KACP Frequently Asked Questions

1. What Kentucky Statute includes authority for the Kentucky Assigned Claims Plan?

Answer: Pursuant to the authority contained in Chapter 304 of the Kentucky Revised Statutes and the duty contained in Subtitle 39, Section 170 thereof, the Executive Director of the Office of Insurance has promulgated and adopted this Assigned Claims Plan hereinafter referred to as the Plan.

 

 

2. Who are members of the Plan?

Answer: Every reparations obligor which qualifies with the Kentucky Department of Insurance to provide basic reparations insurance as security pursuant to KRS Chapter 304, Subtitle 39, shall become and remain a participating member in the Assigned Claims Plan as a condition of its continued approval by the Executive Director as an authorized provider of security for basic reparations insurance in compliance with KRS Chapter 304, Subtitle 39.

 

 

3. Who are servicing insurers and what role do they play?

Answer: All claims received by the Bureau shall be handled through Servicing Insurers.

Upon receipt of notice of a potential claim under the Plan, the servicing insurer receiving the assignment shall act promptly to determine the eligibility of benefits claimed. If the person is found ineligible, notice of ineligibility and the reasons shall be promptly communicated to such person or the legal guardian of that person, with copy to the Assigned Claims Bureau. If the person is determined eligible, benefits required by KRS Chapter 304, Subtitle 39 shall be paid promptly.

The servicing insurer shall have the same rights and obligations in the handling of any assigned claim as if it had issued a policy of basic reparation insurance complying with KRS Chapter 304, Subtitle 39. Each servicing insurer shall be entitled to full reimbursement from the Plan for all amounts paid as benefits pursuant to the Plan, and in addition thereto, shall be paid a handling fee to be set forth in the rules and regulations developed by the Governing Committee.

 

 

4. What persons are entitled to benefits under the Plan?

Answer: A person suffering accrued economic loss as the result of accidental bodily injury occurring in Kentucky and arising out of the operation, maintenance or use of a motor vehicle subject to the provisions of KRS Chapter 304, Subtitle 39 shall be eligible for benefits as provided therein, unless: (See Frequently Ask Question #5)

 

 

5. What persons are not entitled to benefits under the Plan?

Answer: Such person is not entitled to benefits because: 

  • He intentionally caused or attempted to cause injury to himself or another person, or
  • He was injured while maintaining or using a converted vehicle unless used in the good faith belief that he is legally entitled to do so, or
  • He has rejected or is deemed to have rejected the limitations on his tort rights pursuant to the No-Fault Act;

Such person was the owner occupant of the motor vehicle subject to the Kentucky No-Fault Act, which was not insured in accordance with that Act.
Such person qualifies for benefits under a policy of insurance or plan of self-insurance that provides benefits required by the Kentucky No-Fault Act, and such benefits have not been denied such person.

 

 

6. What information is needed to file a claim?

Answer: All persons making application for benefits under the Plan shall do so on forms prescribed by the Governing Committee and shall do so within the time limitations prescribed by KRS Chapter 304, Subtitle 39. All applications shall be directed to the Assigned Claims Bureau. Applicants for benefits shall cooperate with the Bureau or the servicing insurer to which the claim is assigned and shall among other things, provide upon request: 

  • Full information regarding the accident in which the person was injured.
  • Full information relevant to the eligibility of the person to claim benefits under the Plan.
  • Full information establishing the necessity and reasonableness of medical expense incurred and for which claim is made.
  • Full information establishing the necessity and reasonableness of earnings lost.
  • Full information which would establish the identity and, except for immunity granted by KRS Chapter 304, Subtitle 39, probable legal liability of any person or persons alleged to have been the proximate cause of the accident in which the applicant was injured.

A completed Kentucky No-Fault and Supplement to the Application for Benefits must be submitted to the assigned claims plan. (A copy is available on this website). In addition, the following information will assist in providing timely response to the claim:

  1. A complete listing of all group health insurance carriers and any other eligible source for medical payments.
  2. Signed medical and wage authorizations.
  3. List any and all vehicles owned by the person making application and everyone in the household. If they are insured, list the insurance carrier.

 

 

7. How are benefits determined?

Answer: The benefits to which any injured applicant under the Plan is entitled shall be those contained in KRS Chapter 304, Subtitle 39 subject to all applicable deductions, offsets, limitations, or reductions contained therein.

 

 

8. Are benefits otherwise available under Assigned Claims affected by the payment of health insurance, workers compensation or other benefits?

Answer: YES. 304.39-160 (3): Except in the case of a claim assigned under subsection (1)(d), If a person receives basic reparation benefits through the assigned claims plan, all benefits or advantages he receives or is entitled to receive as a result of the injury, other than by way of succession at death, death benefits from life insurance, or in discharge of familial obligations of support, are subtracted in calculating net loss.