PRINTER'S NO. 2919
No. 2209 Session of 1988
INTRODUCED BY MRKONIC, HASAY, BOYES, ANGSTADT, BLACK, MORRIS,
HALUSKA, TIGUE, KASUNIC, B. SMITH, J. L. WRIGHT, BARLEY,
CORRIGAN, GEIST, NOYE, FISCHER, BOWSER, JACKSON, DISTLER,
MOEHLMANN, CARLSON, BILLOW, HERMAN, FOX, KENNEY, GRUPPO,
BIRMELIN, PHILLIPS, BELFANTI, BURD, DUFFY, CIVERA,
E. Z. TAYLOR, BUNT, JOHNSON AND BELARDI, FEBRUARY 24, 1988
REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 24, 1988
AN ACT
1 Amending Title 75 (Vehicles) of the Pennsylvania Consolidated
2 Statutes, repealing provisions relating to the Catastrophic
3 Loss Trust Fund.
4 The General Assembly of the Commonwealth of Pennsylvania
5 hereby enacts as follows:
6 Section 1. Subchapter F of Chapter 17 of Title 75 of the
7 Pennsylvania Consolidated Statutes is repealed.
8 Section 2. Sections 1787(d), 1796, 1797 and 1798 of Title 75
9 are amended to read:
10 § 1787. Self-insurance.
11 * * *
12 [(d) Catastrophic Loss Trust Fund.--Self-insurers shall
13 contribute to the Catastrophic Loss Trust Fund in the manner
14 provided in Subchapter F (relating to Catastrophic Loss Trust
15 Fund).]
16 * * *
1 § 1796. Mental or physical examination of person.
2 (a) General rule.--Whenever the mental or physical condition
3 of a person is material to any claim for medical[,] or income
4 loss [or catastrophic loss] benefits, a court of competent
5 jurisdiction [or the administrator of the Catastrophic Loss
6 Trust Fund for catastrophic loss claims] may order the person to
7 submit to a mental or physical examination by a physician. The
8 order may only be made upon motion for good cause shown. The
9 order shall give the person to be examined adequate notice of
10 the time and date of the examination and shall state the manner,
11 conditions and scope of the examination and the physician by
12 whom it is to be performed. If a person fails to comply with an
13 order to be examined, the court [or the administrator] may order
14 that the person be denied benefits until compliance.
15 (b) Report of examination.--If requested by the person
16 examined, a party causing an examination to be made shall
17 promptly deliver to the person examined a copy of every written
18 report concerning the examination at least one of which must set
19 forth the physician's findings and conclusions in detail. Upon
20 failure to promptly provide copies of these reports, the court
21 [or the administrator] shall prohibit the testimony of the
22 examining physician in any proceeding to recover benefits.
23 § 1797. Customary charges for treatment.
24 A person or institution providing treatment, accommodations,
25 products or services to an injured person for an injury covered
26 by medical [or catastrophic loss] benefits shall not make a
27 charge for the treatment, accommodations, products or services
28 in excess of the amount the person or institution customarily
29 charges for like treatment, accommodations, products and
30 services in cases involving no insurance.
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1 § 1798. Attorney fees and costs.
2 (a) Basis for reasonable fee.--No attorney's fee for
3 representing a claimant in connection with a claim for first
4 party benefits provided under Subchapter B (relating to motor
5 vehicle liability insurance first party benefits) [or a claim
6 for catastrophic loss benefits under Subchapter F (relating to
7 Catastrophic Loss Trust Fund)] shall be calculated, determined
8 or paid on a contingent fee basis, nor shall any attorney's fees
9 be deducted from the benefits enumerated in this subsection
10 which are otherwise due such claimant. An attorney may charge a
11 claimant a reasonable fee based upon actual time expended.
12 (b) Unreasonable refusal to pay benefits.--In the event an
13 insurer is found to have acted with no reasonable foundation in
14 refusing to pay the benefits enumerated in subsection (a) when
15 due, the insurer shall pay, in addition to the benefits owed and
16 the interest thereon, a reasonable attorney fee based upon
17 actual time expended.
18 (c) [Payment by fund.--The Catastrophic Loss Trust Fund may
19 award the claimant's attorney a reasonable fee based upon actual
20 time expended because a claimant is unable to otherwise pay the
21 fees and costs.
22 (d)] Fraudulent or excessive claims.--If, in any action by a
23 claimant to recover benefits under this chapter, the court
24 determines that the claim, or a significant part thereof, is
25 fraudulent or so excessive as to have no reasonable foundation,
26 the court may award the insurer's attorney a reasonable fee
27 based upon actual time expended. The court, in such case, may
28 direct that the fee shall be paid by the claimant or that the
29 fee may be treated in whole or in part as an offset against any
30 benefits due or to become due the claimant.
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1 Section 3. This act shall not be deemed to affect or impair
2 the benefit rights of any person who has filed a claim against
3 the Catastrophic Loss Trust Fund under Subchapter F of Chapter
4 17 prior to the effective date of this act.
5 Section 4. The Insurance Department is directed to make a
6 study of an alternative method of protecting motorists who incur
7 accident claims in excess of $100,000 and make recommendations
8 to the General Assembly within 30 days for the establishment of
9 a new system to replace the Catastrophic Loss Trust Fund. The
10 department shall also make recommendations for the disposition
11 of the funds currently deposited in the Catastrophic Loss Trust
12 Fund.
13 Section 5. This act shall take effect immediately.
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