Section 66.102. [Reserved]  

No Fault Act

Attendant care services are an ‘‘allowable expense’’ under the Pennsylvania No-Fault Motor Vehicle Insurance Act (40 P. S. § 1009.103) (Repealed) when provided by accredited, nonfamily, medical care providers. Travelers Insurance Company v. Obusek, 72 F.3d 1148 (3d Cir. Pa. 1995).

It is necessary to establish a prima facie case for claimant for attorneys fees under section 107 of the No-Fault Motor Vehicle Insurance Act (40 P. S. § 1009.107) (Repealed) to prove that reasonable proof of loss was submitted to insurer or that insurer acted in bad faith. Lee v. Safeguard Mutual Insurance Co., 549 A.2d 927 (Pa. Cmwlth. 1988); appeal denied 562 A.2d 320 (Pa. 1989).

This section is consistent with court’s conclusion that, under section 106(a)(2) of No-Fault Act (40 P. S. § 1009.106), victim or his survivor bears burden of establishing ‘‘reasonable proof of the fact and amount of loss.’’ Ralph v. Ohio Casualty Insurance Company, 525 A.2d 1234 (Pa. Super. 1987).

A policy that provides for work loss benefits to a deceased insured without excluding domiciliaries of another state and provides more benefits than the minimum required by the Pennsylvania No-Fault Act does not violate the act. Manheim v. State Farm Mutual Automobile Insurance Co., 518 A.2d 861 (Pa. Super. 1986).

This section establishes a minimum standard for a No-Fault insurance policy but does not put a ceiling on specified amounts or types of coverage. Manheim v. State Farm Mutual Automobile Insurance Co., 518 A.2d 861 (Pa. Super. 1986).

A provision in a policy which provides that in the event of the existence of other automobile medical payments insurance, the insurance company will not be liable for a greater proportion of the loss than the limit of its policy bears to the total applicable limit of liability of all valid and collectible automobile medical payments insurance is deemed appropriate since it is in basic conformance with the Model Basic Personal Injury Protection Endorsement found in subsection (e). Fireman’s Fund Insurance Co. v. Nationwide Mutual Insurance Co., 464 A.2d 431 (Pa. Super. 1983).

Although the definition of ‘‘replacement services loss’’ under 31 Pa. Code § 66.102 is not dispositive for the interpretation of the statutory version of that phrase under section 202(c) of the No-Fault Motor Vehicle Insurance Act (40 P. S. § 1009.202(c)), nothing in the model policy is inconsistent with the interpretation that insureds are entitled to reimbursement for 365 days of such services, even when these replacement service days occur more than a year after the injuries. Habecker v. Nationwide Insurance Co., 445 A.2d 1222 (Pa. Super. 1982).

It is contrary to public policy and legislative intent to allow an insurance company to reduce the statutorily mandated minimum benefits of its uninsured motorist insurance provisions by setting off those amounts received by the insured under his no-fault coverage, and such policy provisions as well as the model no-fault policy are therefore contrary to public policy and legislative intent. Brader v. Nationwide Mutual Insurance Co., 411 A.2d 516 (Pa. Super. 1979).

No-fault protection afforded to passengers injured in accidents involving common carriers prohibits them from bringing assumpsit claims against third party common carriers. Smith v. Harrisburg Taxicab and Baggage Company 75 Pa. D. & C.2d 786 (1976).