The No-Fault Law, Ins. Law §5101, et seq. and corresponding regulations (11 NYCRR 65-1.1, et seq.) provide for basic personal injury protection (PIP) benefits of $50,000 for reimbursement of covered medical benefits, lost wages and other necessary expenses. An insured may increase PIP coverage and purchase additional benefits above basic economic loss, such as additional personal injury protection coverage (APIP), as provided by 11 NYCRR §65-1.3, and optional basic economic loss coverage (OBEL), as specified in Insurance Law §5102(a)(5).
Ordinarily, the insurance carrier is not required to pay any claims beyond the monetary limits of the policy, and once the policy limits have been exhausted, the insurance carrier’s duties under the insurance contract ceases.1 Policy exhaustion is a coverage defense and, therefore, is not precluded if not raised in a timely denial of claim. Thus, if the insurer pays out the $50,000 (and any increased benefits, as applicable), it may refuse to pay any new claims for no-fault benefits.
This content has been archived. It is available through our partners, LexisNexis® and Bloomberg Law.
To view this content, please continue to their sites.
Not a Lexis Subscriber?
Subscribe Now
Not a Bloomberg Law Subscriber?
Subscribe Now
LexisNexis® and Bloomberg Law are third party online distributors of the broad collection of current and archived versions of ALM's legal news publications. LexisNexis® and Bloomberg Law customers are able to access and use ALM's content, including content from the National Law Journal, The American Lawyer, Legaltech News, The New York Law Journal, and Corporate Counsel, as well as other sources of legal information.
For questions call 1-877-256-2472 or contact us at [email protected]
