{"data":{"id":"us-ky/krs-304.39-210","jurisdiction":"us-ky","citation":"KRS 304.39-210","heading":"Obligor's duty to respond to claims.","body":"(1) (a) Basic and added reparation benefits are payable monthly as loss accrues.\n(b) Loss accrues not when injury occurs, but as work loss, replacement services\nloss, or medical expense is incurred.\n(c) Benefits are overdue if not paid within thirty (30) days afte r the reparation\nobligor receives reasonable proof of the fact and amount of loss realized,\nunless the reparation obligor elects to accumulate claims for periods not\nexceeding thirty-one (31) days after the reparation obligor receives reasonable\nproof of t he fact and amount of loss realized, and pays them within fifteen\n(15) days after the period of accumulation.\n(d) Notwithstanding any provision of this chapter to the contrary, benefits are not\noverdue if a reparation obligor has not made payment to a provider of services\ndue to the request of a secured person when the secured person is directing the\npayment of benefits among the different elements of loss.\n(e) If reasonable proof is supplied as to only part of a claim, and the part totals\none hundred dollars ($100) or more, the part is overdue if not paid within the\ntime provided by this section.\n(f) Medical expense benefits may be paid by the reparation obligor directly to\npersons supplying products, services, or accommodations to the claimant, if\nthe claimant so designates.\n(g) A reparation obligor shall not, in any event, pay a charge for a medical\nexpense that exceeds the maximum fee permitted under KRS 304.39 -\n020(5)(a)2.\n(h) 1. Except as provided in subparagraph 2. of this paragraph, a person\nproviding a product, service, or accommodation shall submit a statement\nof the charge for the medical expense within one hundred eighty (180)\ndays of the date the product, service, or accommodation is rendered.\n2. Subparagraph 1. of this paragraph shall not apply to charges submitted\npursuant to KRS 304.39-241.\n(i) A person providing a product, service, or accommodation shall not:\n1. Knowingly collect, attempt to collect, coerce, or attempt to coerce,\ndirectly or in directly, the payment of any charge for a medical expense\ncovered by a reparation obligor that exceeds the maximum fee permitted\nunder KRS 304.39-020(5)(a)2.; or\n2. Cause the credit of any basic or added reparation insured to be impaired\nby reason of the i nsured's failure or refusal to pay the balance of any\ncharge for a medical expense covered by a reparation obligor that\nexceeds the maximum fee permitted under KRS 304.39-020(5)(a)2.\n(2) Overdue payments bear interest at the rate of twelve percent (12%) pe r annum,\nexcept that if delay was without reasonable foundation, the rate of interest shall be\neighteen percent (18%) per annum.\n(3) (a) A claim for basic or added reparation benefits shall be paid without deduction\nfor the benefits which are to be subtrac ted pursuant to the provisions on\ncalculation of net loss if these benefits have not been paid to the claimant\nbefore the reparation benefits are overdue or the claim is paid.\n(b) The reparation obligor is entitled to reimbursement from the person obligate d\nto make the payments or from the claimant who actually receives the\npayments.\n(4) (a) A reparation obligor may bring an action to recover benefits which are not\npayable, but are in fact paid, because of an intentional misrepresentation of a\nmaterial fact, upon which the reparation obligor relies, by the insured or by a\nperson providing an item of medical expense.\n(b) The action may be brought only against the person providing the item of\nmedical expense, unless the insured has intentionally misrepresented  the facts\nor knows of the misrepresentation.\n(c) An insurer may offset amounts he is entitled to recover from the insured under\nthis subsection against any basic or added reparation benefits otherwise due.\n(5) (a) A reparation obligor who rejects a claim for basic reparation benefits shall\ngive to the claimant prompt written notice of the rejection, specifying the\nreason.\n(b) If a claim is rejected for a reason other than that the person is not entitled to\nthe basic reparation benefits claimed, the written  notice shall inform the\nclaimant that he may file his claim with the assigned claims bureau and shall\ngive the name and address of the bureau.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=57856","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:57Z","sha256":"bf15e98b97173762632af8962f7b98db3de36931d39250636eea1e3ba051c387","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.39-200","next":"us-ky/krs-304.39-215"},"notice":"GroundRules: Original legal text. Not legal advice."}