Personal Injury Protection—Kansas—Archived Article

February, 1996

Personal Auto No-Fault Endorsement

Summary: The Kansas automobile injury reparations act requires the owner of every self-propelled vehicle that must be registered in the state (including trailers, semi-trailers, and pole trailers designed to be used with such vehicles) to provide no-fault coverage on the vehicle. Personal injury protection endorsement PP 05 64 provides the prescribed coverage on vehicles insured under the personal auto policy. This article discusses the endorsement, its offered benefits and exclusions.

Who Is Insured

PP 05 64, the personal injury protection coverage endorsement for Kansas, offers basic personal injury protection benefits to or for an insured who sustains bodily injury (the bodily injury must be caused by an accident arising out of the ownership, operation, maintenance, or use of a motor vehicle). The term “insured” includes the named insured or any family member (a spouse or any other person related to the named insured by blood, marriage, or adoption, including wards and foster children, and who is a resident of the named insured's household or usually resides there but temporarily lives elsewhere) who sustains injury while occupying any motor vehicle, or who sustains injury through direct physical contact with, while not occupying, any motor vehicle. The term also includes any other person who sustains bodily injury while occupying the named insured's covered auto or who is injured through direct physical contact with such an auto while not occupying any motor vehicle.

Exclusions

Coverage with respect to the named insured and family members does not apply while occupying any motor vehicle, other than the named insured's “covered auto”, that is owned by the named insured. Note that a “covered auto” means a motor vehicle owned by the named insured to which the bodily injury liability coverage of the policy applies and for which a specific premium is charged, and for which the security required under the Kansas reparations act is maintained. Persons other than the named insured who themselves own vehicles on which Kansas no-fault insurance is required are not covered under the named insured's policy. Nor is there coverage for anyone other than the named insured injured while occupying or when struck by a motor vehicle—other than the named insured's covered auto—on which Kansas no-fault insurance is required. And coverage on any person, other than the named insured or any family member, does not apply when the person is neither a resident of Kansas nor occupying the named insured's covered auto.

Injury sustained as a result of conduct in the course of a motor vehicle repair, servicing, or maintenance business is not covered if it occurs on the business premises. Nor is injury in connection with the loading or unloading of a motor vehicle covered unless the injured person is occupying the vehicle when the injury occurs. Intentionally self-caused injury is excluded, as is injury suffered by an intentional converter of a motor vehicle. Finally, the coverage does not apply to bodily injury sustained by any person operating the named insured's covered auto without the named insured's express or implied consent.

Benefits

The insuring agreement of PP 05 64 offers the following benefits to an injured insured.

The benefit of medical expenses is offered and this consists of all reasonable expenses incurred for necessary medical, psychological, dental, ambulance, hospital, and nursing services; prosthetic devices are also included. Medical expenses include services recognized and permitted under Kansas laws for an insured who relies upon spiritual means through prayer alone for healing in accordance with that insured's religious beliefs. However, medical expenses do not include rehabilitation expenses. The limit of liability is $4,500 per person.

Rehabilitation expenses are offered separately from medical expenses. This benefit consists of the reasonable expense of necessary psychiatric services, occupational therapy, and occupational training and retraining to enable the injured person to obtain suitable employment. The limit of liability under this particular benefit is $4,500 per person.

Work loss benefits, which compensate the insured for loss during the insured's lifetime of monthly earnings due to inability to engage in “available and appropriate gainful activity”, are payable up to $900 per month. However, work loss is only paid for a period of no more than one year after the inability to work begins. The work loss is equal to 100 percent of monthly earnings; note however, if work loss is not included in gross income for federal income tax purposes, work loss shall be limited to 85 percent of monthly earnings.

Essential services are paid at the rate of $25 per day for a maximum of 365 days. This benefit includes the appropriate and reasonable costs of obtaining ordinary and necessary services as replacement for those an insured would have performed for his or his family's benefit.

Funeral expenses are covered for an amount of $2,000 per person and this includes burial or cremation.

A survivors' loss benefit is also offered. Total allowances to all survivors for loss, after an insured's death, of that insured's monthly earnings are included in this benefit as well as allowances for essential services incurred after an insured's death (reduced to whatever degree the death of the insured makes such expense unnecessary). These benefits are payable subject to the same limits (combined) that govern work loss and essential services expenses—up to $900 per month and $25 per day respectively. If the schedule or declarations on the endorsement indicates that basic personal injury protection benefits apply, survivors' loss shall be paid for a period of not longer than one year after the date of the insured's death; if the deceased received work loss payments before he or she died, the number of months for which such payments were made is subtracted from the survivors' loss benefit period.

Other Information

No-fault benefits are reduced by amounts payable under any workers compensation law, but are primary in relation to any available medical payments coverage. When more than one insurer is liable for no-fault payments because of a single injury, the injured person may not recover benefits in an amount greater than the highest limit of any applicable policy. Priority of payment among multiple policies is prescribed in endorsement PP 05 64 as follows: (1) the policy insuring any motor vehicle owned by the insured; (2) the policy insuring the motor vehicle that struck the insured or that the insured was occupying at the time of the accident; (3) the policy providing coverage for the named insured's covered auto for bodily injury sustained by any family member who was occupying or struck by a motor vehicle outside the state of Kansas and who is not a named insured under another policy.

Kansas personal injury protection benefits may be increased, with respect to the named insured and family members only, by indicating on PP 05 64 that this course has been chosen. Higher benefit levels may be scheduled for each of the six benefit categories. For work loss benefits, both the $900 monthly limit and the one year benefit period may be increased; the $25 per day limit for essential services expenses may not be increased, but the 365 day benefit period may be expanded.

Definitions

There are some terms used throughout the endorsement that are defined terms. “Monthly earnings” means with respect to an insured who is regularly employed or self-employed, one-twelfth of that insured's annual earnings at the time bodily injury is sustained; if the insured is not employed, the amount is one-twelfth of the anticipated annual earnings from the time the insured would reasonably have expected to be regularly employed.

“Motor vehicle” means a self-propelled vehicle of a kind required to be registered in Kansas, but does not include a motorized bicycle.

“Survivor” means a deceased insured's spouse or child under the age of eighteen years. The insured's death must have resulted from bodily injury sustained in the auto accident.

The policy territory under this endorsement is Kansas and, with respect to the named insured and any family member while occupying or when struck by any motor vehicle, the United States and its territories and possessions and Canada.

Tort Liability

Under the Kansas automobile injury reparations act, damages in tort for pain and suffering and other noneconomic loss may be recovered only when the injury results in medical expenses with a reasonable value of at least $2,000, or in the case of permanent disfigurement, injury, or loss of a body function; compound, comminuted, displaced, or compressed fracture, or a fracture of a weight-bearing bone; the loss of a body member; or death.