New Jersey Automobile Recommendation

New Jersey private passenger automobile insureds who have Personal Injury Protection (PIP) coverage have the option to purchase one of the following Added Personal Injury Protection packages. Simply check the appropriate box(es) below and return this form to us.

The benefits indicated under each option for income and essential services are the aggregate of the Basic and Added PIP benefits. The benefits are maximum benefits on a per person, per accident basis, rather than a per year basis. All of the options include a $2,000 maximum funeral expense benefit and $10,000 death benefit.

Please call to obtain any additional coverage information you may need.


(1) Two-Year Benefits: Income Continuation/Survivor and Essential Services Benefits


                   Income/Survivor        |       Essential Services       
A               B              C               D        

Option          Weekly          Total         Per Day          Total      

   1             $100          $10,400          $12            $8,760      

   2             $125          $13,000          $20           $14,600     

   3             $175          $18,200          $20           $14,600     

   4             $250          $26,000          $20           $14,600     

   5             $400          $41,600          $20           $14,600     

   6             $500          $52,000          $20           $14,600     

   7             $600          $62,400          $20           $14,600     

   8             $700          $72,800          $20           $14,600

(2) Extended Income Continuation Benefits: Two-Year Survivor and Essential Services Benefits


                    Income            |            Essential Services          

  A            B              C            D      
Option        Weekly         Total        Daily       Total    

   9           $100        Unlimited       $12        $8,760    

  10           $125        Unlimited       $20       $14,600   

  11           $175        Unlimited       $20       $14,600   

  12           $250        Unlimited       $20       $14,600   

  13           $400        Unlimited       $20       $14,600   

  14           $500        Unlimited       $20       $14,600   

  15           $600        Unlimited       $20       $14,600   

  16           $700        Unlimited       $20       $14,600

(3) Approximate Additional Annual Costs

Please note the approximate additional annual cost of each of the following options:

Option 6 — $7.00 per private passenger vehicle

Option 7 — $11.00 per private passenger vehicle

Option 14 — $54.00 per private passenger vehicle

Option 15 — $69.00 per private passenger vehicle

Option 16 — $82.00 per private passenger vehicle

Also note that resident relatives can be added if named, at an additional annual cost of $8.00.