Coverage
What is the mandatory coverage for medical required in the state of NY?
PIP
What is the VTL violation number for DWI?
1192
If we know someone is working - who is primary for medical bills?
Workers Comp
How long after the DOL can we pay wages?
3 years
How much is the death benefit?
$2000
How much is PIP?
$50,000
If the officer thinks alcohol was a contributing factor in the MVA, he or she will enter the number _____ in boxes 19-22 of the police report
2
One of our main requirements of a WC investigation is to take a _____ ______ of the injured person.
Recorded Statement (Interview)
How long does the injured party have to present a wage claim?
90 Days
To Whom do we pay the death benefit?
To the estate
How much is OBEL?
$25,000
If we deny for DWI, is there any line coverage that will pay? If so, what line coverage?
Yes, if they have med pay on the policy
List some red flags that W/C may apply?
Vehicle is a company/commercial vehicle
Injured Party's occupation - a job that would require travel
The injured party says they were working at TOL
Injured party to/from work in a vehicle that is furnished by the employer.
PIP APP (NF2) - Box #16 is checked YES
PIP template indicates coming from or going to work or YES for WC
NF-6 checked "Yes" to workers comp
Medical records indicate injured party was working at time of loss
Under PIP, what is the monthly wage benefit amount?
$2500 gross / $2000 net
What coverage may be used for funeral expenses?
Medpay
The first step to decide coverage is to determine if the party is an ________ Injured Person. And the 2nd is to determine if any ___________ apply.
eligible
exclusions
Is DWI an exclusion for PIP?
Yes
Exclusion F in policy Under PIP
How much does workers comp pay for wages? How much does Progressive pay?
WC: 66%
PROG: about 14% (13.3%)
Can the deductible be applied to lost wages?
Yes
*However, we try to always apply to medical bills first
What letter do we send to the deceased family?
Death Benefit
List the line coverages in the order of payments
POAM
1. PIP
2. OBEL
3. APIP
4. MEDPAY
If we deny a person's PIP coverage due to the DWI exclusion, we still pay for the ______ ______ ______.
What benefits does Workers Comp afford?
Medical Bills
2/3 of lost wages
OEL's
The injured party makes $55 an hour
They work 5 hours a day
They missed 3 days of work
How much is the gross wages? How much is the net wages? Do we handle? Do we transfer? Show your math
$55 per hour x 5 hours = $275 per day
$275 x 3 days missed = Gross $825
Gross $825 x .08% = NET $660
We would transfer to wage assist
What is the letter of adminstatration?
Names the person that's been appointed to handle the estate