Arkansas Claims Dispute & Statutory Guide
Arkansas operates an At-Fault automobile insurance framework under Ark. Code Ann. § 23-89-202 et seq. Automobile liability insurers must provide first-party medical benefits of at least $5,000 unless rejected in writing. Unpaid claims must be settled under prompt-pay rules carrying a 12% statutory penalty under § 23-89-208, and providers utilize statutory medical liens under Ark. Code Ann. § 18-46-101.
Statutory Framework & Jurisdiction
Add-On PIP (Mandatory First-Party Benefits Offering under Ark. Code Ann. § 23-89-202)
Arkansas combines traditional tort liability with mandatory first-party benefits coverage. Auto insurers must include medical and hospital benefits of at least $5,000 per person in every policy unless the named insured rejects coverage in writing. When bills exceed first-party coverage or when asserting claims against third-party liability insurers, healthcare providers enforce statutory liens on tort recoveries pursuant to the Arkansas Medical, Nursing, Hospital, and Ambulance Service Lien Act.
PIP / MedPay Coverage & Medical Fee Rules
mandatory First Party Coverage
$5,000 statutory minimum per person for reasonable and necessary medical, surgical, X-ray, dental, and hospital expenses incurred within 24 months of the accident (Ark. Code Ann. § 23-89-202(1))
disability And Death
70% of lost weekly wages up to $140 per week for up to 52 weeks, and $5,000 in accidental death benefits
written Rejection Required
Coverage is mandatory unless rejected in writing by the named insured (Ark. Code Ann. § 23-89-203)
assignment Of Benefits
Healthcare providers routinely accept patient assignments of first-party benefits for direct billing
Official Medical Fee Schedule & Reimbursement Standards
name
Reasonable and Customary Fee Standard
rules
Arkansas does not maintain a statutory fee schedule table for motor vehicle accident medical bills. Providers bill based on reasonable charges customary in the community for similar medical services.
cpt Basis
CPT/HCPCS itemized coding on standard CMS-1500 or UB-04 billing claims
Preauthorization & Decision Point Review
requirement
Preauthorization is not required by statute for emergency medical treatment. Insurers may review subsequent treatment plans, advanced imaging, and elective surgical procedures for clinical necessity.
independent Medical Review
Insurers may request medical records or an independent physician examination to evaluate whether continuing treatments are causally related to the motor vehicle accident.
Administrative Appeals & Dispute Mechanism
thirty Day Prompt Payment
Under Ark. Code Ann. § 23-89-208, benefits become overdue if not paid within 30 days after the insurer receives reasonable proof of claim and the fact and amount of loss. Overdue benefits bear interest at 6% per annum.
twelve Percent Penalty And Attorney Fees
If the insurer fails to pay benefits within 45 days after demand without reasonable cause, the insurer is liable for a statutory 12% penalty plus reasonable attorney fees and costs under Ark. Code Ann. § 23-89-208(f).
medical Lien Statute
Under Ark. Code Ann. § 18-46-101 et seq., physicians, hospitals, and ambulance services have a statutory lien upon claims and verdicts of injured patients. Notice of the lien must be served on the patient and tortfeasor/insurer and recorded with the circuit clerk of the county where services were rendered.
Critical Statutory & Dispute Deadlines
| Dispute Phase / Trigger Event | Statutory Timeline / Deadline |
|---|---|
| Accident Notice | Notice to insurer as soon as reasonably practicable |
| Treatment Window | Medical expenses incurred within 24 months of accident date (Ark. Code Ann. § 23-89-202) |
| Carrier 30-Day Pay Window | 30 calendar days from receipt of proof of claim (Ark. Code Ann. § 23-89-208) |
| Demand Letter / 45-Day Penalty Trigger | 45 calendar days from formal written demand before 12% penalty attaches |
| Medical Lien Recording | Notice served and recorded prior to payment of tort settlement or judgment |
| Statute of Limitations | 3 years from accident date for personal injury tort claims (Ark. Code Ann. § 16-56-105); 5 years for written contract actions |
Required Evidentiary Filing Checklist
- ✓Arkansas First-Party Benefits Claim Application
- ✓Executed Assignment of Benefits (AOB) and medical records authorization
- ✓Itemized CMS-1500 or UB-04 billing form with CPT/HCPCS and ICD-10 diagnostic codes
- ✓Contemporaneous medical records, emergency department charting, and diagnostic imaging reports
- ✓Notice of Medical Lien with circuit clerk recording verification (for lien claims under Ark. Code Ann. § 18-46-105)
- ✓Proof of certified mail transmission of claim and statutory demand letter
Official Primary Sources & Legislative Authorities
Governing Regulatory Authorities
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