Cure Dprp

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How To Comply with the DPRP Requirements Of Your CURE Policy
The 'Automobile Insurance Cost Reduction Act' was signed into law on May 19, 1998, and it has led to changes in your no-fault (Personal Injury Protection or PIP) medical coverage. In enacting these reforms, the Legislature found that the substantial increase in the cost of medical expense benefits over the years had to be addressed by providing controls to eliminate medically unnecessary treatments, diagnostic testing and use of durable medical equipment. As a result, in accordance with the provisions of your CURE auto policy including its Decision Point Review Plan (DPRP) requirements, you have certain obligations that you must satisfy so that we may provide coverage for medically necessary treatment, diagnostic testing and use of durable medical equipment arising from an automobile accident in which you are injured. See EXHIBIT I for a copy of the DPRP section of your PIP coverage provisions. Failure to comply with the policy requirements as summarized below may affect the reimbursement for medical treatment, diagnostic tests and durable medical equipment. No decision point requirements shall apply within 10 days of the insured event or to treatment administered in emergency care.

YOUR OBLIGATIONS 1. Treatment of "Identified Injuries” 'Pursuant to N.J.A.C. 11:3-4, the New Jersey Department of Banking and Insurance has published standard courses of treatment, called care paths, for injuries of the neck and back, collectively referred to as the identified injuries. A more specific list of identified injuries is provided in EXHIBIT II attached. The care paths provide that treatment of identified injuries must be evaluated at certain intervals called decision points. At decision points, you or your medical provider must provide…...

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