New York Automobile Recommendation

New York 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 ServicesBenefits


              Income                    Essential Services 
             A      B                             C        D
                                       Maximum
                                       Survivor   Per
          Option   Weekly   Total      Benefits   Day    Total 
          9 { }    $100   Unlimited    $10,400    $12    $ 8,760
         10 { }    $125   Unlimited    $13,000    $20    $14,600
         11 { }    $175   Unlimited    $18,200    $20    $14,600
         12 { }    $250   Unlimited    $26,000    $20    $14,600
         13 { }    $400   Unlimited    $41,600    $20    $14,600
         14 { }    $500   Unlimited    $52,000    $20    $14,600
         15 { }    $600   Unlimited    $62,400    $20    $14,600
         16 { }    $700   Unlimited    $72,800    $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.