KIAA Frequently Asked Questions

 

 

1. Who is a member of KIAA?
304.39-290: All reparation obligors shall be and remain members of the association as a condition of their authority to transact business in the Commonwealth. Other persons, associations, organizations and agencies of government may by written application and upon approval of the Board and the Kentucky Department of Insurance become members.

 

2. What if the other reparation obligor is a non-member?
In order for a case involving a non-member to be heard, the non-member must agree to arbitration. The KIAA application asks the question- “Do you accept arbitration”?

 

3. Does KIAA arbitrate other lines of business such as worker’s comp, general liability, homeowners, etc?
No. KRS 304.39-290 established the KIAA to provide a mechanism for the reimbursement, among reparation obligors of losses paid as basic or added reparation benefits and is applicable to controversies involving reparation obligors and persons having the rights and obligations of a reparation obligor.

 

4. What is the statute of limitations for PIP arbitration?
A claim may be submitted to arbitration not later than two (2) years after the last basic reparation payment made by any reparation obligor, or two (2) years after the settlement of the last bodily injury claim arising out of the same accident; or if there is no settlement, two (2) years after the expiration of the statute of limitations of the last bodily injury claim arising out of the same accident, whichever later occurs.

 

5. What forms are used and where are they located?
This website includes a link to the Arbitration Application, Contentions Form and Amended Application Form. The forms are in PDF and may be completed online and printed locally for submission to the KIAA office.

 

6. How do I file for arbitration and how soon can the application be filed?
An arbitration proceeding is commenced by a reparation obligor filing an application, contentions and supporting documentation with the Association. The filing can be made no earlier than 60 days after a request for reimbursement is submitted to the Respondent and is either denied or is presumed to have been denied. At the time of submission to KIAA, a copy of the application, contentions and supporting documentation must also be submitted to the respondent(s).

 

7. What are the filing fees?
The $35.00 filing fee is incurred upon submission of the application to the KIAA and is non-refundable. If a panel of three is requested the filing fee is $100.

 

8. Is the Respondent required to respond? How is it done and how much time do I have?
The Respondent can choose whether they want to respond. The Respondent has thirty days after the Applicant’s filing to file a written answer. Failure to file an answer will not delay the arbitration hearing. If a Respondent fails to submit its answer within thirty days it is presumed that the Applicant’s claim has been denied and the case is ready for a hearing on the issues. The case will proceed to hearing and the Arbitrator will make a decision based solely on information submitted by the Applicant.

To respond, the Respondent should complete the Respondent’s Allegations section of the application and submit it along with contentions and supporting documentation to KIAA. A copy of the response and documentation must be submitted to the Applicant as well.

 

9. What documentation should be submitted?
Documents considered as evidence include but are not limited to the following: Statements (handwritten or transcribed recordings), police reports, photographs, coroner’s reports, medical reports and any other investigative material. All documentation submitted to KIAA in support of a filing/response is required to be shared with the other involved reparation obligor(s).

 

10. What if the accident happens outside of Kentucky?
If two Kentucky residents are involved in an automobile accident outside of Kentucky, or if both parties are under the jurisdiction of the Kentucky Motor Vehicle Reparations Act, the KIAA can hear the arbitration.

 

11. How or when will a hearing be deferred?
A hearing will be deferred when a reparation obligor provides written notice of the existence of pending claims or suits arising out of the same accident, occurrence or insured event, and specifically requests a deferment in writing. Otherwise the matter will proceed to a hearing and the parties will be deemed to have waived any right they may have had to deferment. A party may at any time challenge deferment by providing notice in writing and upon a determination by the Arbitration Panel that good cause for deferment does not or no longer exists, the Association’s Panel Secretary shall schedule a hearing.

Deferment of a hearing does not relieve a respondent reparation obligor from the obligation to file its written answer asserting therein any affirmative defense once the subject case has been removed from a deferred status.

 

12. Can physical damage and/or medical payments claims be heard?
Yes. Arbitration under the Plan applies to controversies arising out of motor vehicle accidents within the jurisdiction of KRS 304 Sub-Title 39. Physical damage and/or medical payments claims may be heard when submitted with the PIP subrogation claim, HOWEVER, the Respondent must agree to arbitration of this portion of the claim. The KIAA cannot hear a file unless PIP is involved.

