(1) Basic and added reparation benefits are payable monthly as loss accrues. Loss accrues not when injury occurs, but as work loss, replacement services loss, or medical expense is incurred. Benefits are overdue if not paid within thirty (30) days after the reparation obligor receives reasonable proof of the fact and amount of loss realized, unless the reparation obligor elects to accumulate claims for periods not exceeding thirty-one (31) days after the reparation obligor receives reasonable proof of the fact and amount of loss realized, and pays them within fifteen (15) days after the period of accumulation. Notwithstanding any provision of this chapter to the contrary, benefits are not overdue if a reparation obligor has not made payment to a provider of services due to the request of a secured person when the secured person is directing the payment of benefits among the different elements of loss. If reasonable proof is supplied as to only part of a claim, and the part totals one hundred dollars ($100) or more, the part is overdue if not paid within the time provided by this section. Medical expense benefits may be paid by the reparation obligor directly to persons supplying products, services, or accommodations to the claimant, if the claimant so designates.
(2) Overdue payments bear interest at the rate of twelve percent (12%) per annum, except that if delay was without reasonable foundation the rate of interest shall be eighteen percent (18%) per annum.
(3) A claim for basic or added reparation benefits shall be paid without deduction for the benefits which are to be subtracted pursuant to the provisions on calculation of net loss if these benefits have not been paid to the claimant before the reparation benefits are overdue or the claim is paid. The reparation obligor is entitled to reimbursement from the person obligated to make the payments or from the claimant who actually receives the payments.
(4) A reparation obligor may bring an action to recover benefits which are not payable, but are in fact paid, because of an intentional misrepresentation of a material fact, upon which the reparation obligor relies, by the insured or by a person providing an item of medical expense. The action may be brought only against the person providing the item of medical expense, unless the insured has intentionally misrepresented the facts or knows of the misrepresentation. An insurer may offset amounts he is entitled to recover from the insured under this subsection against any basic or added reparation benefits otherwise due.
(5) A reparation obligor who rejects a claim for basic reparation benefits shall give to the claimant prompt written notice of the rejection, specifying the reason. If a claim is rejected for a reason other than that the person is not entitled to the basic reparation benefits claimed, the written notice shall inform the claimant that he may file his claim with the assigned claims bureau and shall give the name and address of the bureau. Effective: July 15, 1998 History: Amended 1998 Ky. Acts ch. 200, sec. 2, effective July 15, 1998. -- Created 1974 Ky. Acts ch. 385, sec. 21, effective July 1, 1975.
Notes of Decisions
Wemyss v. Coleman, 729 S.W.2d 174 (Ky. 1987).
· cites it 6× “The Court of Appeals corrected this error by eliminating the credit for future losses and limiting the credit to accrued medical expenses and lost wages, a proper application of the payment scenario set up by KRS 304.39-210, Obligor's duty to respond to claims, which provides in…”
William C. Eriksen, P.S.C. v. Kentucky Farm Bureau Mut. Ins. Co., 336 S.W.3d 909 (Ky. Ct. App. 2010).
· cites it 10× “In Neurodiagnostics, the issue was whether, under the MVRA, a medical provider has a direct right of action against an insurer for no-fault or personal injury protection payments by assignment from the insured.”
State Auto. Mut. Ins. Co. v. Outlaw, 575 S.W.2d 489 (Ky. Ct. App. 1978).
· cites it 9× “On the merits of the appeals, two issues are raised respecting the application of the MVRA: (1) the extent to which State Auto is subject to penalties under KRS 304.39-210 for delay in paying Outlaw’s claim; and (2) the extent to which State Auto is entitled to deduct benefits…”
Gov't Emps. Ins. Co. v. Sanders, 569 S.W.3d 923 (Mo. Ct. App. 2018).
· cites it 3× “Specifically, KRS 304.39-210(4) provides that if *931 the reparations obligor pays a benefit it was not required to pay due to misrepresentation of a material fact, it may bring an action to recover the improper benefits it has paid.”
Kentucky Farm Bureau Mut. Ins. Co. v. Troxell, 959 S.W.2d 82 (Ky. 1997).
· cites it 4× “Pursuant to KRS 304.39-210(1), to recover benefits for work loss, Troxell was required to provide Farm Bureau with "reasonable proof of the fact and amount of loss realized.”
Bolz v. State Farm Mut. Ins. Co., 52 P.3d 898 (Kan. 2002).
