107th CONGRESS
1st Session
H. R. 1704
To enable drivers to choose a more affordable form of auto insurance
that also provides for more adequate and timely compensation for accident
victims, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
May 3, 2001
Mr. ARMEY (for himself, Mr. MORAN of Virginia, and Mr. COX) introduced the
following bill; which was referred to the Committee on Financial Services
A BILL
To enable drivers to choose a more affordable form of auto insurance
that also provides for more adequate and timely compensation for accident
victims, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE AND TABLE OF CONTENTS.
(a) SHORT TITLE- This Act may be cited as the `Auto Choice Reform Act of
2001'.
(b) TABLE OF CONTENTS- The table of contents for this Act is as
follows:
Sec. 1. Short title and table of contents.
Sec. 2. Findings and purposes.
Sec. 4. Auto choice insurance system.
Sec. 5. Personal injury protection system.
Sec. 6. Tort maintenance system.
Sec. 7. Protection against insurance fraud.
Sec. 8. Source of compensation in cases of accidental injury.
Sec. 9. Preservation of State and private rights.
Sec. 10. Applicability to States.
SEC. 2. FINDINGS AND PURPOSES
(a) FINDINGS- The Congress finds the following:
(1) Auto insurance premiums are too high, largely because the current
auto liability insurance system (referred to in this subsection as the
`present system')--
(A) encourages costly fraudulent claims and unnecessarily contentious
behavior by both claimants and defendants; and
(B) often requires expensive lawyers on both sides of a dispute to
settle claims.
(2) The adversarial tort system that is in effect in 35 States poorly
compensates the most needy individuals, in that the system--
(A) pays no liability benefits to more than 30 percent of all accident
victims;
(B) takes too long to pay victims when it does pay them;
(C)(i) pays victims with minor injuries an average of two to three
times the cost of their medical bills and lost wages; but
(ii) pays victims with serious injuries an average of less than 50
percent of those bills and lost wages; and
(D) pays twice as much for plaintiff and defense lawyers combined as
it pays for victims' medical bills and lost wages.
(3) The chance of winning the lawsuit lottery in the present
system--
(A) results in the filing of billions of dollars of fraudulent or
otherwise unnecessary auto insurance claims annually;
(B) generates billions of dollars in unnecessary health care costs for
private, Federal, and State health care programs;
(C) raises auto insurance premiums for all drivers, including drivers
operating business vehicles; and
(D) makes auto insurance premiums unaffordable for many low-income
individuals.
(4) The present system harms cities by--
(A) encouraging the filing of frivolous and inflated claims that
cities pay at the expense of all taxpayers; and
(B) contributing to the abandonment of cities by taxpayers who can
achieve substantial reductions in their auto insurance premiums by moving
to the suburbs.
(5) The present system provides individuals little incentive to purchase
safer automobiles.
(6) All of the no-fault insurance reform laws that exist in 13 States
provide more timely and equitable compensation for medical bills and lost
wages to more accident victims.
(7) Some of those no-fault insurance reform laws, however, have not been
successful in controlling insurance premiums, in large part because
opponents of such reform have weakened the laws by creating loopholes for
unnecessary and costly lawsuits.
(8) The alternative form of insurance, personal injury protection, that
may be offered to drivers by reason of this Act, gives drivers the ability
to--
(A)(i) insure themselves in all accidents for their own medical bills
and lost wages; and
(ii) sue other drivers on the basis of fault for any economic losses
that are not covered by their insurance; and
(B) forgo lawsuits against other drivers for noneconomic damages on
the basis of fault in return for being free from suit for noneconomic
damages by other drivers.
(9) Personal injury protection, by reducing the need for auto liability
lawsuits and the incentives for fraudulent and otherwise questionable
claims, could--
(A) save drivers billions of dollars annually; and
(B) enable them to receive more adequate and timely compensation when
they are seriously injured.
(10) Personal injury protection would benefit society by--
(A) increasing respect for the law by eliminating the incentives of
the adversarial present system for fraudulent claims and unnecessarily
contentious behavior by both claimants and defendants;
(B) saving precious health care resources;
(C) making it more affordable for low-income individuals to operate an
automobile to get to better paying jobs;
(D) reducing the incentives for individuals to abandon cities, by
providing greater savings for drivers who reside in cities;
(E) freeing city taxpayers' dollars for reductions in taxes or
expanded city programs by reducing the amount of frivolous and unnecessary
lawsuits against cities;
(F) encouraging drivers to own safer automobiles by giving insurers
the opportunity to reduce premiums for the owners of safe automobiles;
and
(G) helping to free up court dockets that are currently overburdened
with personal injury lawsuits fueled by the incentives for lawsuits under
the present system.
(11) A new auto insurance system that allows drivers to select the form
of auto insurance that best meets their needs, by choosing between--
(A) a modified version of the present system, or
(B) the personal injury protection system described in paragraph
(9),
would enable drivers to reduce the cost of auto insurance, increase the
amount of average compensation in the event of a serious accident, and
enhance individual freedom.
(12) The Federal Government should encourage consumer choice, but not
exercise regulatory authority over the business of auto insurance, including
rates and insurer solvency, as that authority is appropriately exercised by
the States.
(13) During the period beginning January 1, 1957, and ending December
31, 1996--
(A) the Federal Government spent more than $400 billion to facilitate
highway construction in the United States; and
(B) hundreds of thousands of individuals have been killed in motor
vehicle accidents on highways constructed with those funds.
(14) The auto insurers who operate in interstate commerce pay greater
than 70 percent of the compensation paid to accident victims.
(15) Through programs such as medicare, medicaid, and social security,
the Federal Government pays a significant amount of the costs for
compensating motor vehicle accident victims.
