Bill Text: NJ A478 | 2010-2011 | Regular Session | Introduced
Bill Title: Limits motor bus owner responsibility for no-fault medical expense benefits coverage for certain injured passengers.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2010-01-12 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A478 Detail]
Download: New_Jersey-2010-A478-Introduced.html
STATE OF NEW JERSEY
214th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2010 SESSION
Sponsored by:
Assemblywoman JOAN M. VOSS
District 38 (Bergen)
Co-Sponsored by:
Assemblyman Thompson
SYNOPSIS
Limits motor bus owner responsibility for no-fault medical expense benefits coverage for certain injured passengers.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act concerning certain medical expense benefits coverage for passengers injured on certain motor buses and amending various parts of the statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 18 of P.L.1985, c.520 (C.17:28-1.4) is amended to read as follows:
18. Any insurer authorized to transact or transacting automobile or motor vehicle insurance business in this State, or controlling or controlled by, or under common control by, or with, an insurer authorized to transact or transacting insurance business in this State, which sells a policy providing automobile or motor vehicle liability insurance coverage, or any similar coverage, in any other state or in any province of Canada, shall include in each policy coverage to satisfy at least the personal injury protection benefits coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 19 of P.L.1983, c.362 (C.17:28-1.3) and, if applicable, the motor bus medical expense benefits coverage requirements set forth in section 2 of P.L.1991, c.154 (C.17:28-1.6) for any New Jersey resident who is not required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) and who is not otherwise eligible for such benefits, whenever the automobile or motor vehicle insured under the policy is used or operated in this State. In addition, any insurer authorized to transact or transacting automobile or motor vehicle insurance business in this State, or controlling or controlled by, or under common control by, or with, an insurer authorized to transact or transacting automobile or motor vehicle insurance business in this State, which sells a policy providing automobile or motor vehicle liability insurance coverage, or any similar coverage, in any other state or in any province of Canada, shall include in each policy coverage to satisfy at least the liability insurance requirements of subsection a. of section 1 of P.L.1972, c.197 (C.39:6B-1) or section 3 of P.L.1972, c.70 (C.39:6A-3), the uninsured motorist insurance requirements of subsection a. of section 2 of P.L.1968, c.385 (C.17:28-1.1), [and] personal injury protection benefits coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or of section 19 of P.L.1983, c.362 (C.17:28-1.3), and, if applicable, the motor bus medical expense benefits coverage requirements set forth in section 2 of P.L.1991, c.154 (C.17:28-1.6), whenever the automobile or motor vehicle insured under the policy is used or operated in this State.
Any liability insurance policy subject to this section shall be construed as providing the coverage required herein, and any named insured, and any immediate family member as defined in section 14.1 of P.L.1983, c.362 (C.39:6A-8.1), under that policy, shall be subject to the tort option specified in subsection a. of section 8 of P.L.1972, c.70 (C.39:6A-8).
Each insurer authorized to transact or transacting automobile or motor vehicle insurance business in this State and subject to the provisions of this section shall file and maintain with the Department of Banking and Insurance written certification of compliance with the provisions of this section.
"Automobile" means an automobile as defined in section 2 of P.L.1972, c.70 (C.39:6A-2).
"Motor bus" means a motor bus as defined by section 1 of P.L.1991, c.154 (C.17:28-1.5).
(cf: P.L.1998, c.21, s.72)
2. Section 2 of P.L.1991, c.154 (C.17:28-1.6) is amended to read as follows:
2. a. Every owner, registered owner or operator of a motor bus registered or principally garaged in this State shall maintain medical expense benefits coverage, under provisions approved by the commissioner, for the payment of benefits without regard to negligence, liability or fault of any kind, to any passenger who sustained bodily injury as a result of an accident while occupying, entering into or alighting from a motor bus.
b. Medical expense benefits coverage maintained pursuant to this section shall include the payment of reasonable medical expenses in an amount not to exceed $250,000 per person per accident. In event of death, payments shall be made to the estate of the decedent.
c. (1) Any passenger who sustained bodily injury as a result of an accident while occupying, entering into or alighting from a motor bus and who is not required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) and who is not otherwise eligible to receive those benefits at the time of sustaining the bodily injury, and who is not covered under any other health benefits plan, including any coverage or benefits provided under any federal or State program, shall be entitled to medical expense benefits paid by the medical expense benefits coverage maintained pursuant to subsections a. and b. of this section.
