For Insurers New To PA

Davis Parry & Tyler has assisted insurers new to auto insurance coverage in Pennsylvania, addressing the applicable provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law (75 Pa.C.S. §§ 7102 et seq.) and the implementing provisions of the Pennsylvania Code.  Our analysis for clients has included:

  • Insurance Coverage & Policy Interpretation
  • General Claims Handling Guidelines required by the Pennsylvania Code
  • The utility and management of the insurer’s use of peer review organizations (PRO’s) in First Party Medical (a/k/a “PIP”) Benefits analysis, such as
  • The PRO review process
  • Determining approved PRO’s
  • The course of PRO reviews, reconsiderations and and remedies available
  • The timeline for an insurer to challenge expenses of a medical provider
  • The means for an insurer to request reimbursement from a provider for previous payments by the insurer of expenses denied by the PRO process
  • The interplay between Independent Medical Examinations and the Peer Review process
  • Recent developments in Pennsylvania case law placing constraints on the resort by insurers to medical evaluations in the management of first party benefits coverage
  • Changes to the law affecting property damage appraisals
  • Bad faith exposure in the handling of first party benefit claims
  • Priority of coverage for first party benefits
  • Management of liens imposed by Medicare/The Center for Medicare Services (CMS)
  • UIM issues in Pennsylvania, such as:
  • Coverage in Pennsylvania: Is it Gap or Excess coverage?
  • The Pennsylvania Supreme Court’s abrogation of the Household Vehicle Exclusion in UIM claims
  • Issues regarding effective versus ineffective stacking of UIM coverages
  • Litigation of a UIM claim: must it be an arbitration or civil action?
  • The interplay between recovery of UM/UIM benefits and Workers’ Compensation benefits
  • Limited Tort versus Full Tort options selected by claimants
  • Application of the “Car For Hire” exclusion

We stand ready to reliably assist in any inquiry arising from your claims department that will facilitate your prompt & effective claims handling!