Statutory Text
§ 1712. Availability of benefits.
An insurer issuing or delivering liability insurance policies covering any motor vehicle of the type required to be registered under this title, except recreational vehicles not intended for highway use, motorcycles, motor-driven cycles or motorized pedalcycles or like type vehicles, registered and operated in this Commonwealth, shall make available for purchase first party benefits with respect to injury arising out of the maintenance or use of a motor vehicle as follows:
(1) Medical benefit.--Subject to the limitations of section 1797 (relating to customary charges for treatment), coverage to provide for reasonable and necessary medical treatment and rehabilitative services, including, but not limited to, hospital, dental, surgical, psychiatric, psychological, osteopathic, ambulance, chiropractic, licensed physical therapy, nursing services, vocational rehabilitation and occupational therapy, speech pathology and audiology, optometric services, medications, medical supplies and prosthetic devices, all without limitation as to time, provided that, within 18 months from the date of the accident causing injury, it is ascertainable with reasonable medical probability that further expenses may be incurred as a result of the injury. Benefits under this paragraph may include any nonmedical remedial care and treatment rendered in accordance with a recognized religious method of healing.
(2) Income loss benefit.--Includes the following:
(i) Eighty percent of actual loss of gross income.
(ii) Reasonable expenses actually incurred for hiring a substitute to perform self-employment services thereby mitigating loss of gross income or for hiring special help thereby enabling a person to work and mitigate loss of gross income.
Income loss does not include loss of expected income for any period following the death of an individual or expenses incurred for services performed following the death of an individual. Income loss shall not commence until five working days have been lost after the date of the accident.
(3) Accidental death benefit.--A death benefit paid to the personal representative of the insured, should injury resulting from a motor vehicle accident cause death within 24 months from the date of the accident.
(4) Funeral benefit.--Expenses directly related to the funeral, burial, cremation or other form of disposition of the remains of a deceased individual, incurred as a result of the death of the individual as a result of the accident and within 24 months from the date of the accident.
(5) Combination benefit.--A combination of benefits described in paragraphs (1) through (4) as an alternative to the separate purchase of those benefits.
(6) Extraordinary medical benefits.--Medical benefits, as defined in paragraph (1), which exceed $100,000.
Key Definitions:
First Party Benefits:
These are benefits payable directly to the insured or beneficiary in the event of an injury arising from the maintenance or use of a motor vehicle.
Customary Charges:
They refer to the standard or usual costs for medical and other forms of professional treatment.
Vocational Rehabilitation:
Refers to a process supporting individuals with functional, psychological, developmental, cognitive, and emotional impairments to overcome barriers to accessing, maintaining, or returning to employment or other useful occupation.
Mitigating Loss:
This involves taking steps or actions to reduce the severity, seriousness, or painfulness of something, such as loss of income.
Personal Representative:
A person who administers the estate of a deceased person.
Relevance to Pennsylvanian Drivers:
This section of the MVFRL speaks directly to drivers about the coverages that should be available to them in their automobile insurance policies and the types of benefits they can expect to receive in the event of an accident.
These aspects include medical coverage, income loss benefits, accidental death benefits, funeral benefits, combination benefits, and extraordinary medical benefits. It explains what is covered under these benefits, providing transparency and clarification for drivers on their rights to adequate compensation and coverage.
Relevance to Pennsylvania Attorneys:
For attorneys, a deep understanding of this section is critical as it directly affects how they guide and represent clients involved in motor vehicle accidents. Understanding these provisions enables attorneys to accurately interpret and apply the regulation to ensure their clients receive all benefits they are entitled to. Additionally, it can inform their advice on insurance policy choices and influence how you construct arguments in disputes related to automobile accidents.
Analysis of the Language:
The language used in § 1712 is comprehensive and explicit, ensuring there is little room for misinterpretation. For instance, the clause about medical benefits has been broken down to list individual treatments and rehabilitative services explicitly, preventing vague interpretations by insurance companies.
The law carefully includes a fail-safe section - the combination benefit - illustrating flexibility in the law which allows the benefits to be adjusted to suit an individual's unique circumstances.
Despite being worded comprehensively, the law has room for upgrades. For example, the Income loss benefit would benefit from clarifications about situations that enable the coverage of expenses for hiring substitutes or special help.
Moreover, the law is generally updated to keep pace with changes in the medical and disability sector. This can be seen from the amendments in 2002 that affected paragraph (1) dealing with Medical Benefit, solidifying the law's continuous adaptation.
In conclusion, Section 1712 is an essential part of the MVFRL, offering a roadmap for insurance coverage and benefits available to Pennsylvania drivers and providing a reference point for attorneys advocating for their clients' rights and benefits should an automobile accident occur.