(2) In the case of any passenger who sustained bodily injury as a result of an accident while occupying, entering into or alighting from a motor bus and who is required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) or who is otherwise eligible to receive those benefits at the time of sustaining the bodily injury, that passenger's personal injury protection coverage shall be responsible for paying the first $10,000 of medical expense benefits per person per accident. All medical expense benefits in excess of $10,000 shall be paid by the medical expense benefits coverage maintained pursuant to subsection a. and b. of this section.
(3) In the case of any passenger who sustained bodily injury as a result of an accident while occupying, entering into or alighting from a motor bus and who is not required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) and who is not otherwise eligible to receive those benefits at the time of sustaining the bodily injury, but who is covered under any other health benefits plan, including any coverage or benefits provided under any federal or State program, that passenger's health benefits plan, to the extent allowable pursuant to law, shall be responsible for paying the first $10,000 of medical expense benefits per person per accident. All medical expense benefits in excess of $10,000 shall be paid by the medical expense benefits coverage maintained pursuant to subsections a. and b. of this section.
(4) In the case of any passenger who sustained bodily injury as a result of an accident while occupying, entering into or alighting from a motor bus and who is required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) or who is otherwise eligible to receive those benefits at the time of sustaining the bodily injury, and whose health benefits plan has been designated as the primary insurance for that personal injury protection coverage pursuant to subsection d. of section 13 of P.L.1983, c.362 (C.39:6A-4.3), that passenger's health benefits plan shall be responsible for paying the first $10,000 of medical expense benefits per person per accident. All medical expense benefits in excess of $10,000 shall be paid by the medical expense benefits coverage maintained pursuant to subsections a. and b. of this section.
(5) The commissioner annually shall increase or decrease the limit on medical expense benefits liability set forth in paragraphs (2) through (4) of this subsection by the rate of increase or decrease in the medical care component of the Consumer Price Index for All Urban Consumers, as reported by the United States Department of Labor, shown as an average index for the New York-Northern New Jersey-Long Island region and the Philadelphia-Wilmington- Atlantic City region , or successor regions, combined.
d. Notwithstanding any other provision of law to the contrary, a passenger who sustained bodily injury as a result of an accident while occupying, entering into or alighting from a motor bus, shall recover any personal injury protection benefits available to that passenger pursuant to section 12 of P.L.1983, c.362 (C.39:6A-4.2). No person shall recover personal injury protection benefits under more than one automobile insurance policy providing personal injury protection benefits for the injuries sustained in any one accident.
(cf: P.L.1991, c.154, s.2)
3. Section 4 of P.L.1998, c.21 (C.39:6A-3.1) is amended to read as follows:
4. As an alternative to the mandatory coverages provided in sections 3 and 4 of P.L.1972, c.70 (C.39:6A-3 and 39:6A-4), any owner or registered owner of an automobile registered or principally garaged in this State may elect a basic automobile insurance policy providing the following coverage:
a. Personal injury protection coverage, for the payment of benefits without regard to negligence, liability or fault of any kind, to the named insured and members of his family residing in his household, who sustained bodily injury as a result of an accident while occupying, entering into, alighting from or using an automobile, or as a pedestrian, caused by an automobile or by an object propelled by or from an automobile, or who sustained bodily injury as a result of an accident while occupying, entering into, alighting from or using a motor bus as defined by section 1 of P.L.1991, c.154 (C.17:28-1.5), and to other persons sustaining bodily injury while occupying, entering into, alighting from or using the automobile of the named insured, with the permission of the named insured. "Personal injury protection coverage" issued pursuant to this section means and includes payment of medical expense benefits, as provided in the policy and approved by the commissioner, for the reasonable and necessary treatment of bodily injury in an amount not to exceed $15,000 per person per accident; except that medical expense benefits shall be paid in an amount not to exceed $10,000 or such other amount as required by section 2 of P.L.1991, c.154 (C.17:28-1.6) as a result of an accident while occupying, entering into, alighting from or using a motor bus; and except that, medical expense benefits shall be paid in an