§431:10C-103.5  Personal injury protection benefits; defined; limits.  (a)  Personal injury protection benefits, with respect to any accidental harm, means all appropriate and reasonable treatment and expenses necessarily incurred as a result of the accidental harm and which are substantially comparable to the requirements for prepaid health care plans, including medical, hospital, surgical, professional, nursing, advanced practice nursing licensed pursuant to chapter 457, dental, optometric, naturopathic medicine, chiropractic, ambulance, prosthetic services, medical equipment and supplies, products and accommodations furnished, x-ray, psychiatric, physical therapy pursuant to prescription by a medical doctor, occupational therapy, rehabilitation, and therapeutic massage by a licensed massage therapist when prescribed by a medical doctor.

     (b)  Personal injury protection benefits, when applied to a motor vehicle insurance policy issued at no cost under section 431:10C-410(3)(A), shall not include benefits under subsection (a) for any person receiving public assistance benefits.

     (c)  Personal injury protection benefits shall be subject to an aggregate limit of $10,000 per person for services provided under this section.  An insurer may offer additional coverage in excess of the $10,000 aggregate limit for services provided under this section, or as provided by rule of the commissioner. [L 1997, c 251, pt of §2; am L 1998, c 275, §5; am L 1999, c 222, §4; am L 2000, c 65, §1; am L 2004, c 56, §1; am L Sp 2009, c 22, §11(2); am L 2015, c 35, §46]


Case Notes


  Fee schedule was intended to apply to medical services rendered as a result of motor vehicle accidents and paid by a no-fault insurer.  73 F. Supp. 2d 1189 (1999).

  Disputed issue of material fact existed as to whether or not the information requested by defendant insurer from plaintiff personal injury protection company was necessary and reasonable; defendant insurer was entitled to do some investigation to determine whether claimed benefits are appropriate and reasonable.  732 F. Supp. 2d 1107 (2010).