75c1702s

§ 1702.  Definitions.

The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise:

"Assigned Risk Plan."  A program for the equitable apportionment of assigned risks and clean risks among insurers.

"Automobile Insurance Policy Act."  The act of June 5, 1968 (P.L.140, No.78), entitled "An act regulating the writing, cancellation of or refusal to renew policies of automobile insurance; and imposing powers and duties on the Insurance Commissioner therefor."

"Benefits" or "first party benefits."  Medical benefits, income loss benefits, accidental death benefits and funeral benefits.

"Clean risk."  An insured or an applicant for insurance who, for the 36-month period immediately preceding the date of application or renewal date of the policy:

(1)  has not been involved in an accident as a driver, provided that, for purposes of this paragraph, an "accident" shall not include accidents described in section 3 of the Automobile Insurance Policy Act or section 1799.3 (relating to limit on cancellations, refusals to renew, refusals to write, surcharges, rate penalties and point assignments);

(2)  has not received more than three points for violations as set forth in Chapter 15 (relating to licensing of drivers); and

(3)  whose operator's license has not been suspended or revoked except under section 1533 (relating to suspension of operating privilege for failure to respond to citation) and the insured is able to produce proof that he or she has responded to all citations and paid all fines and penalties imposed under that section and provided further that the named insured has been a licensed operator in Pennsylvania or another state for the immediately preceding three years.

"Commissioner."  The Insurance Commissioner of the Commonwealth.

"Department."  The Department of Transportation or Insurance Department, as applicable.

"Financial responsibility."  The ability to respond in damages for liability on account of accidents arising out of the maintenance or use of a motor vehicle in the amount of $15,000 because of injury to one person in any one accident, in the amount of $30,000 because of injury to two or more persons in any one accident and in the amount of $5,000 because of damage to property of others in any one accident. The financial responsibility shall be in a form acceptable to the Department of Transportation.

"Injury."  Accidentally sustained bodily harm to an individual and that individual's illness, disease or death resulting therefrom.

"Insured."  Any of the following:

(1)  An individual identified by name as an insured in a policy of motor vehicle liability insurance.

(2)  If residing in the household of the named insured:

(i)  a spouse or other relative of the named insured; or

(ii)  a minor in the custody of either the named insured or relative of the named insured.

"Insurer" or "insurance company."  A motor vehicle liability insurer subject to the requirements of this chapter.

"Necessary medical treatment and rehabilitative services."  Treatment, accommodations, products or services which are determined to be necessary by a licensed health care provider unless they shall have been found or determined to be unnecessary by a State-approved Peer Review Organization (PRO).

"Noneconomic loss."  Pain and suffering and other nonmonetary detriment.

"Peer Review Organization" or "PRO."  Any Peer Review Organization with which the Federal Health Care Financing Administration or the Commonwealth contracts for medical review of Medicare or medical assistance services, or any health care review company, approved by the commissioner, that engages in peer review for the purpose of determining that medical and rehabilitation services are medically necessary and economically provided. The membership of any PRO utilized in connection with this chapter shall include representation from the profession whose services are subject to the review.

"Private passenger motor vehicle."  A four-wheel motor vehicle, except recreational vehicles not intended for highway use, which is insured by a natural person and:

(1)  is a passenger car neither used as a public or livery conveyance nor rented to others; or

(2)  has a gross weight not exceeding 9,000 pounds and is not principally used for commercial purposes other than farming.

The term does not include any motor vehicle insured exclusively under a policy covering garage, automobile sales agency repair shop, service station or public parking place operation hazards.

"Self-insurer."  An entity providing benefits and qualified in the manner set forth in section 1787 (relating to self-insurance).

"Serious injury."  A personal injury resulting in death, serious impairment of body function or permanent serious disfigurement.

"Underinsured motor vehicle."  A motor vehicle for which the limits of available liability insurance and self-insurance are insufficient to pay losses and damages.

"Uninsured motor vehicle."  Any of the following:

(1)  A motor vehicle for which there is no liability insurance or self-insurance applicable at the time of the accident.

(2)  A motor vehicle for which the insurance company denies coverage or the insurance company is or becomes involved in insolvency proceedings in any jurisdiction.

(3)  An unidentified motor vehicle that causes an accident resulting in injury provided the accident is reported to the police or proper governmental authority and the claimant notifies his insurer within 30 days, or as soon as practicable thereafter, that the claimant or his legal representative has a legal action arising out of the accident.

"Voluntary rate."  An insurer's rating plan approved by the commissioner. In the case of an insurer with multiple rating plans, the voluntary rate shall be that rating plan applicable to the risk.

75c1702v

(Feb. 12, 1984, P.L.53, No.12, eff. Oct. 1, 1984; Feb. 7, 1990, P.L.11, No.6, eff. imd.)

 

1990 Amendment.  Act 6 added the defs. of "Assigned Risk Plan," "Automobile Insurance Policy Act," "clean risk," "commissioner," "necessary medical treatment and rehabilitative services," "noneconomic loss," "Peer Review Organization" or "PRO," "private passenger motor vehicle," "serious injury" and "voluntary rate."

References in Text.  The act of June 5, 1968 (P.L.140, No.78), referred to as the Automobile Insurance Policy Act, referred to in the defs. of "Automobile Insurance Policy Act" and "clean risk," was repealed by the act of June 17, 1998, P.L.464, No.68. The subject matter is now contained in Article XX of the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921.

Cross References.  Section 1702 is referred to in sections 1161, 1798.3 of this title.