NYCRR Part 65 - Insurance Regulation 68: Regulations ...

1 65 ( Regulation 68) Regulations IMPLEMENTING THE COMPREHENSIVE MOTOR VEHICLE Insurance REPARATIONS ACT Editor s Note: The former No-Fault Regulation was repealed effective April 5, 2002. It is therefore no longer included in the offcial New York Codes, Rules and Regulations . However, because there may still be claims or claim procedures which remain covered by the old Regulation , the New York State Insurance Depart-ment is making a copy of this Regulation available for histori-cal reference at the Insurance Department s website at http:// Questions as to whether specifc claims and claims procedures are subject to the old or new No-Fault Regulations are clarifed under the FAQ section for No-Fault at (Statutory authority.)

2 Insurance Law, 201, 301, 2307, 2601, 5103, 5106, 5109, 5221, arts. 4, 51; Vehicle and Traffc Law, 2407; Financial Services Law, 202, arts. 3, 4) Historical Note Part ( ) fled Oct. 3, 1973; amd. fled Aug. 30, 1985 eff. Sept. 1, 1985. Amended Part title and statutory authority. Part 65 fled Oct. 18, 1999, declared invalid, null and void on June 9, 2000 in Medical Society of New York v. Neil D. Levin as Superintendent of Insurance , 712 NY2d 745 (Supreme Court, New York County).

3 Amendments to such Part fled Jan. 31, 2000 as emergency measure eff. Jan. 31, 2000; fled April 26, 2000 as emergency measure eff. Jan. 31, 2000; fled July 24, 2000 as emergency measure eff. July 24, 2000; fled Oct. 19, 2000 as emergency measure eff. Oct. 19, 2000; amd. fled Jan. 8, 2001 as emergency measure eff. Jan. 8, 2001, invalid, null and void by operation of Medical Society of New York, Id. Former Part 65 as extant prior to Nov. 1, 1999, continued effective from Oct.

4 31, 1999; Part (Regula-tions Implementing the Comprehensive Motor Vehicle Insurance Reparations Act, ) repealed, new (Subparts 65-1 65-4) fled Aug. 2, 2001 eff. Sept. 1, 2001. Effective-ness stayed Aug. 29, 2001; stay overruled April 4, 2002, Part effective April 5, 2002. SUBPART 65-1 ( Regulation 68-A) PRESCRIBED POLICY ENDORSEMENTS Historical Note Subpart ( ) fled Aug. 2, 2001 eff. Sept. 1, 2001. Requirements for minimum beneft Insurance policies for personal injuries.

5 (a) Every owner s policy of liability Insurance issued in satisfaction of the minimum require-ments of article 6 or 8 of the Vehicle and Traffc Law and article 51 of the Insurance Law and every policy issued in satisfaction of the minimum requirements of article 44-B of the Vehicle and Traffc Law shall contain provisions providing minimum frst-party benefts equal to those set out below in the mandatory personal injury protection endorsement (New York), or manda-tory personal injury protection endorsement - motorcycles (New York), respectively.

6 (b) An insurer shall provide the appropriate endorsement to be used with a policy. The Manda-tory Personal Injury Protection Endorsement (New York) and the Mandatory Personal Injury Protection Endorsement - Motorcycles (New York) set out below are approved and promulgated for use by an insurer. Except as provided in subdivision (c) of this section and section of this Subpart, an insurer shall provide: (1) the Mandatory Personal Injury Protection Endorsement (New York) to every insured with respect to a policy issued, renewed, modifed, altered or amended on or after January 26, 2011; or (2) the Mandatory Personal Injury Protection Endorsement - Motorcycles (New York) to every insured with respect to a motorcycle policy issued or renewed.

7 --1 (c) The mandatory personal injury protection endorsement - all-terrain vehicles (New York), set out below is approved and promulgated for use by an insurer and, except as provided in sec-tion of this Subpart, must be issued with every liability policy covering an all-terrain vehi-cle as required by section 2407 of article 48-C of the New York Vehicle and Traffc Law and Subpart 64-2 of this Title and must be: (1) furnished to all new insureds with policies effective on and after September 1, 2001; and (2) enclosed with the frst renewal policies renewed on and after September 1, 2001.

8 (d) Mandatory personal injury protection endorsement. MANDATORY PERSONAL INJURY PROTECTION ENDORSEMENT (New York) The Company agrees with the named insured, as follows: Section I Mandatory Personal Injury Protection The company will pay frst-party benefts to reimburse for basic economic loss sustained by an eligible injured person on account of personal injuries caused by an accident arising out of the use or operation of a motor vehicle or a motorcycle during the policy period and within the United States of America, its territories or possessions, or First-Party Benefts First-party benefts, other than death benefts.

9 Are payments equal to basic economic loss, reduced by the following: (a) 20 percent of the eligible injured person s loss of earnings from work to the extent that an eligible injured person s basic economic loss consists of such loss of earnings; (b) amounts recovered or recoverable on account of personal injury to an eligible injured person under State or Federal laws providing social security disability or workers compensation benefts, or disability benefts under article 9 of the New York Workers Compensation Law.

10 (c) the amount of any applicable deductible, provided that such deductible shall apply to each accident, but only to the total of frst-party benefts otherwise payable to the named insured and any relative as a result of that accident. Basic Economic Loss Basic economic loss shall consist of medical expense, work loss, other expense and, when death occurs, a death beneft as herein provided. Except for such death beneft, basic economic loss shall not include any loss sustained on account of death.