 

13. Can I include my insured’s deductible in the amount of damages claimed?
No. The Arbitration Plan of Operation is applicable to controversies involving reparation obligors and persons having the rights and obligations of a reparation obligor. The interests of other persons may not be arbitrated under the Plan. The fact that other persons may be insured’s of reparation obligors does not alter this rule.

 

14. What if a court of law or another forum has rendered a decision?
Where there are companion claims arising out of the same accident each of which would be, or is subject to this Plan, only one filing is necessary to determine the issue of liability as to the drivers of the respective vehicles. A decision on the issue is res judicata on the liability issue in all companion matters involving the same reparation obligors under this Plan, except as to special defenses arising in companion claim or suit.

 

15. How is a counterclaim made?
The procedure set out for filing a claim (See #6) is also applicable to counterclaims. The Application should clearly indicate that the filing is being submitted as a counterclaim and the original arbitration case to which it pertains shall be plainly identified. A filing fee is also required with the counterclaim application. Unless a counterclaim is filed by a respondent and heard with the original arbitration case, the respondent with the counterclaim is thereafter precluded from pursuing its claim against the adverse reparation obligor.

 

16. After the hearing is set how long do I have to submit additional evidence?
The Applicant and Respondent(s) shall be notified by the Association of the time and place of a scheduled hearing at least 15 days in advance of the hearing date. Notice of hearing is sent by certified mail, return receipt requested or by priority mail with proof of delivery, to any respondent which has not filed a written answer. If a written response is not received by the Plan 7 days prior to the hearing it will not be considered. Additional documentation by either party must be submitted 7 days prior to the hearing.

 

17. Can either party request a continuance?
Requests for continuances must be received 10 days prior to the scheduled hearing. Continuances may be granted at the sole discretion of the secretary for good cause shown.

 

18. Witnesses or Representation at a hearing?
Upon 10 days notice to the adverse party and the Association witnesses may be present at an Arbitration Hearing. Upon 10 days notice to the adverse party and the Association, parties may be represented at an arbitration hearing by any member of their staffs, an adjuster or by attorneys.

 

19. Is there an offset (deductible)? How do I apply the offset to each injured person? What if one party’s BI limits are exhausted?
No member shall make application for or be entitled to receive, and no arbitration award shall be made for damages paid or payable by the member reparations obligor as basic benefits for the first $1,000 in the aggregate of loss so paid arising from a single occurrence without regard to the number of persons to whom basic or added reparations benefits were paid or payable. (Plan of Operation, Article 4E)

If there are multiple injured parties and the BI limits are paid in full for any one party, the $1,000 offset is absorbed within those limits which are unrecoverable and the remaining amount of PIP is due in full.

When rendering decisions, the $1,000 offset is taken first. Any comparative negligence would then be applied.

Example 1 (no comparative negligence):

  • Aggregate loss is $9,000.
    • Less offset – 1,000.
    • Net loss $ 8,000.

Example 2 (comparative negligence is applied):

  • Aggregate loss is $9,000.
    • Less offset – 1,000.
    • Net loss $ 8,000.
    • Less 30%
    • Negligence – 2,400 (net loss multiplied by the negligence)
    • Award is: $ 5,600 (net loss minus negligence)

 

20. What if the BI limits are exhausted?
KRS 304.39-070 (4): Any entitlement to recovery for basic or added reparation benefits paid or to be paid by the subrogee shall in no event exceed the limits of automobile bodily injury liability coverage available to the secured party after priority of entitlement as provided in this section and KRS 304.39-140(3) has been satisfied.

 

21. How do I appeal a rendered decision?
Decisions of the Arbitrators are final except as otherwise provided in the Plan. (Note: The following is extracted from Article 5, B, 3 of the Plan of Operations): Any member of the Association who makes application for arbitration and any Respondent who agrees to arbitration under this article shall be deemed to have consented to be bound by the decision of the arbitration panel. A decision of an Arbitrator or Arbitration Panel is final and binding with no right of rehearing or appeal.