New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter III - Policy and Certificate Provisions
Subchapter B - Property and Casualty Insurance
Part 65 - Regulations Implementing The Comprehensive Motor Vehicle Insurance Reparations Act
Subpart 65-3 - Claims For Personal Injury Protection Benefits
Section 65-3.14 - Scope of coverage
Universal Citation: 11 NY Comp Codes Rules and Regs ยง 65-3.14
Current through Register Vol. 46, No. 39, September 25, 2024
(a) An insurer shall be liable only for the payment of benefits for losses caused by the accident, including those caused by the aggravation of preexisting conditions.
(b) An insurer shall pay benefits to an applicant for losses arising out of an accident in the following situations:
(1) where coverage has
been excluded for an applicant operating a vehicle while in an intoxicated
condition or while the applicant's ability is impaired by the use of a drug, if
such intoxicated or drugged condition was not a contributing cause of the
accident causing the injuries;
(2)
where coverage has been excluded for an applicant operating or occupying a
motor vehicle known to the applicant to be stolen, and the applicant is an
involuntary operator or occupant of said vehicle;
(3) where there is no physical contact
between the applicant and a motor vehicle or motorcycle which is the proximate
cause of the injury;
(4) where the
motor vehicle or motorcycle is used without the specific permission of the
owner, but is not a stolen vehicle; or
(5) where the accident arises out of
repairing, servicing or otherwise maintaining a motor vehicle or a motorcycle,
other than in the course of a business, and for which no charge or fee is
contemplated.
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