(16) It is necessary and proper for the Congress, in the exercise of its
authority to establish post roads and regulate commerce under section 8 of
article I of the Constitution, to provide drivers throughout the United
States with an alternative to address the problems of the adversarial
present system and the inadequate no-fault insurance reforms.
(b) PURPOSES- The purposes of this Act are as follows:
(1) To enable consumers of auto insurance to choose between two
insurance systems, which are--
(A) a tort maintenance system based on applicable State law that
provides for substantially similar insurance premiums and compensation for
injuries as compared to the auto insurance system in existence in that
State on the date of enactment of this Act; and
(B) a personal injury protection system that compensates accident
victims directly for their medical bills and lost wages with substantially
less need to pursue lawsuits and provides the opportunity for--
(i) substantial reductions in auto insurance premiums;
(ii) more comprehensive recovery of medical bills and lost wages in
a shorter period of time; and
(iii) the right to sue negligent drivers for any uncompensated
medical bills or lost wages.
(2) To preserve the rights of States to regulate the business of auto
insurance.
SEC. 3. DEFINITIONS.
(1) ACCIDENT- The term `accident' means an unforeseen or unplanned event
that--
(B) arises from the operation, maintenance, or use of a motor
vehicle.
(2) ADD-ON LAW- The term `add-on law' means a State law that provides
that persons injured in motor vehicle accidents--
(A) are compensated without regard to fault for economic loss;
and
(B) have the right to claim without any limitation for noneconomic
loss based on fault.
(3) COLLATERAL SOURCE- The term `collateral source' means a person,
other than a tortfeasor or a motor vehicle insurer, that has a legal
obligation to pay compensation for economic loss to a person who is injured
in an accident.
(4) COMMON CARRIER- The term `common carrier' means a motorized vehicle
of any kind, licensed for highway use, that is--
(A) required to be registered under the provisions of applicable State
law relating to motor vehicles; and
(B) used in the business of transporting persons.
(5) ECONOMIC LOSS- The term `economic loss' means objectively verifiable
pecuniary loss caused by an accident for--
(A) reasonable and necessary medical and rehabilitation
expenses;
(D) replacement services loss.
(6) ELECTRONIC SIGNATURE- The term `electronic signature' means any
letters, characters, or symbols executed or adopted by a party with an
intent to authenticate a writing that are--
(ii) any other similar means; and
(B) logically associated with that writing.
(7) FINANCIAL RESPONSIBILITY LAW- The term `financial responsibility
law' means a law (including a law requiring compulsory coverage) penalizing
motorists for failing to carry defined limits of tort liability insurance
covering motor vehicle accidents.
(8) FIRST PARTY BENEFITS- The term `first party benefits' means benefits
paid or payable by an insurer to an insured of that insurer under a personal
injury protection policy or a tort maintenance coverage policy applicable to
that insured.
(9) INJURY- The term `injury' means bodily injury, sickness, disease, or
death.
(10) INSURER- The term `insurer' means any person who is engaged in the
business of issuing or delivering motor vehicle insurance policies
(including an insurance agent, if appropriate) under applicable State
law.
(11) MOTOR CARRIER- The term `motor carrier' means--
(i) transports by motor vehicle goods for another person or entity
for compensation; and
(ii) is liable for the operation of the vehicle under part 387 of
title 49, Code of Federal Regulations; or
(B) a person who transports such person's goods by a motor vehicle
that such person owns or leases.
(12) MOTOR VEHICLE- The term `motor vehicle' means a vehicle with 4 or
more wheels licensed for highway use that is required to be registered under
the provisions of the applicable State financial responsibility law relating
to motor vehicles.
(13) NAMED INSURED- The term `named insured' means a person designated
by name in a personal injury protection policy or tort maintenance coverage
policy as the insured.
(14) NO-FAULT MOTOR VEHICLE LAW- The term `no-fault motor vehicle law'
means a State law that provides that--
(A) persons injured in motor vehicle accidents are paid compensation
without regard to fault for their economic loss that results from injury;
and
(B) in return for the payment referred to in subparagraph (A), claims
based on fault, including claims for noneconomic loss, are limited to a
defined extent.
(15) NONECONOMIC LOSS- The term `noneconomic loss' means subjective,
nonmonetary losses recognized under applicable State tort law.
(16) OCCUPY- The term `occupy' means, with respect to the operation,
maintenance, or use of a motor vehicle, to be in or on a motor vehicle or to
be engaged in the immediate act of entering into or alighting from a motor
vehicle.
(17) OPERATION, MAINTENANCE, OR USE OF A MOTOR VEHICLE- (A) The term
`operation, maintenance, or use of a motor vehicle' means any activity
involving or related to the transportation by a motor vehicle.
(B) Such term includes occupying or being engaged in the immediate act
of entering into or alighting from a motor vehicle before or after its use
for transportation.
(C) Such term does not include--
(i) conduct within the course of a business of manufacturing, sale,
repairing, servicing, or otherwise maintaining motor vehicles, unless the
conduct occurs outside the scope of the business activity; or
(ii) conduct within the course of loading or unloading a motor
vehicle, unless the conduct occurs while occupying or being engaged in the
immediate act of entering into or alighting from a motor vehicle before or
after its use for transportation.
(18) PERSON- The term `person' means any individual, corporation,
company, association, firm, partnership, society, joint stock company, or
any other entity, including any governmental entity.
(19) PERSONAL INJURY PROTECTION- The term `personal injury protection'
means insurance that provides for--
(A) benefits to a personal injury protection insured for economic loss
without regard to fault for injury resulting from a motor vehicle accident
in accordance with this Act;
(B) a waiver of tort claims against other drivers, other
than--
(i) claims for uncompensated economic loss based on fault;
and
(ii) other tort claims exempted from such a waiver under this
Act;
(C) coverage against claims for uncompensated economic losses based on
fault by another party that is entitled to recover those losses under this
Act; and
(D) coverage against claims for economic or noneconomic losses of a
third party with respect to which the recovery of those losses is not
covered under this Act.
