No Fault Q2 Quiz

1. Our policy carries Basic PIP, OBEL, APIP and Med Pay. Medical bills are received/accepted in excess of the combined limits. In which order does coverage apply?

Basic, OBEL, APIP, Med Pay

Basic, Med Pay, APIP, OBEL

Med Pay, Basic, OBEL, APIP

Basic, APIP, OBEL, Med Pay

The coverage applies in the following order: Basic, OBEL, APIP, Med Pay. This means that the Basic coverage is applied first, followed by OBEL, then APIP, and finally Med Pay.

Explanation

The coverage applies in the following order: Basic, OBEL, APIP, Med Pay. This means that the Basic coverage is applied first, followed by OBEL, then APIP, and finally Med Pay.

2. What is the time limit to send PIP forms to an Eligible Injured Person after receipt of Notice of injury?

3 Business Days

5 Business Days

5 Calendar Days

10 Calendar Days

The correct answer is 5 Business Days. This means that once a Notice of injury is received, the PIP forms must be sent to the Eligible Injured Person within 5 Business Days. Business Days typically refer to weekdays, excluding weekends and public holidays.

Explanation

The correct answer is 5 Business Days. This means that once a Notice of injury is received, the PIP forms must be sent to the Eligible Injured Person within 5 Business Days. Business Days typically refer to weekdays, excluding weekends and public holidays.

3. In accordance with Regulation 68, which of the following is an Eligible Injured Person under Basic PIP Coverage is:

not-available-via-ai

Explanation

not-available-via-ai

4. What is the time limit to send NF3, NF4, NF6, NF7 forms?

5 Business Days

5 Calendar Days

10 Business Days

15 Calendar Days

The correct answer is 10 Business Days. This means that the forms NF3, NF4, NF6, and NF7 must be sent within 10 business days. Business days refer to the days from Monday to Friday, excluding weekends and public holidays. This time limit allows for a reasonable amount of time to complete and submit the necessary forms.

Explanation

The correct answer is 10 Business Days. This means that the forms NF3, NF4, NF6, and NF7 must be sent within 10 business days. Business days refer to the days from Monday to Friday, excluding weekends and public holidays. This time limit allows for a reasonable amount of time to complete and submit the necessary forms.

5. Which of the following is not a Statutory Exclusion to No-fault coverage?

Any person who intentionally causes his or her own personal injury.

Any person while operating or occupying a motor vehicle known to that person to be stolen.

Any person who makes fraudulent statements or engages in fraudulent conduct.

The given answer is not a statutory exclusion to no-fault coverage because it does not fall under any of the specific conditions mentioned in the options. The other options provide situations where coverage may be excluded, such as intentionally causing personal injury, operating a stolen vehicle, or not having the required insurance coverage. However, making fraudulent statements or engaging in fraudulent conduct is not mentioned as a specific exclusion. Therefore, it is not a statutory exclusion to no-fault coverage.

Explanation

The given answer is not a statutory exclusion to no-fault coverage because it does not fall under any of the specific conditions mentioned in the options. The other options provide situations where coverage may be excluded, such as intentionally causing personal injury, operating a stolen vehicle, or not having the required insurance coverage. However, making fraudulent statements or engaging in fraudulent conduct is not mentioned as a specific exclusion. Therefore, it is not a statutory exclusion to no-fault coverage.

6. What is the time limit to send a Denial of Claim based on a Statutory Exclusion?

5 Business Days

10 Calendar Days

10 Business Days

30 Calendar Days

The correct answer is 10 Business Days. This means that the time limit to send a Denial of Claim based on a Statutory Exclusion is 10 Business Days. Business days refer to weekdays excluding weekends and public holidays. Therefore, the insurance company has 10 working days to send a denial of claim notification to the policyholder if the claim is based on a statutory exclusion.

Explanation

The correct answer is 10 Business Days. This means that the time limit to send a Denial of Claim based on a Statutory Exclusion is 10 Business Days. Business days refer to weekdays excluding weekends and public holidays. Therefore, the insurance company has 10 working days to send a denial of claim notification to the policyholder if the claim is based on a statutory exclusion.

7. Which of the following is not a criteria for potential No-fault Recovery?

Livery vehicle involvement

Vehicle weight up to 6500 lbs

Manufacturer defect

APIP paid

The criteria for potential No-fault Recovery include livery vehicle involvement, manufacturer defect, and APIP paid. However, vehicle weight up to 6500 lbs is not a criteria for potential No-fault Recovery.

Explanation

The criteria for potential No-fault Recovery include livery vehicle involvement, manufacturer defect, and APIP paid. However, vehicle weight up to 6500 lbs is not a criteria for potential No-fault Recovery.

8. What is the time limit to send a verification request after a medical bill is received?

10 Business Days

10 Calendar Days

15 Business Days

15 Calendar Days

The time limit to send a verification request after a medical bill is received is 15 business days. This means that the request must be sent within 15 working days, excluding weekends and public holidays. It is important to adhere to this time limit in order to ensure timely processing and resolution of the verification request.

Explanation

The time limit to send a verification request after a medical bill is received is 15 business days. This means that the request must be sent within 15 working days, excluding weekends and public holidays. It is important to adhere to this time limit in order to ensure timely processing and resolution of the verification request.

9. Which of the following is not considered a necessary Medical Expense in accordance with Regulation 68:

Household Help Aide

Prosthetic Services

Occupational therapy

Religious methods of healing

Household Help Aide is not considered a necessary Medical Expense in accordance with Regulation 68. This means that the cost of hiring a household help aide is not eligible for reimbursement or coverage under medical insurance. While prosthetic services, occupational therapy, and religious methods of healing may be considered necessary medical expenses and eligible for coverage, hiring a household help aide is not typically considered a medical necessity.

Explanation

Household Help Aide is not considered a necessary Medical Expense in accordance with Regulation 68. This means that the cost of hiring a household help aide is not eligible for reimbursement or coverage under medical insurance. While prosthetic services, occupational therapy, and religious methods of healing may be considered necessary medical expenses and eligible for coverage, hiring a household help aide is not typically considered a medical necessity.

10. Our insured struck and killed a NY State resident pedestrian in NY State. In addition to Basic PIP, our policy carries $5000.00 Med Pay coverage. What is the limit NYCM would pay up for funeral expenses?

$2000.00

$5000.00

$7000.00

None of the above

Pedestrian is not eligible for Med Pay

Explanation

Pedestrian is not eligible for Med Pay