“Paper Reviews” by No-Fault Insurers

UPDATE:  In September 2016, the Kentucky Court of Appeals held that PIP insurers cannot deny such benefits based solely on independent medical reviews.  In Houchens v. GEICO (2014-CA-002017), the Court of Appeals reversed a summary judgment in favor of GEICO, which had used “paper reviews” from retained physicians to terminate no-fault benefits for two claimants.  It reasoned that Kentucky law requires insurers to do more before denying such benefits, such as seeking court orders to have the claimants examined by physicians.  However, in April 2017, the Kentucky Supreme Court granted discretionary review of the Court of Appeals’ opinion.  This case bears watching because it may greatly affect how insurers evaluate and handle no-fault claims in Kentucky.