amount not to exceed $250,000: (1) for all medically necessary treatment of permanent or significant brain injury, spinal cord injury or disfigurement or (2) for medically necessary treatment of other permanent or significant injuries rendered at a trauma center or acute care hospital immediately following the accident and until the patient is stable, no longer requires critical care and can be safely discharged or transferred to another facility in the judgment of the attending physician. In the event benefits paid by an insurer pursuant to this subsection are in excess of $75,000 on account of personal injury to any one person in any one accident covered by a policy issued or renewed prior to January 1, 2004, such excess shall be paid by the insurer and shall be reimbursable to the insurer from the Unsatisfied Claim and Judgment Fund pursuant to section 2 of P.L.1977, c.310 (C.39:6-73.1). Benefits provided under basic coverage shall be in accordance with a benefit plan provided in the policy and approved by the commissioner. The policy form, which shall be subject to the approval of the commissioner, shall set forth the benefits provided under the policy, including eligible medical treatments, diagnostic tests and services as well as such other benefits as the policy may provide. The commissioner shall set forth by regulation a statement of the basic benefits which shall be included in the policy. Medical treatments, diagnostic tests, and services provided by the policy shall be rendered in accordance with commonly accepted protocols and professional standards and practices which are commonly accepted as being beneficial for the treatment of the covered injury. Protocols and professional standards and practices which are deemed to be commonly accepted pursuant to this section shall be those recognized by national standard setting organizations, national or state professional organizations of the same discipline as the treating provider, or those designated or approved by the commissioner in consultation with the professional licensing boards in the Division of Consumer Affairs in the Department of Law and Public Safety. The commissioner, in consultation with the Commissioner of the Department of Health and Senior Services and the applicable licensing boards, may reject the use of protocols, standards and practices or lists of diagnostic tests set by any organization deemed not to have standing or general recognition by the provider community or the applicable licensing boards. Protocols shall be deemed to establish guidelines as to standard appropriate treatment and diagnostic tests for injuries sustained in automobile accidents, but the establishment of standard treatment protocols or protocols for the administration of diagnostic tests shall not be interpreted in such a manner as to preclude variance from the standard when warranted by reason of medical necessity. The policy form may provide for the precertification of certain procedures, treatments, diagnostic tests, or other services or for the purchase of durable medical goods, as approved by the commissioner, provided that the requirement for precertification shall not be unreasonable, and no precertification requirement shall apply within ten days of the insured event. The policy may provide that certain benefits provided by the policy which are in excess of the basic benefits required by the commissioner to be included in the policy may be subject to reasonable copayments in addition to the copayments provided for herein, provided that the copayments shall not be unreasonable and shall be established in such a manner as not to serve to encourage underutilization of benefits subject to the copayments, nor encourage overutilization of benefits. The policy form shall clearly set forth any limitations on benefits or exclusions, which may include, but need not be limited to, benefits which are otherwise compensable under workers' compensation, or benefits for treatments deemed to be experimental or investigational, or benefits deducted pursuant to section 6 of P.L.1972, c.70 (C.39:6A-6). The commissioner may enlist the services of a benefit consultant in establishing the basic benefits level provided in this subsection, which shall be set forth by regulation no later than 120 days following the enactment date of this amendatory and supplementary act. The commissioner shall not advertise for the consultant as provided in sections 3 and 4 of P.L.1954, c.48 (C.52:34-8 and 52:34-9).
Medical expense benefits payable under this subsection shall not be assignable, except to a provider of service benefits, in accordance with policy terms approved by the commissioner, nor shall they be subject to levy, execution, attachment or other process for satisfaction of debts. Medical expense benefits payable in accordance with this subsection may be subject to a deductible and copayments as provided for in the policy, if any. No insurer or provider providing service benefits to an insured shall have a right of subrogation for the amount of benefits paid pursuant to any deductible or copayment under this section.
