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Catastrophic Loss Benefits Continuation Fund

Frequently Asked Questions

Is the CAT Fund still in existence?
CAT Fund benefits are still in existence for those people who were injured in a motor vehicle accident from 10/1/84 through 12/31/89. Certain restrictions apply. 
 
How do I obtain copies of Acts, Laws, and Regulations? 
You may obtain a copy of an Act, Law, or Regulation by contacting the:
Legislative Office
Pennsylvania Insurance Department
(717)783-2005 

The Insurance Department's Administrative Hearings Office also publishes Case Decision Digests that no other publisher or reporting service compiles.  The Decision Digest pertaining to the CAT Fund summarizes CAT Fund cases decided by the Insurance Commissioner.  The digest is a valuable resource for use in connection with administrative hearings or in answering questions about insurance laws and regulations.
 
How is the CAT Fund financed?
The CAT Fund is financed by interest earned on the current Fund.
 
Can I purchase similar CAT Fund coverage now? 
Extraordinary Medical Benefit coverage is optional coverage which can be purchased through your auto insurance carrier. Contact your auto insurance carrier or insurance agent for more information.
 
I paid a surcharge when I received a speeding ticket.  Does that make me eligible for benefits?
No, the surcharge was created to finance the CAT Fund. Per Act 13 of 2002, surcharges levied on motor vehicle violations are no longer remitted to the CAT Fund as of December 31, 2003.
 
How do I apply for CAT Fund benefits?
You or your authorized representative must call the Insurance Department and provide basic information such as, the applicant's full name, current address, phone number, and date of accident  (including month, day and year) in order to process an application for benefits.
 
Is CAT Fund eligibility subject to any monetary limitations?
Yes, no payment shall be made by the CAT Fund for the first $100,000 of medically necessary, reasonable, and accident related expenses for medical treatments and rehabilitation services incurred by an eligible claimant.
The CAT Fund cannot expend more than $50,000 per annual limit year for the covered expenses for medical treatment and rehabilitative services of each claimant.  The annual limit period begins 18 months from the injury date and continues yearly thereafter.
 
CAT Fund benefits are provided for the claimant's lifetime up to $50,000 per annual limit period and $1,000,000 lifetime aggregate.
 
What do the CAT Fund benefits cover? 
Benefits are provided for medical treatment and rehabilitative services that are deemed medically necessary, reasonable, and accident related.
 
Is pre-authorization required for medical treatment and rehabilitative services?  
In most cases CAT Fund claimants are not required to obtain pre-authorization for medical treatment and rehabilitative services.  The CAT Fund's contracted third party administrator (TPA) can assist you with any other specific requests or questions.
 
Who should I contact if I have questions on my benefits or on letters I've received about my medical treatment? 
Contact your adjuster at the current Third Party Administrator:
AmeriHealth Casualty Services Inc. / CAT
PO Box 8861
Camp Hill, PA 17001
 
What if my provider is not sure if the invoice is eligible for CAT Fund benefits?  
All requests and invoices should be forwarded to the CAT Fund's third party administrator to determine if the request or service is medically necessary, reasonable, and accident-related.
 
Can the CAT Fund question prescribed medical treatment and rehabilitative services and if so, why? 
The CAT Fund has the responsibility to ensure that prescribed medical treatment and rehabilitative services are  medically necessary, reasonable, and accident related.
 
Why won't the CAT Fund pay all my doctor bills if I am an eligible Auto CAT Fund claimant?  
The CAT Fund provides benefits only for medical treatment and rehabilitative services that are medically necessary, reasonable, and related to your motor vehicle accident.
 
Why can't I bill my services to Medicare/Medicaid first, so I can conserve my CAT Fund benefits? 
By law, all accident related services must be billed to the CAT Fund as primary.  A secondary carrier may be billed only if the CAT Fund benefits are exhausted for the annual period or life time limit or if services do not meet the criteria of being medically necessary, reasonable, and accident related.
 
Must an CAT Fund claimant incur a yearly deductible? 
A claimant does not have to incur a yearly deductible.
 
What is a third party administrator?
A third party administrator provides claims administration services to the CAT Fund. These services include managed care services, auditing provider services, invoices, and coordination with CAT Fund outside counsel on matters of litigation.