(20) PERSONAL INJURY PROTECTION INSURED- The term `personal injury
protection insured' means a person covered by the form of insurance
described in section 5.
(21) PERSONAL INJURY PROTECTION INSURER- The term `personal injury
protection insurer' means an insurer who is engaged in the business of
providing personal injury protection.
(22) PERSONAL INJURY PROTECTION SYSTEM- The term `personal injury
protection system' means the insurance system described in section 5.
(23) REPLACEMENT SERVICES LOSS- The term `replacement services loss'
means expenses reasonably incurred in obtaining ordinary and necessary
services from other persons who are not members of the injured person's
household, in lieu of the services the injured person would have performed
for the benefit of the household.
(24) RESIDENT RELATIVE OR DEPENDENT- (A) The term `resident relative or
dependent' means a person--
(i) who is related to the named insured by blood, marriage, adoption,
or otherwise (including a dependent receiving financial services or
support from such insured); and
(I) resides in the same household as the named insured at the time
of the accident; or
(II) usually makes a home in the same family unit as the named
insured, even though that person may temporarily live
elsewhere.
(B) Such term does not include any person who maintains or is required
to maintain insurance for a motor vehicle that such person owns.
(25) STATE- The term `State' includes the District of Columbia, the
Commonwealth of Puerto Rico, Guam, the United States Virgin Islands,
American Samoa, the Commonwealth of the Northern Mariana Islands, the Trust
Territories of the Pacific Islands, and any other territory or possession of
the United States.
(26) TORT LIABILITY- The term `tort liability' means the legal
obligation to pay damages for an injury in an accident adjudged to have been
caused by a tortfeasor, under applicable State law.
(27) TORT LIABILITY INSURANCE- The term `tort liability insurance' means
a contract of insurance under which an insurer agrees to pay, on behalf of
an insured, damages that the insured is obligated to pay to a third person
because of the liability of the insured to that person.
(28) TORT MAINTENANCE COVERAGE- The term `tort maintenance coverage'
means insurance coverage under which a tort maintenance insured, if involved
in an accident with a personal injury protection insured, may recover first
party benefits for economic and noneconomic losses from the insurer of that
insured, based on fault under applicable State law.
(29) TORT MAINTENANCE INSURED- The term `tort maintenance insured' means
a person covered by the form of insurance described in section 6.
(30) TORT MAINTENANCE SYSTEM- The term `tort maintenance system' means
an insurance system described in section 6.
(31) UNCOMPENSATED ECONOMIC LOSS- (A) The term `uncompensated economic
loss' means any objectively verifiable pecuniary loss payable based on fault
under applicable State tort law, except for any such loss that is determined
by a court of competent jurisdiction to be, in whole or in part, a product
of fraudulent activity by the person making the claim.
(B) Such term includes a reasonable attorney's fee calculated on the
basis of the time actually expended and the value of the attorney's efforts
as reflected in payment to the attorney's client, other than any attorney's
fees when the uncompensated economic loss is attributable only to a
deductible for coverage specified in subparagraph (C)(i).
(C) Subject to section 8(j)(2), such term does not include amounts paid
or payable under--
(i) personal injury protection;
(ii) tort maintenance coverage;
(iii) no-fault or add-on motor vehicle insurance;
(iv) Federal, State, or private disability or sickness
programs;
(v) Federal, State, or private health insurance programs;
(vi) employer wage continuation programs; or
(vii) workers' compensation or similar occupational compensation
laws.
(32) UNINSURED MOTORIST- The term `uninsured motorist' means the owner
of a motor vehicle, including the resident relatives or dependents of the
owner, who is uninsured under either the personal injury protection system
described in section 5 or the tort maintenance system described in section
6--
(A) at the limits prescribed by the applicable State financial
responsibility law; or
(B) an amount prescribed under section 5(a)(1).
SEC. 4. AUTO CHOICE INSURANCE SYSTEM.
(a) OPERATION OF THE RIGHT TO CHOOSE-
(1) IN GENERAL- Under this Act, an insurer may offer a choice
between--
(A) the personal injury protection system described in section 5;
and
(B) the tort maintenance system described in section 6.
(2) ELECTION BY SELF-INSURED PERSONS- A self-insured person, as
determined under an applicable State law, may elect coverage under paragraph
(1) by filing a notice with the appropriate State or Federal agency.
(3) EFFECT OF ELECTION BY ELECTRONIC MEANS- For purposes of making an
election of an insurance system under this subsection, unless prohibited by
applicable State law, an electronic signature shall have the same force and
effect as a handwritten signature.
(b) EFFECT OF CHOICE ON RESIDENT RELATIVES OR DEPENDENTS-
(1) IN GENERAL- Except as provided in paragraph (2), a person who
chooses either the personal injury protection system or the tort maintenance
system also binds the resident relatives or dependents of that person.
(2) EXCEPTION- An adult resident relative or dependent of a person
described in paragraph (1) may select the form of insurance that such person
does not select if the adult resident relative or dependent makes that
selection expressly in writing to the insurer.
(3) TERMS AND CONDITIONS- Insurers may specify reasonable terms and
conditions governing the commencement, duration, and application of
the
chosen coverage, depending on the number of motor vehicles and owners of such
vehicles in a household.
(1) IN GENERAL- Notwithstanding subsection (b)(2) and in order to
minimize conflict between the insurance options, an insurer may maintain and
apply underwriting rules that encourage uniformity in the provision of
insurance benefits within a household.