· cites it 2× “The claimant-insured may also assign any right to benefits accruing in the future to the extent the benefits are for the cost of services. UMVARA §§ 23(a), 29(2) (1972); 14 U.”
Ohio Cas. Ins. Co. v. Ruschell, 834 S.W.2d 166 (Ky. 1992).
· cites it 2× “Ruschell also seeks prejudgment interest on overdue payments, costs and attorney fees, under KRS 304.39-210(2) and -220, but there are certain statutory preconditions to this liability yet to be resolved.”
Auto. Club Ins. Co. v. Lainhart, 609 S.W.2d 692 (Ky. Ct. App. 1980).
· cites it 3× “INTEREST AND ATTORNEY’S FEE KRS 304.39-210 reads, in applicable part, as follows: (1) .”
Kentucky Farm Bureau Mut. Ins. Co. v. Roberts ex rel. Roberts, 603 S.W.2d 498 (Ky. Ct. App. 1980).
· cites it 4× “This is an appeal from a judgment for the appellee, plaintiff below, in an action against the appellant, defendant below, for failure to provide basic reparation benefits within the time limitation provided for within KRS 304.39-210(1) and KRS 304.39-280(l)(b).”
— Ky. Rev. Stat. § 304.39-210(1) — 14 cases
Kentucky Farm Bureau Mut. Ins. Co. v. Troxell, 959 S.W.2d 82 (Ky. 1997).
“Pursuant to KRS 304.39-210(1), to recover benefits for work loss, Troxell was required to provide Farm Bureau with "reasonable proof of the fact and amount of loss realized.”
Kentucky Farm Bureau Mut. Ins. Co. v. Roberts ex rel. Roberts, 603 S.W.2d 498 (Ky. Ct. App. 1980).
“This is an appeal from a judgment for the appellee, plaintiff below, in an action against the appellant, defendant below, for failure to provide basic reparation benefits within the time limitation provided for within KRS 304.39-210(1) and KRS 304.39-280(l)(b).”
— Ky. Rev. Stat. § 304.39-210(2) — 17 cases
Ohio Cas. Ins. Co. v. Ruschell, 834 S.W.2d 166 (Ky. 1992).
“Ruschell also seeks prejudgment interest on overdue payments, costs and attorney fees, under KRS 304.39-210(2) and -220, but there are certain statutory preconditions to this liability yet to be resolved.”
State Auto. Mut. Ins. Co. v. Outlaw, 575 S.W.2d 489 (Ky. Ct. App. 1978).
“On the merits of the appeals, two issues are raised respecting the application of the MVRA: (1) the extent to which State Auto is subject to penalties under KRS 304.39-210 for delay in paying Outlaw’s claim; and (2) the extent to which State Auto is entitled to deduct benefits…”
Kentucky Farm Bureau Mut. Ins. Co. v. Roberts ex rel. Roberts, 603 S.W.2d 498 (Ky. Ct. App. 1980).
“This is an appeal from a judgment for the appellee, plaintiff below, in an action against the appellant, defendant below, for failure to provide basic reparation benefits within the time limitation provided for within KRS 304.39-210(1) and KRS 304.39-280(l)(b).”
— Ky. Rev. Stat. § 304.39-210(3) — 4 cases
State Auto. Mut. Ins. Co. v. Outlaw, 575 S.W.2d 489 (Ky. Ct. App. 1978).
“On the merits of the appeals, two issues are raised respecting the application of the MVRA: (1) the extent to which State Auto is subject to penalties under KRS 304.39-210 for delay in paying Outlaw’s claim; and (2) the extent to which State Auto is entitled to deduct benefits…”
— Ky. Rev. Stat. § 304.39-210(4) — 5 cases
Gov't Emps. Ins. Co. v. Sanders, 569 S.W.3d 923 (Mo. Ct. App. 2018).
“Specifically, KRS 304.39-210(4) provides that if *931 the reparations obligor pays a benefit it was not required to pay due to misrepresentation of a material fact, it may bring an action to recover the improper benefits it has paid.”
— Ky. Rev. Stat. § 304.39-210(5) — 1 case
Gov't Emps. Ins. Co. v. Sanders, 569 S.W.3d 923 (Mo. Ct. App. 2018).
“Specifically, KRS 304.39-210(4) provides that if *931 the reparations obligor pays a benefit it was not required to pay due to misrepresentation of a material fact, it may bring an action to recover the improper benefits it has paid.”
— Ky. Rev. Stat. § 304.39-210(l)(2) — 1 case
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