Section 26-A503. ELECTION OF BENEFITS UNDER OPTIONAL PERSONAL INJURY PROTECTION (PIP) COVERAGE

 

503.1A victim sustaining injury in a motor vehicle accident which forms the basis of a claim against an insurer shall have the responsibility of informing the insurer of the accident according to the terms of the policy provided by the insurer.

 

503.2Upon notification of an accident by the victim, or in any event whenever notification is received of an accident involving a person covered under any optional personal injury protection plan, the insurer providing such coverage shall immediately upon notification, mail to any identifiable victim a letter informing the victim of his or her right to elect to receive benefits under optional personal injury protection coverage within sixty (60) days of the date of the accident.

 

503.3The notification by the insurer to all identifiable victims referred to in § 503.2 shall be by Post Office Receipt Secured mail to the stated address as written in the policy providing coverage or to the last known address of the victim.

 

503.4The notification to the victim shall state the following:

 

(a)The possible benefits comprising the optional personal injury protection coverage provided by the policy;

 

(b)The restrictions on bringing a civil action based on the liability of another person as stated in § 504 of the regulations;

 

(c)The consequences of failing to make an election within sixty (60) days; and

 

(d)That there is an available space for making an election or waiver of benefits and an appropriate signature line for the victim.

 

503.5The notification to the victim shall contain a form by which the victim can request extension of the sixty (60) day limit to make an election.

 

503.6The notification to the victim will be written in ordinary non-technical language.

 

503.7The envelope containing the notification to the victim and the request for extension form shall have printed on the outside "IMPORTANT INSURANCE NOTICE" in capital letters of at least eighteen (18) point bold face type or larger size.

 

503.8The insurer shall mail the notification to the victim so as to allow reasonable time for the victim to either make an election or to request an extension of time to make such an election.

 

503.9The victim shall notify an insurer providing coverage under an optional personal injury protection plan, of his or her election to receive benefits under such coverage for injuries sustained in an accident within sixty (60) days of the date of such accident, unless the insurer failed to mail such notification in the manner provided in § 503.3 and in a timely fashion as required by §§ 503.8 of this chapter.

 

503.10In the event that the insurer fails to mail the required notification within a reasonable time, an extension of time shall be given the victim in order to make a reasonable decision as to the election or waiver of benefits.

 

503.11 If a victim requests an extension of time to make an election, the mailing of a request by midnight of the sixtieth (60) day after the date of the accident shall be considered a timely request for an extension.

 

503.12Notification by a victim may be made in any of the following ways:

 

(a)By telephone;

 

(b)In person;

 

(c)By telegraph, letter or postcard; or

 

(d)By any other means reasonably calculated to give notification to the insurer providing the optional personal injury protection coverage; provided, that if a victim is incapacitated or in some way unable to make the election, it may be made by the next closest relative, or if there is no relative, an individual taking responsibility for the victim's affairs.

 

503.13The sixty (60) day election period may be extended upon the mutual written agreement of the victim and the insurer.

 

source

Final Rulemaking published at 35 DCR 7649 (October 21, 1988).