Catastrophic Loss Benefits Continuation Fund
The Catastrophic Loss Benefits Continuation Fund (Auto CAT Fund) continues benefits for medical treatment and rehabilitative services previously provided by the Catastrophic Loss Trust Fund. Except for workers' compensation the Auto CAT Fund is the primary payor for eligible claimants and coordinates benefits with health and other insurance carriers. Insurers may confirm whether the Auto CAT Fund is the primary payor on a particular claim by contacting the current third party administrator.
A person who has suffered injuries in a motor vehicle accident may apply for Auto CAT Fund benefits if they meet the following criteria:
- The person was a resident of the Commonwealth of Pennsylvania at the time of the accident.
- The injury arose out of the maintenance or use of a motor vehicle on or after October 1, 1984 but prior to June 1, 1989 and for the vehicle registration year through December 31, 1989. (Accidents occurring between June 1, 1989 and December 31, 1989, benefits are limited to the owner of the vehicle for which the registration fee had been paid.)
- The motor vehicle accident occurred in the United States, its territories or possessions, or Canada.
- The person was not the driver or occupant of a recreational vehicle not intended for highway use, a motorcycle, a motorized pedal cycle, a motor driven cycle, or any vehicle required to be registered under 75 Pa.C.S. (relating to the Vehicle Code) but not subject to the Auto CAT Fund charge.
- As a result of the motor vehicle accident, the person incurred medically necessary and reasonable medical and rehabilitative expenses exceeding $100,000.
- The person's medical and rehabilitative expenses were not covered by workers' compensation.
- The person's medical and rehabilitative expenses were not covered by a policy issued under the Pennsylvania No-fault Motor Vehicle Insurance Act in effect prior to the MVFRL.
- The person complied with the registration requirements of the PA Vehicle Code (Chapter 13) and had paid the applicable CAT Fund charge for vehicle(s) registered in the Commonwealth of Pennsylvania.
When a person has met the eligibility criteria, they are considered to be an "eligible claimant" of the CAT Fund.
Auto CAT Fund benefits are provided to eligible claimants for the payment of medical and rehabilitative services, in excess of $100,000, which are medically necessary, reasonable, and accident related. The claimant must provide proof that the first $100,000 of medical expenses have been paid.
The maximum benefit paid by the Auto CAT Fund on behalf of any one eligible claimant is $50,000 per annual limit year with a $1,000,000 lifetime aggregate. During the first 18 months after the motor vehicle accident, benefits are provided without regard to the $50,000 per annual period limit but subject to the $1,000,000 lifetime aggregate.