FSCO A01-10

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  1. 34/10 - New Statutory AB Schedule - New Caps
    • cap medical/rehab and assessment/examination expenses for minor injuries to $3,500
    • cap each assessment to $2,000 whether requested by claimant or insurer
  2. 34/10 - New Statutory AB Schedule - New coverages to be offered
    • offer $2,500 for accounting reports to support income replacement benefits claims
    • provide standard medical and rehab coverage for non-cat claims of $50K/$100K/$1.1M
    • offer standard attendant care coverage for non-cat claims of $36K/$72K/$1.072M
    • supply optional caregiver, housekeeping and home maintenance benefits (non-cat)
  3. 34/10 - New Statutory AB Schedule - Administrative changes
    • replace PAF for Grade I and II Whiplash with new MIG
    • provide payment for in-home assessments only to non-minor injury claimants
    • eliminate rebuttal examinations
    • merge treatment plans and applications for approval of assessment or examinations
    • provide adjusters with discretion in the use of insurer examinations
    • create a definition for incurred expense
    • simplify and consolidate the rules that govern claims processing
    • eliminate a number of approved forms
  4. 283/95 - Disputes Between Insurers
    • ensure that, where there may be a dispute regarding which insurer is liable to pay for statutory AB, claims will not be deflected and claimants will receive payments without delay, pending a resolution regarding which insurer is required to pay the benefits.
    • require insurers to provide timely access to application for benefits to claimants
    • prohibit insurers from attempting to prevent or discourage claimants from submitting applications to them
    • prohibit insurers from refusing applications or attempting to redirect claimants
    • require claimants to submit their applications for benefits to only one insurer, rather then all liable insurers
    • require the first insurer that receives a completed application to provide benefit payments without delay
  5. 7/00 - Unfair or Deceptive Acts or Practices
    • ensure insurers cannot use credit information for specific auto insurance purposes
    • provide a definition for credit information that includes a person’s credit rating, credit score, credit-based insurance score, occupation, place of residence, number of dependants, education, profession, place(s) or employment, income, debts, cost of living and assets
    • prohibit insurers from requiring that a consumer consent to the collection and use of his/her credit info before providing an insurance quote or offering to renew policy
    • prohibit insurers from using credit information in order to treat consumers differently when they respond to requests for quotes, process applications or renewals
    • require affiliated insurers that use the same distribution channel to provide a consumer with the lowest rate available through the channel
  6. 664 - Automobile Insurance
    • option for consumers to purchase an endorsement that provides first-party coverage to reduce the tort deductible for pain and suffering awards to $20K from $30K
    • adding a $500 deductible option for DC-PD
    • prohibit the use of accidents occurring on or after September 1st, 2010 where the insured is 25% or less at fault for classification purposes 
    • introduce a cap of $2,500 for arbitration awards in respect of accounting report regarding claim for income replacement benefits
Card Set
FSCO A01-10
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