(2) UNIFORMITY IN INSURANCE IN EMPLOYMENT- Except as provided in
paragraph (6), an employer that elects an insurance option described in
subparagraph (A) or (B) of subsection (a)(1) binds the employees of that
employer for purposes of coverage of that employee in the course of
employment by that employer.
(3) UNIFORMITY IN INSURANCE FOR MOTOR CARRIERS- Except as provided in
paragraph (6), a motor carrier that elects an insurance option described in
subparagraph (A) or (B) of subsection (a)(1) binds any owner, operator, or
occupant of a motor vehicle operated by that motor carrier.
(4) UNIFORMITY IN INSURANCE FOR COMMON CARRIERS- Except as provided in
paragraph (6), an owner of a common carrier that elects an insurance option
described in subparagraph (A) or (B) of subsection (a)(1) binds the owner
and any operator or occupant of that common carrier.
(5) UNIFORMITY IN INSURANCE FOR MOTOR VEHICLE RENTALS-
(A) IN GENERAL- Except as provided in subparagraph (B), a person who
is engaged in the business of renting motor vehicles and who elects an
insurance option described in subparagraph (A) or (B) of subsection (a)(1)
binds any operator or occupant of the rented motor vehicle with respect to
the operation of that vehicle.
(B) EXCEPTION- Subparagraph (A) shall not apply if a customer who
rents a motor vehicle--
(i) specifically elects to obtain coverage within the rental
agreement other than the coverage elected by the person engaged in the
business of renting the motor vehicle; and
(ii) pays a separate charge for that optional coverage.
(6) RIGHT OF EMPLOYEES, OPERATORS, AND CERTAIN OCCUPANTS TO PURCHASE
ADDITIONAL COVERAGE-
(A) EMPLOYEES- An employee under paragraph (2) may elect to purchase
separate personal injury protection or tort maintenance coverage in excess
of the insurance provided by the employer in the scope of the employment
of that employee.
(B) OPERATORS AND OCCUPANTS OF MOTOR CARRIERS- An operator or occupant
of a motor carrier under paragraph (3) may elect to purchase separate
personal injury protection or tort maintenance coverage in excess of the
insurance provided to that operator or occupant by the motor carrier as an
operator or occupant of that motor carrier.
(C) OPERATORS AND OCCUPANTS OF COMMON CARRIERS- An operator or
occupant of a common carrier under paragraph (4) may elect to purchase
separate personal injury protection or tort maintenance coverage in excess
of the insurance provided to that operator or occupant by the owner of the
common carrier as an operator or occupant of the common carrier.
(D) EFFECT OF ELECTION- The election by an employee, operator, or
occupant to purchase insurance coverage under this paragraph shall not
affect the liability of an employer, motor carrier, or common
carrier.
(d) FAILURE TO ELECT TYPE OF INSURANCE-
(1) IN GENERAL- Except as provided in subsection (b)(1), any person who
fails to elect a type of insurance under subsection (a)(1) shall be deemed
to have elected insurance under the tort maintenance system in effect in the
State of that person's residence.
(2) RULE OF CONSTRUCTION- This subsection shall not be construed to
prevent a State from enacting a law that deems a person who fails to elect a
type of insurance under this section to have elected insurance under the
personal injury protection system.
(e) CONSUMER INFORMATION PROGRAM-
(1) STATE PROGRAM- The State official charged with jurisdiction over
insurance rates for motor vehicles may establish and maintain a program
designed to ensure that consumers are adequately informed concerning--
(A) the comparative cost of insurance under the personal injury
protection system and the tort maintenance system; and
(B) the benefits, rights, and obligations of insurers and insureds
under each such system.
(2) INSURER PROGRAM- An insurer that offers a choice of insurance
systems under subsection (a)(1) shall provide to each consumer, before that
consumer chooses motor vehicle insurance, written consumer information to
ensure that consumers are adequately informed about--
(A) the comparative cost of insurance under the personal injury
protection system and the tort maintenance system; and
(B) the benefits, rights, and obligations of insurers and insureds
under each system.
(3) ADEQUATE NOTICE- If an insurer files consumer information forms
under paragraph (2) with the State official charged with jurisdiction over
insurance rates for motor vehicles and such forms are not disapproved within
a reasonable period of time after that filing, such filing and use of the
information in accordance with paragraph (2) shall be presumed to be
adequate notice.
(f) SUPERSEDING PROVISION- Subject to section 10, this Act supersedes a
State law to the extent that the State law is otherwise inconsistent with the
requirements of this Act.
SEC. 5. PERSONAL INJURY PROTECTION SYSTEM.
(a) MINIMUM POLICY REQUIREMENTS- In order to constitute a personal injury
protection policy covered by this Act, a motor vehicle insurance policy issued
by an insurer shall, at a minimum--
(1) for each accident, provide personal injury protection benefits to
each personal injury protection insured in amounts equal to--
(A) the minimum per-person limits of liability insurance for personal
injury under the relevant State financial responsibility law applicable to
private passenger vehicles; or
(B) in a State covered by a no-fault motor vehicle law, the minimum
level of insurance required for no-fault benefits;
(2) contain provisions for a waiver of tort claims against drivers other
than the insured, except--
(A) claims for uncompensated economic loss based on fault; or
(B) other tort claims exempted from such a waiver under this
Act;
(3) contain provisions for third party liability coverage in amounts
equal to the minimum limits required under applicable Federal or State
financial responsibility law for--
(B) bodily injury to cover--
(i) uncompensated economic losses for parties who are entitled to
recover such losses under this Act; and
(ii) economic and noneconomic losses of third parties whose recovery
is not affected by this Act.
