No-Fault Automobile Insurance

Question 0

Motor Vehicle Defined

Answer 0

A vehicle operated on a public highway propelled by any power other than muscular power - except motorcycles.

Does not include
Electric mobility devices driven by disabled person
vehicles that run only on tracks or rails
snowmobiles and atv’s

Question 1

NY No-Fault Insurance in General

Answer 1

An operator or passenger of a vehicle will look first to his own insurance provider to compensate for injuries.

May seek compensation from the other party where losses exceed $50k or include “serious injury”

Question 2

Insurance Coverage

Answer 2

Insurance will cover basic economic loss plus a death benefit of $2k

Covered parties include owner, occupant, operator, and pedestrian injured through the operation of a motor vehicle.

Question 3

Basic Economic Loss

Answer 3

Medical expenses
Lost wages - $2k per month for up to 3 years
Other reasonable expenses up to $25 per day including cabs, parking and tolls for doctor visits.

Up to $50k

Question 4

Medical Expenses under No-fault

Answer 4

Necessary medical expenses for hospital, surgical, nursing, dental, prescriptions and prosthetics
Psychiatric, physical, and occupational therapy and rehab
non-medical remedial care in accordance with a religious method of healing
other health services provided that within one year of the accident it is ascertainable that further expenses from the accident may be accruing.

Question 5

Lost Wages under No-Fault

Answer 5

Reasonable and necessary expenses to obtain services in lieu of those the injured person would have
lost profits, need not be proved with exactitude.
No merely speculative damages are allowed.
Lost wages above $2000 are outside basic economic losses. May seek recovery of these excesses without sustaining serious injury

Question 6

Additional action available under no-fault

Answer 6

P may bring an action against the tortfeasor for recovery of property damages

Question 7

No Recovery for Injured Party for:

Answer 7

1. 1st 20% of the lost earnings
2. amounts paid under SSI, SSD, or medicare
3. Insurance deductibles

Question 8

First Party Benifits

Answer 8

Available to

1. anyone injured by an insured’s motor vehicle who is not the occupant of another motor vehicle or motorcycle.
2. the insured and members of his household
3. An uncovered NY resident injured by the use of an insured motor vehicle outside of NY but within the US.
4. the estate of a covered person not the occupant of another vehicle for a death benefit of $2000 in addition to first party benefits for basic economic loss.

Question 9

Benefit Recovery

Answer 9

To recover 1st party benefits the injury must be produced by “use or operation” of the vehicle
Insurer may refuse to pay first party benefits to an insured who:
1. intentionally caused his own injury; or
2. is injured by
a. driving intoxicated or impaired by drugs
b. committing a felony or avoiding lawful arrest
c. racing
d. operating a vehicle known to be stolen
e. operating an uninsured vehicle
f. as a pedestrian by own vehicle that is not insured
g. while repairing or servicing a motor vehicle in the course of such a business and on business premises.

Question 10

1st Party Payment Requirements

Answer 10

Must be paid within 30 days of the claimant supplying proof of loss.

Question 11

Negligent Operation of a motor vehicle under No-Fault

Answer 11

No recovery for basic economic loss up to $50000

Non-economic loss unless accompanied by a serious injury