New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 3 - AUTOMOBILE INSURANCE
Subchapter 14 - PERSONAL INJURY PROTECTION OPTIONS FOR STANDARD POLICIES
Section 11:3-14.3 - Optional medical expense benefits for standard policies
Current through Register Vol. 56, No. 6, March 18, 2024
(a) With respect to personal injury protection under standard automobile insurance policies, issued pursuant to 39:6A-4, each insurer shall make available as an option, at appropriately reduced premiums, medical expense benefits in amounts of $ 150,000, $ 75,000, $ 50,000, and $ 15,000. If none of these options is affirmatively chosen in writing, the policy shall provide medical expense benefits in an amount not to exceed $ 250,000 per person per accident.
(b) Notwithstanding (a) above, if an optional medical expense benefit option is chosen, the policy shall provide that medical expense benefits shall be paid in an amount not to exceed $ 250,000, inclusive of any limit of medical expense benefits pursuant to (a) above, for all medically necessary treatment of permanent or significant brain injury, spinal cord injury or disfigurement or 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.
(c) "Significant disfigurement" as used in (b) above means the result and/or manifestation of a serious traumatic injury that is observable as a permanent and substantial defect in the appearance and functional ability of the person injured. "Significant disfigurement" is a serious outward change that substantially detracts from the appearance and functional ability of the person injured.