(A) PERSONAL INJURY PROTECTION BENEFITS-
(i) IN GENERAL- Except as provided in subparagraph (B), in any case
in which a personal injury protection insurer and a collateral source
are obligated to pay benefits for the same economic loss under this Act,
the personal injury protection insurer shall be liable for the primary
payment of benefits to cover that economic loss.
(ii) LIABILITY OF COLLATERAL SOURCES- A collateral source shall be
liable for economic loss only to the extent that the loss exceeds
benefits paid or payable by an insurer under an applicable personal
injury protection insurance policy.
(B) EXCEPTION- Personal injury protection benefits shall be reduced by
an amount equal to any benefits provided or required to be provided
under--
(i) an applicable Federal or State law for workers'
compensation;
(ii) any State-required nonoccupational disability insurance;
or
(iii) any occupational disability insurance covering professional
drivers of motor vehicles who are independent contractors.
(2) REIMBURSEMENT OF PAYORS-
(A) IN GENERAL- A personal injury protection insurer may take
appropriate measures to ensure that any person otherwise eligible for
personal injury protection benefits who has been paid or is being paid for
losses payable by personal injury protection from a source other than the
applicable personal injury protection insurer shall not receive multiple
payment for those losses.
(B) ACCRUAL OF RIGHTS- Any right to payment for losses referred to in
subparagraph (A) from a personal injury protection insurer accrues only to
that payor. Payments by a payor referred to in subparagraph (A) shall not
be counted against personal injury limits for personal injury protection
until such time as the payor is reimbursed under this
subparagraph.
(3) PROTECTION AGAINST DUPLICATION- Upon receipt of reasonable notice, a
personal injury protection insurer shall reimburse a collateral source for
payments made by that collateral source for economic loss for injury
resulting from a motor vehicle accident, to the extent that the personal
injury protection insurer is obligated to pay for that economic loss.
(c) PROMPT AND PERIODIC PAYMENT-
(1) IN GENERAL- A personal injury protection insurer may pay personal
injury protection benefits periodically as losses accrue.
(2) LATE PAYMENT- Except as provided in section 7, a personal injury
protection insurer that does not pay a claim for personal injury protection
benefits during the 30-day period beginning on the date on which that
insurer receives a submission of
reasonable proof of the loss for which those benefits are payable, shall
pay--
(A) the loss compounded at a rate of 24 percent per annum as
liquidated damages; and
(B) a reasonable attorney's fee calculated on the basis of the time
actually expended or the value of the attorney's efforts as reflected in
payment to the attorney's client.
(3) ADMINISTRATION OF PERSONAL INJURY PROTECTION BENEFITS- To the extent
consistent with this Act, any applicable provision of a State no-fault motor
vehicle law or add-on law governing the administration of payment of
benefits without reference to fault shall apply to the payment of benefits
under personal injury protection under this subsection.
(d) AUTHORIZATIONS FOR DEDUCTIONS AND EXCLUSIONS-
(1) IN GENERAL- A personal injury protection insurer may write personal
injury protection--
(A)(i) without any deductible; or
(ii) subject to a reasonable deductible; and
(B) with an exclusion of coverage for first party benefits to cover
the losses of the personal injury protection insured caused by that
insured's--
(i) driving under the influence of alcohol or illegal drugs;
or
(ii) driving while seeking to intentionally injure another
person.
(2) APPLICABILITY OF DEDUCTIBLES- The deductibles and exclusions
described in paragraph (1) shall apply only to--
(A) the person named in the applicable insurance policy; and
(B) the resident relatives or dependents of the person described in
subparagraph (A).
SEC. 6. TORT MAINTENANCE SYSTEM.
(a) MINIMUM POLICY REQUIREMENTS-
(1) IN GENERAL- The coverage for a person who chooses insurance under
section 4(a)(1)(B) shall include--
(A) the type of motor vehicle insurance that is otherwise required
under applicable State law; and
(B) tort maintenance coverage at a level that is at least equivalent
to the level of insurance required under the applicable State financial
responsibility law for bodily injury liability.
(2) RESPONSIBILITY FOR PAYMENT UNDER TORT MAINTENANCE COVERAGE- The
responsibility for payment for any claim under tort maintenance coverage is
assumed by the insurer of the tort maintenance insured to the extent of such
coverage.
(b) ADDITIONAL PAYMENTS FROM UNINSURED MOTORIST COVERAGE AND UNDERINSURED
MOTORIST COVERAGE- A tort maintenance insured who also purchases an insurance
policy that provides uninsured motorist coverage or underinsured motorist
coverage may recover under the terms of that policy for any economic or
noneconomic loss arising from an accident involving a personal injury
protection insured, in any case in which the amount of those economic or
noneconomic losses exceed the aggregate amount recovered or recoverable from
the--
(1) tort maintenance coverage of the tort maintenance insured; and
(2) personal injury protection insured.
SEC. 7. PROTECTION AGAINST INSURANCE FRAUD.
(a) TIMELY SUBMISSION OF CLAIMS FOR FIRST PARTY BENEFITS- (1) No insurer
shall be obligated to pay first party benefits to a personal injury protection
insured for any economic loss that occurred more than 60 days prior to the
submission of a claim for such loss.
(2) The time for submission of a claim shall be tolled during any period
during which the insured can show that--
(A) the insured was physically unable--
(i) to submit proof of the claim; or
(ii) to supply the identity of the insurer to the provider of
services; or
(B) the insured was unable to identify the insurer despite good faith
efforts to do so.
(b) LOSS OF FIRST PARTY BENEFITS- No insurer shall be obligated to pay any
first party benefits to a personal injury protection insured for any economic
loss that a court of competent jurisdiction determines is, in whole or in
part, the product of fraudulent activity by the insured with respect to an
accident.
