# DE Auto Bulletin No. 10: Personal Injury Protection (PIP)

> Delaware · Agency guidance · In force

URL: https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_10_19981015

## Section

- **Citation:** DE Auto Bulletin No. 10
- **Heading:** Personal Injury Protection (PIP)
- **Jurisdiction:** Delaware
- **Kind:** Agency guidance
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Delaware Department of Insurance Bulletins / Personal Injury Protection (PIP)

## Text

AUTO BULLETIN NO. 10
PERSONAL INJURY PROTECTION (“PIP”)
Original No._____
Adopted December 5, 1994
Amended June 12, 1995
Amended October 15, 1998
Legal reference:
Title 21 Delaware Code, Section 2118(a)(2)
Title 18 Delaware Code, Section 2304(16)
It has come to the attention of the Insurance Commissioner that a number of automobile insurers are refusing
to pay Personal Injury Protection (“PIP”) benefits in the amount charged by health care providers as a result of a
determination that the amount charged is not “reasonable” as required by statute.
Under the applicable law, 21 Delaware Code, Section 2118(a)(2), insurers are responsible for paying the
“reasonable and necessary expenses” for PIP coverage. Some insurers are refusing to pay more than a portion of the
medical, hospital, or other professional medical expenses on behalf of their insureds based upon what those carriers
believe are “unreasonable” fees billed.
In interpreting the relevant statute, it is the Commissioner’s opinion that PIP carriers must pay all of an
insured’s PIP costs (less any applicable deductible) if those costs are reasonable and pertain to services that are
necessarily required for the care of the insured. This does not apply when a provider of services and carrier have
previously agreed on a price for a specified service.
If a medical provider has charged in “unreasonable fee” for a necessary treatment, the unreasonableness of
that fee does not render the treatment “unnecessary.” That portion of the fee which is not in dispute shall be paid
according to relevant law. A dispute over the remaining amount of such a fee should remain a dispute between the
carrier and the provider. It is expected that carriers will make good faith efforts to resolve such disputes and not expose
the insured party to harassment or legal action
fee does not render the treatment “unnecessary.” That portion of the fee which is not in dispute shall be paid
according to relevant law. A dispute over the remaining amount of such a fee should remain a dispute between the
carrier and the provider. It is expected that carriers will make good faith efforts to resolve such disputes and not expose
the insured party to harassment or legal action. However, if a claim is made or legal action is filed by the provider
against the insured party for the amount of the fee in dispute, the carrier must provide a defense for its insured against
that claim or legal action.
Under the Delaware Unfair Practice Act, Title 18 Delaware Code, Section 2304(16), it is an unfair trade
practice to attempt with such frequency as to indicate a general business practice to settle a claim for less than the
insurance policy requires. The Department will vigorously enforce the rights of insured to receive the benefits to which
they are contractually entitled. It will be considered a violation of 18 Delaware Code, Section 2304 if a carrier asserts
that the provisions of this bulletin prohibit balance billing.

## Nearby sections

- [DE Auto Bulletin No. 1 Determination of Replacement Value of Automobiles](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_1_20180125.md)
- [DE Auto Bulletin No. 2 Premium Charges for Automobiles Principally Garaged Out-of-State but Registered in Delaware](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_2_19920415.md)
- [DE Auto Bulletin No. 3 Late Issuance of Renewal Policies](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_3_19920415.md)
- [DE Auto Bulletin No. 4 Salvaged or Junked Vehicles](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_4_19920415.md)
- [DE Auto Bulletin No. 5 Minimum Standards for Defensive Driving Course](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_5_19960710.md)
- [DE Auto Bulletin No. 7 Adoption of Section 3915 of Title 18 (refunds on auto-policy cancellations)](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_7_19920415.md)
- [DE Auto Bulletin No. 8 Implementation of Seat Belt Legislation](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_8_19920415.md)
- [DE Auto Bulletin No. 10 Personal Injury Protection (PIP)](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_10_19981015.md)
- [DE Auto Bulletin No. 17 Defensive Driving Course Discount](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_17_20100107.md)
- [DE Auto Bulletin No. 23 Widow’s Penalty – Increased Auto Rates for Widows and Widowers 606](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_23_20151006.md)
- [DE Auto Bulletin No. 24 Liability Carrier’s Obligation to Provide Coverage](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_24_20160308.md)
- [DE Auto Bulletin No. 25 Passage of HB 114 and HB 333](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_25_20180815.md)
- [DE Auto Bulletin No. 27 Notice of Signing of HS1 to HB 80, The Use of Credit Information in Personal Insurance Act, and the Withdrawal of Auto Bulletin No. 23](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_27_20170807.md)
- [DE Auto Bulletin No. 28 Auto Insurance Rate Information Required Annually 606](https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_28_20170915.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/DE_INS_AUTO_10_19981015. Check the current official text before relying on it. Not legal advice.