Notwithstanding the provisions of P.L.2003, c.18, physical therapy treatment shall not be reimbursable as medical expense benefits pursuant to this subsection unless rendered by a licensed physical therapist pursuant to a referral from a licensed physician, dentist, podiatrist or chiropractor within the scope of their respective practices.
b. Liability insurance coverage insuring against loss resulting from liability imposed by law for property damage sustained by any person arising out of the ownership, maintenance, operation or use of an automobile in an amount or limit of $5,000, exclusive of interest and costs, for damage to property in any one accident.
c. In addition to the aforesaid coverages required to be provided in a basic automobile insurance policy, optional liability insurance coverage insuring against loss resulting from liability imposed by law for bodily injury or death in an amount or limit of $10,000, exclusive of interests and costs, on account of injury to, or death of, one or more persons in any one accident.
If a named insured has elected the basic automobile insurance policy option and an immediate family member or members or relatives resident in his household have one or more policies with the coverages provided for in sections 3 and 4 of P.L.1972, c.70 (C.39:6A-3 and 39:6A-4), the provisions of section 12 of P.L.1983, c.362 (C.39:6A-4.2) shall apply.
Every named insured and any other person to whom the basic automobile insurance policy, with or without the optional $10,000 liability coverage insuring against loss resulting from liability imposed by law for bodily injury or death provided for in subsection c. of this section, applies shall be subject to the tort option provided in subsection a. of section 8 of P.L.1972, c.70 (C.39:6A-8).
No licensed insurance carrier shall refuse to renew the coverage stipulated by this section of an eligible person as defined in section 25 of P.L.1990, c.8 (C.17:33B-13) except in accordance with the provisions of section 26 of P.L.1988, c.119 (C.17:29C-7.1) or with the consent of the Commissioner of Banking and Insurance.
(cf: P.L.2003, c.89, s.36)
4. Section 4 of P.L.1972, c.70 (C.39:6A-4) is amended to read as follows:
4. Personal injury protection coverage, regardless of fault.
Except as provided by section 45 of P.L.2003, c.89 (C.39:6A-3.3) and section 4 of P.L.1998, c.21 (C.39:6A-3.1), every standard automobile liability insurance policy issued or renewed on or after the effective date of P.L.1998, c.21 (C.39:6A-1.1 et al.) shall contain personal injury protection benefits for the payment of benefits without regard to negligence, liability or fault of any kind, to the named insured and members of his family residing in his household who sustain bodily injury as a result of an accident while occupying, entering into, alighting from or using an automobile, or as a pedestrian, caused by an automobile or by an object propelled by or from an automobile, or who sustain bodily injury as a result of an accident while occupying, entering into, alighting from or using a motor bus as defined by section 1 of P.L.1991, c.154 (C.17:28-1.5), and to other persons sustaining bodily injury while occupying, entering into, alighting from or using the automobile of the named insured, with permission of the named insured.
"Personal injury protection coverage" means and includes:
a. Payment of medical expense benefits in accordance with a benefit plan provided in the policy and approved by the commissioner, for reasonable, necessary, and appropriate treatment and provision of services to persons sustaining bodily injury, in an amount not to exceed $250,000 per person per accident; except that medical expense benefits shall be paid in an amount not to exceed $10,000 or such other amount as required by section 2 of P.L.1991, c.154 (C.17:28-1.6) as a result of an accident while occupying, entering into, alighting from or using a motor bus. In the event benefits paid by an insurer pursuant to this subsection are in excess of $75,000 on account of bodily injury to any one person in any one accident, that excess shall be paid by the insurer and shall be reimbursable to the insurer from the Unsatisfied Claim and Judgment Fund pursuant to section 2 of P.L.1977, c.310 (C.39:6-73.1). The policy form, which shall be subject to the approval of the commissioner, shall set forth the benefits provided under the policy, including eligible medical treatments, diagnostic tests and services as well as such other benefits as the policy may provide. The commissioner shall set forth by regulation a statement of the basic benefits which shall be included in the policy. Medical treatments, diagnostic tests, and services provided by the policy shall be rendered in accordance with commonly accepted protocols and professional standards and practices which are commonly accepted as being beneficial for the treatment of the covered injury. Protocols and professional standards and practices and lists of valid diagnostic tests which are deemed to be commonly accepted pursuant to this section shall be those recognized by national standard setting organizations, national or state professional organizations of the same discipline as the treating provider, or those designated or approved by the commissioner in consultation with the professional licensing boards in the Division