(c) LOSS OF ENTITLEMENT TO PURCHASE INSURANCE- An insurer may cancel,
decline to renew, or refuse to issue a personal injury protection policy to
any person who a court of competent jurisdiction has determined has engaged in
fraudulent activity with respect to an accident during the previous three
years.
SEC. 8. SOURCE OF COMPENSATION IN CASES OF ACCIDENTAL INJURY.
(a) ACCIDENTS INVOLVING PERSONS CHOOSING THE TORT MAINTENANCE SYSTEM-
(1) IN GENERAL- A tort maintenance insured who is involved in an
accident with another person shall be subject to applicable State law for
injury, except that, based on fault, that person may, upon submission of
proof of insurance--
(A) recover from any personal injury protection insured for
uncompensated economic loss (and not for noneconomic loss); and
(B) be liable to a personal injury protection insured for
uncompensated economic loss (and not for noneconomic loss).
(2) ALLOCATION OF TORT MAINTENANCE PAYMENTS- In determining the extent
of recovery of a tort maintenance insured from a personal injury protection
insured under subsection (b), the payments made to the tort maintenance
insured from tort maintenance coverage shall first be allocable to economic
loss, and any remainder may be allocable to noneconomic loss.
(b) ACCIDENTS INVOLVING PERSONS CHOOSING THE PERSONAL INJURY PROTECTION
SYSTEM-
(1) RIGHT TO RECOVER ECONOMIC LOSS- A personal injury protection insured
who is injured in an accident may recover under the policy of that insured
only for economic loss, without regard to fault.
(2) RIGHT TO SUE FOR UNCOMPENSATED ECONOMIC LOSS BASED ON FAULT- A
personal injury protection insured who is involved in an accident with a
tort maintenance insured, or another personal injury protection insured, may
recover based on fault from that other insured for uncompensated economic
loss (and not for noneconomic loss).
(c) ALLOCATION OF COMPARATIVE FAULT- In any case in which a claim is made
under this Act for uncompensated economic loss on the basis of comparative
fault under applicable State law, the recovery of damages shall be based on
the percentage of fault with respect to the amount of uncompensated economic
loss.
(d) ACCIDENTS INVOLVING PERSONS CHOOSING THE PERSONAL INJURY PROTECTION
SYSTEM AND PERSONS WHO ARE UNLAWFULLY UNINSURED-
(1) RIGHTS OF PERSONAL INJURY PROTECTION INSUREDS- A personal injury
protection insured who is involved in an accident with an uninsured
motorist--
(A) shall be compensated under the insured person's policy for
economic loss without regard to fault; and
(B) may recover from the uninsured motorist (other than under
uninsured or underinsured motorist coverage) for economic loss and for
noneconomic loss based on fault.
(2) LIMITATIONS ON LAWSUITS BY UNINSURED MOTORISTS- An uninsured
motorist may not recover from a personal injury protection insured for
noneconomic loss.
(e) ACCIDENTS INVOLVING MOTORISTS UNDER THE INFLUENCE OF ALCOHOL OR
ILLEGAL DRUGS OR INFLICTING INTENTIONAL INJURY- Notwithstanding any other
provision of this Act, a personal injury protection insured who is in an
accident may--
(1) recover all damages based on fault under applicable State law from a
person who--
(A) at the time of the accident, was driving under the influence of
alcohol or illegal drugs (as those terms are defined under applicable
State law); or
(B) caused an injury while seeking to intentionally injure another
person; and
(2) be liable for all damages based on fault under applicable State law,
if such insured--
(A) at the time of the accident, was driving under the influence of
alcohol or illegal drugs (as those terms are defined under applicable
State law); or
(B) caused an injury while seeking to intentionally injure another
person.
(f) RIGHTS OF LAWFULLY UNINSURED PERSONS- Nothing in this Act shall be
construed to affect the tort rights or obligations of any person lawfully
uninsured under the terms of an applicable State law for insurance under
either the personal injury protection system or tort maintenance system under
section 4(a)(1).
(g) RIGHTS OF PERSONS OCCUPYING MOTOR VEHICLES WITH FEWER THAN FOUR
LOAD-BEARING WHEELS- Nothing in this Act shall be construed to affect the tort
rights or obligations of a person who occupies a motor vehicle with fewer than
4 load-bearing wheels or an attachment thereto, unless an applicable contract
for personal injury protection under which that person is insured specifies
otherwise. The preceding sentence applies without regard to whether the person
is otherwise legally insured for personal injury protection or tort
maintenance coverage.
(h) FORFEITURE OF FRAUDULENT CLAIMS- An owner, operator, or occupant of a
motor vehicle involved in an accident forfeits the right to make a claim
against an insured motorist for economic or noneconomic loss resulting from
injury incurred by that owner, operator, or occupant if that owner, operator,
or occupant knowingly participated in a scheme to obtain insurance payments
for any accident that was staged with the intent to commit insurance fraud.
(i) PRIORITY OF BENEFITS-
(1) IN GENERAL- Except as provided in paragraph (2), a personal injury
protection insured or a tort maintenance insured may recover first party
benefits only under the coverage of that insured in effect at the time of
the accident.
(A) IN GENERAL- Except as provided in subparagraph (B), with respect
to an accident that occurred while an injured individual was occupying a
motor vehicle--
(i) furnished by an employer, the primary coverage shall be the
coverage applicable to the motor vehicle; or
(ii) that was being used in the business of transporting individuals
or property, the primary coverage shall be the coverage applicable to
that motor vehicle.
(B) CERTAIN CLAIMANTS- A claimant may claim first party benefits in an
amount greater than the amounts determined under the limits under the
primary insurance coverage described in clause (i) or (ii) of subparagraph
(A), if that claimant would otherwise be able to receive those increased
benefits by reason of insurance coverage of that claimant that would
otherwise apply, but for the operation of subparagraph (A).
