured Motorists

What is the range for the limit of Liability under Part B - Medical Payments? How does the limit apply?

$1,000 - $10,000 max amount that will be paid to each injured person in a single accident (regardless of the number of persons injured, claims made)

List / Discuss the vehicles excluded under Part B - Medical Payments

*Motorcycles & 3-wheelers* *Other Owned Vehicles* if not a covered auto and furnished / available for insured regular use then no med pay coverage in injury sustained while occupying or when struck by vehicle *Family Vehicles* if not a covered auto and vehicle is owned, furnished, or available for the regular use of any family member then no med pay coverage in injury sustained while occupying or when struck by vehicle exception: does not apply to named insured and spouse *Business Vehicles* no coverage if vehicle is used in insured's business exception: does not apply to PPA, pickup, van or trailer used with these vehicles

who is covered under Part B Medical Payments?

*Named insured and "Family Members"* covered if injured while occupying a motor vehicle or as a pedestrian when struck by a motor vehicle designed for use on mainly public roads *any other passenger while occupying a covered auto*

List / discuss the Part B - Medical Payments Exclusions

*Public Livery or Conveyance* exception: share the expense car pools *Vehicles Used as Residences* *Racing*

List / Discuss the (4) exclusions related to the circumstance of vehicle operation

*WC injuries* injuries that occur during the course of employment are excluded if WC benefits are available *Unauthorized Use* does not apply to a "family member" using an owned auto of the named insured (also implied consent to use if family member) *Nuclear Weapons or War* *Nuclear Radiation*

what coverage does Part B of the PAP provide?

auto medical coverage up to a limited amount without requiring a determination of fault

How does Part B - Medical Payments apply in the case of a non-owned vehicle or a temporary substitute vehicle?

it is excess over any other collectible auto insurance that pays medical or funeral expenses

what types of expenses are payable under Part B

medical surgical x-ray dental funeral all of the above are considered "medical expenses"

Summarize the Part B Insuring agreement

pay reasonable and necessary medical expenses incurred by an insured because of bodily injury caused by an accident coverage only covers those expenses incurred for services rendered within 3 years from the accident date

How is coverage divided when more than one insurance policy applies to each claim (two PAP cover the same vehicle)

pro rata based on the applicable limits of the policies