of Consumer Affairs in the Department of Law and Public Safety. The commissioner, in consultation with the Commissioner of the Department of Health and Senior Services and the applicable licensing boards, may reject the use of protocols, standards and practices or lists of diagnostic tests set by any organization deemed not to have standing or general recognition by the provider community or the applicable licensing boards. Protocols shall be deemed to establish guidelines as to standard appropriate treatment and diagnostic tests for injuries sustained in automobile accidents, but the establishment of standard treatment protocols or protocols for the administration of diagnostic tests shall not be interpreted in such a manner as to preclude variance from the standard when warranted by reason of medical necessity. The policy form may provide for the precertification of certain procedures, treatments, diagnostic tests, or other services or for the purchase of durable medical goods, as approved by the commissioner, provided that the requirement for precertification shall not be unreasonable, and no precertification requirement shall apply within ten days of the insured event. The policy may provide that certain benefits provided by the policy which are in excess of the basic benefits required by the commissioner to be included in the policy may be subject to reasonable copayments in addition to the copayments provided for pursuant to subsection e. of this section, provided that the copayments shall not be unreasonable and shall be established in such a manner as not to serve to encourage underutilization of benefits subject to the copayments, nor encourage overutilization of benefits. The policy form shall clearly set forth any limitations on benefits or exclusions, which may include, but need not be limited to, benefits which are otherwise compensable under workers' compensation, or benefits for treatments deemed to be experimental or investigational, or benefits deducted pursuant to section 6 of P.L.1972, c.70 (C.39:6A-6). The commissioner may enlist the services of a benefit consultant in establishing the basic benefits level provided in this subsection, which shall be set forth by regulation no later than 120 days following the enactment date of P.L.1998, c.21 (C.39:6A-1.1 et al.). The commissioner shall not advertise for bids for the consultant as provided in sections 3 and 4 of P.L.1954, c.48 (C.52:34-8 and 52:34-9).
Notwithstanding the provisions of P.L.2003, c.18, physical therapy treatment shall not be reimbursable as medical expense benefits pursuant to this subsection unless rendered by a licensed physical therapist pursuant to a referral from a licensed physician, dentist, podiatrist or chiropractor within the scope of their respective practices.
b. Income continuation benefits. The payment of the loss of income of an income producer as a result of bodily injury disability, subject to a maximum weekly payment of $100. Such sum shall be payable during the life of the injured person and shall be subject to an amount or limit of $5,200, on account of injury to any one person in any one accident, except that in no case shall income continuation benefits exceed the net income normally earned during the period in which the benefits are payable.
c. Essential services benefits. Payment of essential services benefits to an injured person shall be made in reimbursement of necessary and reasonable expenses incurred for such substitute essential services ordinarily performed by the injured person for himself, his family and members of the family residing in the household, subject to an amount or limit of $12 per day. Such benefits shall be payable during the life of the injured person and shall be subject to an amount or limit of $4,380, on account of injury to any one person in any one accident.
d. Death benefits. In the event of the death of an income producer as a result of injuries sustained in an accident entitling such person to benefits under this section, the maximum amount of benefits which could have been paid to the income producer, but for his death, under subsection b. of this section shall be paid to the surviving spouse, or in the event there is no surviving spouse, then to the surviving children, and in the event there are no surviving spouse or surviving children, then to the estate of the income producer.
In the event of the death of one performing essential services as a result of injuries sustained in an accident entitling such person to benefits under subsection c. of this section, the maximum amount of benefits which could have been paid to such person, under subsection c., shall be paid to the person incurring the expense of providing such essential services.
e. Funeral expenses benefits. All reasonable funeral, burial and cremation expenses, subject to a maximum benefit of $1,000, on account of the death of any one person in any one accident shall be payable to the decedent's estate.
Benefits payable under this section shall:
(1) Be subject to any option elected by the policyholder pursuant to section 13 of P.L.1983, c.362 (C.39:6A-4.3);
(2) Not be assignable, except to a provider of service benefits under this section in accordance with policy terms approved by the commissioner, nor subject to levy, execution, attachment or other process for satisfaction of debts.