(j) REIMBURSEMENT RIGHTS OF PERSONAL INJURY PROTECTION INSURERS AND
COLLATERAL SOURCES-
(1) REIMBURSEMENT RIGHTS OF PERSONAL INJURY PROTECTION INSURERS-
(A) IN GENERAL- A personal injury protection insurer may seek
reimbursement under subparagraph (B), from--
(i) an uninsured motorist who is liable for damages caused by the
accident;
(ii) a motorist who was under the influence of alcohol or illegal
drugs at the time of the accident and whose conduct was the proximate
cause of the accident;
(iii) a person who caused an injury while seeking to intentionally
injure another person; or
(iv) any other person who is not affected by the limitations on tort
rights and liabilities under this Act and whose conduct was the
proximate cause of the accident.
(B) REIMBURSEMENT- A personal injury protection insurer may seek
reimbursement under this subparagraph to the extent of the obligations of
that insurer, with respect to payments for a personal injury protection
insured of that insurer with respect to an accident caused in whole or in
part, as determined in accordance with applicable State law, from a person
referred to in subparagraph (A), for the losses that insurer--
(i) has paid or reimbursed; or
(ii) under applicable law, is obligated to pay.
(2) REIMBURSEMENT RIGHTS OF COLLATERAL SOURCES- With respect to an
accident, a collateral source may seek reimbursement from an insurer in a
civil action based on fault.
(3) PROHIBITION ON MULTIPLE RECOVERY- In any action to recover losses
arising out of an accident, a person may not recover or introduce into
evidence in a civil action against another person any amount of a loss that
a collateral source or personal injury protection insurer--
(A) has paid or reimbursed; or
(1) APPLICABLE LAW- With respect to a claim relating to a motor vehicle
accident involving persons from different States, the choice-of-law
principles applicable under the law of the State of competent jurisdiction
shall apply.
(2) APPLICABLE COVERAGE IN AN AUTO CHOICE STATE- With respect to an
accident that involves a person from a State in which this Act does not
apply and a person from a State in which this Act applies, in any case in
which the accident occurs in a State in which this Act applies, the coverage
of the person from the State in which this Act does not apply shall be
deemed to be the form of insurance (whether personal injury protection or
tort maintenance coverage) that most closely reflects the form of insurance
that the person maintains in the State of residence of the person.
(l) JURISDICTION- This Act shall not confer jurisdiction on the district
courts of the United States under section 1331 or 1337 of title 28, United
States Code.
(m) STATUTES OF LIMITATIONS-
(1) IN GENERAL- Subject to paragraph (2), nothing in this Act shall
supersede an applicable State law that imposes a statute of limitations for
claims related to an injury caused by an accident, except that such statute
shall be tolled during the period during which any personal injury
protection or tort maintenance coverage benefits are paid.
(2) CLAIMS- Unless otherwise provided by State law, a claim for personal
injury protection benefits under this Act shall be filed not later than two
years after the economic loss that is the subject of the claim is
incurred.
(n) LIMITATIONS ON NONRENEWAL, CANCELLATION, AND PREMIUM INCREASES- An
insurer shall not cancel, decline to renew, or increase the premium of a
person insured by the insurer solely because that insured person or any other
injured person made a claim for--
(1) personal injury protection benefits; or
(2) tort maintenance coverage benefits in any case in which there is no
basis for ascribing fault to the insured or one for whom the insured is
vicariously liable.
(o) NEGLIGENT DRIVER RATINGS- Nothing in this Act shall be construed to
limit insurers from canceling, failing to renew, or increasing premiums for an
insured person if there is a basis for ascribing moving traffic violations or
fault for an accident caused by that insured or any resident relative or
dependent, or employee of that insured.
(1) IN GENERAL- Except as provided in paragraph (2), no insurer,
insurance agent or broker, insurance producer representing a motor vehicle
insurer, automobile residual market plan, or attorney licensed to practice
law within a State, or any employee of any such person or entity, shall be
liable in an action for damages on account of--
(i) the tort maintenance system under section 4(a)(1)(B);
or
(ii) the personal injury protection system under section 4(a)(1)(A);
or
(B) a failure to make a required election.
(2) EXCEPTION- Paragraph (1) shall not apply in any case in
which--
(A) a person described in that paragraph--
(i) willfully and intentionally misrepresents the insurance choices
available to a customer or client of that person; or
(ii) willfully and with the intent to defraud, induces the election
of one motor vehicle insurance system described in paragraph (1)(A) over
the other motor vehicle insurance system described in that paragraph;
and
(B) the misrepresentation or inducement under subparagraph (A) was the
proximate cause of that customer or client's electing or failing to make
an election of an insurance system under subparagraph (A) or (B) of
section 4(a)(1).
SEC. 9. PRESERVATION OF STATE AND PRIVATE RIGHTS.
(a) RIGHTS OF STATES- Nothing in this Act shall be construed--
(1) to waive or affect any defense of sovereign immunity asserted by any
State under any law or by the United States;
(2) to preempt State choice-of-law rules with respect to claims brought
by a foreign nation or a citizen of a foreign nation;
(3) to affect the right of any court to transfer venue, to apply the law
of a foreign nation, or to dismiss a claim of a foreign nation or of a
citizen of a foreign nation on the ground of inconvenient forum;
(4) to preclude a State from establishing a schedule of payments for
medical protocols for treatment of an injury that arises from an
accident;
(5) to preclude a State from requiring personal injury protection
insurers to offer first party insurance that establishes a dollar value for
noneconomic loss in objectively verifiable defined classes of cases
involving death or serious and permanent bodily injury;
(6) to preclude a State from enacting a law applicable to all motor
vehicle accident cases, including cases covered by this Act, to establish a
minimum dollar value for economic losses for defined classes of cases
involving death or serious bodily injury;
(7) to preclude a State from providing that forms of insurance other
than those listed in section 5(b) shall be subtracted from personal injury
protection insurance benefits otherwise payable for injury; or
(8) to preclude a State from enacting a law that--
(A) allows litigation by tort maintenance insureds against personal
injury protection insureds for economic and noneconomic loss; and
(B) assures through a reallocation device that the advantage of tort
claim waivers by personal injury protection insureds against tort
maintenance insureds is reflected in the premiums of personal injury
protection insureds.
