Bill Text: NJ S300 | 2012-2013 | Regular Session | Introduced
Bill Title: Clarifies right to access the judicial system in PIP benefit disputes.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2012-01-10 - Introduced in the Senate, Referred to Senate Commerce Committee [S300 Detail]
Download: New_Jersey-2012-S300-Introduced.html
STATE OF NEW JERSEY
215th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2012 SESSION
Sponsored by:
Senator JOSEPH PENNACCHIO
District 26 (Essex, Morris and Passaic)
SYNOPSIS
Clarifies right to access the judicial system in PIP benefit disputes.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act concerning personal injury protection benefits and supplementing P.L.1972, c. 70 (C.39:6A-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. Notwithstanding any other provision of law to the contrary, a dispute regarding the recovery of medical expense benefits or other benefits provided under personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4), section 4 of P.L.1998, c.21 (C.39:6A-3.1) or section 45 of P.L.2003, c.89 (C.39:6A-3.3) arising out of the operation, ownership, maintenance or use of an automobile may be submitted, upon the initiative of any party to the dispute, to the Superior Court of New Jersey, Law Division, including the Special Civil Part and the Small Claims Section.
b. A dispute submitted to the Superior Court of New Jersey pursuant to subsection a. of this section may be filed in any county in which: (1) an individual claimant resides; (2) a health care provider who provides medical services to an injured party maintains an office; or (3) an insurer involved in the dispute does business.
c. A health care provider who provides medical services to an injured party shall be deemed to be a party to the dispute and shall be permitted to pursue a claim for the payment of medical expenses pursuant to subsection a. of this section.
d. A health care provider who submits a claim to an insurer or files an action pursuant to subsection a. of this section against an insurer for reimbursement of services shall not demand payment for those services from an injured party for medical expense benefits nor shall the injured party or the insured be liable to any health care provider for the payment of any services that are included within that claim or action.
2. This act shall take effect immediately.
STATEMENT
This bill clarifies that insureds and health care providers have the right to access the court system in any dispute regarding the recovery of medical expense benefits or other benefits provided under personal injury protection (PIP) coverage.
The State of New Jersey adopted the "New Jersey Automobile Reparation Reform Act" in 1972. A primary purpose of the act was to provide for the prompt and efficient provision of benefits for all accident injury victims. The act provides that every standard automobile insurance policy shall contain PIP benefits to the named insured and resident family members; to pedestrians struck by the insured automobile; and to occupants in the insured automobile. The PIP benefits include medical expenses up to $250,000 per person per accident.
As initially enacted, the act did not provide any statutory remedy for the resolution of disputes between an insured and an insurer. Thus, a claimant was required to file suit in the Superior Court of New Jersey for the payment of PIP benefits when the insurer refused to pay.
In 1983, the act was revised to provide that a claimant may submit a dispute regarding the recovery of PIP benefits to a dispute resolution proceeding, commonly referred to as PIP arbitration. In 1998, the law was revised again to provide that any party "may" submit a dispute to PIP arbitration. Nonetheless, despite the clear statutory language that PIP arbitration is an optional alternative to a PIP lawsuit, some insurers require that all disputes be submitted to PIP arbitration.
The primary purpose of this bill is to restore to an insured and health care provider the fundamental right to file a civil action in the Superior Court of New Jersey, Law Division, including the Special Civil Part and the Small Claims Division, for the payment of medical expense benefits. Any party to the dispute will still have the option to submit any dispute to PIP arbitration.
In addition, the bill will clarify that health care providers are a real party to the dispute with respect to the payment of medical expenses. Thus, a health care provider has the right to pursue a claim in court for the payment of medical expenses.
However, if a health care provider submits a claim or files an action for the payment of medical expenses, the provider may not demand payment for that claim from the injured party and neither the injured party nor the insured shall be liable to the health care provider for the payment of those services.
