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Flashcards in No-Fault Insurance Deck (12)
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1

What is New York No-Fault Automobile Insurance?

  • an operator or a passenger of a motor vehicle look tot heir own insurance provided 1st for compensation for their injuries
  • Only seek compensation from other pty when:
    • losses are greater than $50K OR
    • a "serious injury"

2

What is the motor vehicle insurance requirements?

Owner w/a registered vehicle in NY is required to carry liability insurance in specific amounts particularly

  • $50K for injuries sustained by passengers ^ pedestrians
  • $50K for death of one person in oe accident
  • $50K  for bodily injury to 2 or more persons in one accident
  • $25K for bodily injury to one person in one accident
  • $100K death of 2 or more persons in one accident AND
  • $10K for injury to or destruction of property in any one accident

3

What is considered a motor vehicle?

  • It is a vehicle operated or driven on a public highway
  • that is propelled by any power other than muscular power
  • INCLUDES - steering a car w/a disabled battery
  • EXCLUDED as motor vehicles:
    • motorcycles
    • electricially driven mobility devices operated by a disabled individual
    • vehicles that only runs on rails or tracks
    • snowmobiles
    • ATVs

4

What is the motor vehicle financial security act?

Recovery from Insurance Co. 1st

  • Basic economic loss up to $50K
    • Med exp + lost wages + reasonable & nec. exp.
  • $2K death benefits

Economic loss exceed $50K or "serious injury"

  • collect tortfeasor
  • can bring an action against tortfeasor for property loss

 

5

What & who is covered under no-fault insurance?

  • A person involved in a motor veh accident is covered by his own ins. for:
    • basic economic loss +
    • death benefits of $2K
  • Covered pty inculde:
    • owner, operator or occupant of the motor vehicle while having the required insurance
    • pedestrians injured through operation of the motor vehicle

6

What basic economic loss are covered?

  • Basic economic loss is up to $50K/person including:
    • medical expenses
    • lost wages up to $2K/mth for 3 yrs from the date on injury AND
    • other reasonable & necessary expenses up to $25/day for up to a yr from the date of injury
      • cabs, parking, tolls

7

What is included under medical expenses?

  • nec. exp. for medicial, hospital, surgical, nursing, dental, ambulance, xray, prescriptions & prosthetics
  • psychatric, physical, occupational therapy & rehabilitation
  • non-medical remedial care in according w/religous method of healing
  • other health services if determined that w/in one yr of accident future med exp needed

8

What is include in lost wages?

Up to $2K/mth for 3 years from date of injry:

  • reasonable & nec. exp to obtain service in lieu of the injuries
  • lost profits
  • no double dipping if you also get from employer
  • if lost wages is over $2K/mrh but less than the $50K, inddividual can seek compensation outside his own insurance provider even if not a "serious injury"

9

What does the injured person not recover for?

  • the first 20% of lost wages
  • the amounts paid under SS, disability benefits or Medicare AND
  • insurance policy deductibles

10

When are first pty benefits available?

  1. anyone injured by the operation of the insured’s motor vehicle who is not the occupant of another motor vehicle or motorcycle;
  2. the insured and members of his household, including spouse, children, or relatives;
  3. a New york resident who is not covered (because he neither owns a motor vehicle nor is a household member of a motor vehicle owner) who is injured by the use or operation of the insured motor vehicle outside of New york and within the United States; and
  4. the estate of a covered person who is not the occupant of another motor vehicle for a death benefit of $2,000 in addition to first-party benefits for basic economic loss. 

11

When may a insurer refuse to pay first pty benefits?

If the insured:

  • intentionally caused his own injury
  • insured is injured by
    • operating notor veh under influence of drug or alcohol
    • committing a felony or avoiding unlawful arrest
    • racing
    • operating a known stolen veh
    • operating/occupying a veh in which ins. not in effect
    • pedestrian hit by his own veh where no ins. in effect
    • repairing/servicing veh in course of bus. while on bus premise

12

What constitutes a serious injury?

  • death
  • dismemberment
  • significant disfigurement
  • non-permanent injury that prevents the injured from forming substantially all of the material acts which constitute such person's usual & customary daily activities for a period of 3 months
  • loss of fetus
  • fracture