(b) PRESERVATION OF STATE REGULATORY AUTHORITY- Nothing in this Act may be
construed--
(1) to preclude a State or State official charged with regulatory
authority over the business of insurance from fully exercising that
regulatory authority, including adopting regulations and procedures
regarding--
(E) underwriting and marketing practices; and
(F) carrying out the requirements of this Act; or
(2) to allow or provide for Federal regulation of motor vehicle
insurance.
(c) RIGHTS OF PRIVATE PARTIES- Nothing in this Act may be construed--
(1) to require a personal injury protection insurer to offer, or a
personal injury protection insured to purchase, any coverage for bodily
injury in addition to the coverage required under this Act, including
uninsured motorist coverage, underinsured motorist coverage, or coverage for
medical payments;
(2) to prevent insurers and insureds from contracting to limit recovery
for the loss of earnings under personal injury protection by--
(A) limiting such recovery to only 60 percent or more of lost wages or
income;
(B) limiting the amount of such recovery payable per week; or
(C) limiting the period of time after an accident during which the
benefits referred to in this paragraph are payable to a period of not less
than one year;
(3) to prevent insurers and insureds from contracting--
(A) to limit recovery for economic loss for medical and rehabilitation
expenses to the average amount actually paid for a particular course of
treatment; or
(B) to provide medical or rehabilitation services through designated
health care providers;
(4) to prevent an insurer from contracting with insureds, as permitted
by applicable State law, to have submitted to arbitration any dispute with
respect to payment of personal injury protection or tort maintenance
coverage;
(5) to affect the worker classification of a person, either as an
employee or an independent contractor, on the basis of the election of an
employer or motor carrier of an insurance system under section 4(a);
or
(6) to affect the awarding of punitive damages, or damages for bad faith
refusal to pay a claim, under any applicable State law.
SEC. 10. APPLICABILITY TO STATES.
(a) ELECTION OF NONAPPLICABILITY BY STATES- Subject to subsections (c)
through (e), this Act shall apply with respect to a State, unless--
(1) by not later than the earlier of the date that is one year after the
date of enactment of this Act or the expiration of the first regular
legislative session of the State beginning after the date of enactment of
this Act, the State enacts a statute that--
(A) cites the authority of this subsection;
(B) declares the election of that State that this Act shall not apply
with respect to that State; and
(C) contains no other provision; or
(2)(A) the State official charged with jurisdiction over insurance rates
for motor vehicles makes a finding that this Act does not apply by reasons
of the applicability of the conditions described in subsection (b)(1)(A);
and
(B) that finding is made and any review described in subsection
(b)(1)(B) is completed not later than the date specified in subsection
(b)(1)(C).
(b) NONAPPLICABILITY BASED ON STATE FINDING-
(1) IN GENERAL- This Act shall not apply with respect to a State,
if--
(A) the State official charged with jurisdiction over insurance rates
for motor vehicles makes a finding that the statewide average motor
vehicle premiums for bodily injury insurance in effect immediately before
the date of enactment of this Act will not be reduced by an average of at
least 30 percent for persons choosing the personal injury protection
system, in the amounts required under section 5 (without including in the
calculation for personal injury protection insureds any costs for
uninsured, underinsured, or medical payments coverages);
(B) the finding described under subparagraph (A) is supported by
evidence adduced in a public hearing and reviewable under the applicable
State administrative procedure law; and
(C) the finding described under subparagraph (A) is made, and any
review of such finding under subparagraph (B) is completed, not later than
120 days after the date of enactment of this Act.
(2) COMPARISON OF BODILY INJURY PREMIUMS- For purposes of making a
comparison under paragraph (1)(A) of premiums for personal injury protection
with preexisting premiums for bodily injury insurance (in effect immediately
before the date of enactment of this Act), the preexisting bodily injury
insurance premiums shall include premiums for--
(A) bodily injury liability, uninsured and underinsured motorists'
liability, and medical payments coverage; and
(B) if applicable, no-fault benefits under a no-fault motor vehicle
law or add-on law.
(c) IMPLEMENTATION PERIOD- Except as provided in subsection (d), if a
State fails to enact a law by the applicable date specified in paragraph (1)
of subsection (a) or if a finding described in paragraph (2) of that
subsection is not made and reviewed by the date specified in subsection
(b)(1)(C), this Act shall apply to that State beginning on the date that is
270 days after the later of those dates.
(d) ACCELERATED APPLICABILITY-
(1) IN GENERAL- Subject to paragraph (2), a State may enact a law that
provides for the implementation of the provisions of this Act in that State
before an otherwise applicable date determined under subsection (a).
(2) APPLICABILITY- If a State makes an election under paragraph (1),
this Act shall apply to that State beginning on the date that is 270 days
after the date of such election.
(e) ELECTION OF NONAPPLICABILITY BY A STATE AFTER THIS ACT BECOMES
APPLICABLE WITH RESPECT TO THE STATE- After this Act becomes applicable with
respect to a State under subsection (c) or (d), this Act shall cease to apply
with respect to that State if the State enacts a statute that meets the
requirements of subparagraphs (A) through (C) of subsection (a)(1).
END