Name*

First Name Last Name

1. When does an insured need to sign the BI/PIP selection form?*

Always Never Sometimes

2. Can an insured opt out of work loss coverage?*

Yes No

3. How many different PIP selections can an insured choose from?*

3 6 4 5

4. What are the three ways an injured person can claim PIP Benefits? (Check all that apply)*

Insurer of Named Insured Insurer of Spouse or Resident-Relative Applies for Benefits through the MCCA Insurer of the Driver of the accident-involved vehicle Insurer of the Owner or Registrant of the accident-involved vehicle

5. What is the lifetime maximum medical expense limit through the Michigan Assigned Claims Program (MACP)?*

$250,000 $500,000 No Limit

6. Can an insured reduce their PIP coverage without a signed selection form?*

Yes No

7. What is covered under Replacement Services?*

8. What additional expenses could an insured incur when choosing their primary health coverage over PIP coverage?*

9. If an insured opts out of PIP coverage, are they still eligible for attendant care coverage?*

Yes, the attendant care is not associated with PIP coverage No Yes, the insured can purchase separately from PIP coverage

8. What is covered under Attendant Care?*

11. Can an insured elect to have a deductible applied to their PIP coverage?*

Yes, with all carriers Yes, with some carriers No

12. What factors can no longer be used when rating an auto policy? (Check all that apply)*

13. What is the MCCA fee when an insured elects less than Unlimited PIP coverage?*

$220 $100 $0 $50

14. An insured has employer-sponsored health coverage that pays secondary for auto accidents and has an annual deductible of $6,500. Does their plan meet the definition of Qualified Health Coverage?*

Yes No

15. Are there taxes/fees associated assessed to the MCCA for those electing Unlimited PIP coverage?*

Yes No

16. Where can one find the needed PIP and BI selection forms? (Check all that apply)*

Carrier Websites (ie. CARA) Kapnick Community Indio Kapnick No-Fault Web Page

17. What is needed when an insured declines umbrella protection?*

Signed Kapnick Declination Form Verbal confirmation insured does not want coverage Email confirmation insured does not want coverage Nothing further is needed

18. Can an insured elect to have their medical insurance pay primary, and their selected $500K PIP limit pay secondary?*

Yes No

19. What is the Kapnick Recommendation to all Personal Insurance Clients?*

20. What PIP coverage applies to Medicaid, and to Medicare?*

Medicaid participants can elect $50K in PIP, and Medicare Part A&B can opt out of PIP Medicare Part A&B participants can elect $50K in PIP, and Medicaid can opt out of PIP Medicaid/Medicare have no impact on PIP coverage

Kapnick No-Fault Certification Knowledge Check