Medical expense benefit payments shall be subject to any deductible and any copayment which may be established as provided in the policy. Upon the request of the commissioner or any party to a claim for benefits or payment for services rendered, a provider shall present adequate proof that any deductible or copayment related to that claim has not been waived or discharged by the provider.
No insurer or health provider providing benefits to an insured shall have a right of subrogation for the amount of benefits paid pursuant to any deductible or copayment under this section.
(cf: P.L.2003, c.89, s.37)
5. This act shall take effect on the 180th day after the date of enactment.
STATEMENT
Private motor bus carriers have been placed in a unique situation with respect to motor vehicle accidents. Under current law, every owner or operator of a motor bus registered or principally garaged in this State must provide no-fault medical expense benefits coverage up to $250,000 per person per accident, for passengers who sustain bodily injury as a result of an accident while occupying, entering into or alighting from a motor bus. New Jersey Transit buses, school buses, hotel-owned buses, paratransit vehicles, taxicabs and limousines are exempt from providing such benefits. Private motor bus carriers have been experiencing tremendous increases in insurance costs, which are exerting substantial pressure for fare increases.
This bill, limits the extent to which motor bus carriers must provide this coverage, in situations in which the injured passenger is entitled to health insurance benefits or personal injury protection benefits through private passenger automobile insurance, and requires those policies to cover the injured passenger, up to certain amounts.
Specifically, the bill provides that any motor bus passenger who sustained bodily injury and who is not required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) and who is not otherwise eligible to receive such benefits at the time of sustaining the bodily injury and who is not covered under any other health benefits plan, including any coverage or benefits provided under any federal or State program, shall be entitled to the no-fault medical expense benefits coverage that motor bus owners are currently required to maintain.
In the case of any passenger who sustained injury and who is required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) or who is otherwise eligible to receive such benefits at the time of sustaining the bodily injury, such passenger's personal injury protection coverage shall be responsible for paying the first $10,000 of medical expense benefits per person per accident. All medical expenses in excess of $10,000 shall be paid by the no-fault medical expense benefits coverage that motor bus owners are currently required to maintain.
In the case of any passenger who sustained injury and who is not required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) and is not otherwise eligible to receive such benefits at the time of sustaining the bodily injury, but who is covered under any other health benefits plan, including any coverage or benefits provided under any federal or State program, such passenger's health benefits plan, to the extent allowable pursuant to law, shall be responsible for paying the first $10,000 of medical expense benefits per person per accident. All medical expense benefits in excess of $10,000 shall be paid by the no-fault medical expense benefits coverage that motor bus owners are currently required to maintain.
In the case of any passenger who sustained injury and who is required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) or who is otherwise eligible to receive such benefits at the time of sustaining the bodily injury and whose health benefits plan has been designated as the primary insurance for such personal injury protection coverage pursuant to subsection d. of section 13 of P.L.1983, c.362 (C.39:6A-4.3), such passenger's health benefits plan shall be responsible for paying the first $10,000 of medical expense benefits per person per accident. All medical expense benefits in excess of $10,000 shall be paid by the no-fault medical expense benefits coverage that motor bus owners are currently required to maintain.
The bill provides that the Commissioner of Banking and Insurance annually shall increase or decrease the $10,000 limit on medical expense benefits liability by the rate of increase or decrease in the medical care component of the Consumer Price Index for All Urban Consumers, as reported by the United States Department of Labor, shown as an average index for the New York-Northern New Jersey-Long Island region and the Philadelphia-Wilmington-Atlantic City region combined.
The bill also provides that injured motor bus passengers must recover personal injury protection benefits that are available to them pursuant to section 12 of P.L.1983, c.362 (C.39:6A-4.2), and that no person shall recover personal injury protection benefits under more than one automobile insurance policy providing those benefits for injuries sustained in any one accident.
The bill also provides that the bill's limitations on the extent to which motor bus carriers must provide coverage, and the requirements that any available private passenger automobile insurance or health insurance cover the passenger's medical expenses, also applies to out-of-state motor buses when driven in New Jersey.
The bill becomes effective 180 days following enactment.
