NY Ins L § 5103 (2021)
2021 New York Laws ISC - Insurance Article 51 - Comprehensive Motor Vehicle Insurance Reparations 5103 - Entitlement to First Party Benefits; Additional Financial Security Required.

§  5103.  Entitlement  to  first  party benefits; additional financial security required. (a)  Every  owner's  policy  of  liability  insurance issued on a motor vehicle in satisfaction of the requirements of article six  or  eight  of  the  vehicle and traffic law shall also provide for; every owner who maintains another form of financial security on a  motor vehicle  in  satisfaction  of the requirements of such articles shall be liable for; and every owner of a motor vehicle required to be subject to the provisions of this article  by  subdivision  two  of  section  three hundred  twenty-one  of the vehicle and traffic law shall be liable for; the payment of first party benefits to:  (1) Persons, other than  occupants  of  another  motor  vehicle  or  a motorcycle,  for  loss arising out of the use or operation in this state of such motor vehicle. In the case of occupants  of  a  bus  other  than operators,  owners,  and  employees of the owner or operator of the bus, the coverage for first party benefits shall be afforded under the policy or policies, if any, providing  first  party  benefits  to  the  injured person  and  members of his household for loss arising out of the use or operation of any motor vehicle of such household. In the event there  is no such policy, first party benefits shall be provided by the insurer of such bus.  (2)  The  named  insured  and  members  of  his  household, other than occupants of a motorcycle, for loss arising out of the use or  operation of  (i)  an  uninsured  motor  vehicle  or motorcycle, within the United States, its territories or possessions, or Canada; and (ii)  an  insured motor  vehicle or motorcycle outside of this state and within the United States, its territories or possessions, or Canada.  (3) Any New York resident who is neither the owner of a motor  vehicle with  respect  to which coverage for first party benefits is required by this article nor, as a member of a household, is entitled to first party benefits under paragraph two of this subsection, for loss arising out of the use or operation  of  the  insured  or  self-insured  motor  vehicle outside  of  this state and within the United States, its territories or possessions, or Canada.  (4) The estate of any  covered  person,  other  than  an  occupant  of another  motor vehicle or a motorcycle, a death benefit in the amount of two thousand dollars for the death of such person arising out of the use or operation of such motor vehicle which is in  addition  to  any  first party benefits for basic economic loss.  (b)  An  insurer  may exclude from coverage required by subsection (a) hereof a person who:  (1) Intentionally causes his own injury.  (2) Is injured as a result of operating a motor vehicle  while  in  an intoxicated  condition  or  while his ability to operate such vehicle is impaired by the use of a drug  within  the  meaning  of  section  eleven hundred  ninety-two  of  the vehicle and traffic law; provided, however, that an insurer shall not exclude such person from coverage with respect to necessary emergency health services rendered in a  general  hospital, as  defined in subdivision ten of section two thousand eight hundred one of the public health law, including ambulance services attendant thereto and related medical screening. Notwithstanding any other law, where  the covered  person  is  found  to  have  violated  section  eleven  hundred ninety-two of the vehicle and traffic law, the insurer has  a  cause  of action  for the amount of first party benefits paid or payable on behalf of such covered person against such covered person.  (3) Is injured  while  he  is:  (i)  committing  an  act  which  would constitute  a  felony, or seeking to avoid lawful apprehension or arrest by a law enforcement officer, or (ii) operating a  motor  vehicle  in  a race  or  speed  test,  or  (iii) operating or occupying a motor vehicle  known to him to be stolen, or (iv)  operating  or  occupying  any  motor vehicle  owned by such injured person with respect to which the coverage required by subsection (a) hereof is not in effect, or (v) a pedestrian, through  being  struck  by  any  motor  vehicle  owned  by  such injured pedestrian with respect to which the coverage required by subsection (a) hereof is not in effect,  or  (vi)  repairing,  servicing  or  otherwise maintaining  a  motor  vehicle if such conduct is within the course of a business of  repairing,  servicing  or  otherwise  maintaining  a  motor vehicle and the injury occurs on the business premises.  (4)  Is  injured  while a motor vehicle is being used or operated by a TNC driver pursuant to article forty-four-B of the vehicle  and  traffic law, provided, however, that only the insurer issuing the owner's policy of  liability  insurance  providing coverage for the motor vehicle being operated by a TNC driver may exclude such coverage and  an  insurer  may not  include this exclusion in a policy used to satisfy the requirements under article forty-four-B of the vehicle and traffic law.  (c) Insurance offered by any company to satisfy  the  requirements  of subsection (a) hereof shall be offered (i) without a deductible and (ii) with  a family deductible of up to two hundred dollars (which deductible shall apply only to the loss of the named insured  and  members  of  his household).  The  superintendent  may approve a higher deductible in the case of insurance policies providing additional benefits or pursuant  to a  plan designed and implemented to coordinate first party benefits with other benefits.  (d) Insurance policy forms for insurance to satisfy  the  requirements of  subsection  (a)  hereof  shall  be  subject  to approval pursuant to article twenty-three of this chapter. Minimum benefit standards for such policies and for self-insurers, and rights of  subrogation,  examination and  other  such matters, shall be established by regulation pursuant to section three hundred one of this chapter.  (e) Every owner's policy of liability insurance issued in satisfaction of article six or eight of  the  vehicle  and  traffic  law  shall  also provide, when a motor vehicle covered by such policy is used or operated in  any  other state or in any Canadian province, insurance coverage for such motor vehicle at least in the minimum amount required by  the  laws of that state or province.  (f) Every owner's policy of liability insurance issued on a motorcycle or an all terrain vehicle in satisfaction of the requirements of article six  or  eight  of  the  vehicle  and traffic law or section twenty-four hundred seven of such law  shall  also  provide  for;  every  owner  who maintains  another  form of financial security on a motorcycle or an all terrain vehicle in satisfaction of the requirements of such articles  or section  shall  be liable for; and every owner of a motorcycle or an all terrain vehicle required to be subject to the provisions of this article by subdivision two of section three hundred twenty-one of such law shall be liable for; the payment of first party  benefits  to  persons,  other than  the  occupants  of such motorcycle or all terrain vehicle, another motorcycle or all terrain  vehicle,  or  any  motor  vehicle,  for  loss arising  out  of  the  use or operation of the motorcycle or all terrain vehicle within this state. Every insurer and  self-insurer  may  exclude from the coverage required by this subsection a person who intentionally causes  his own injury or is injured while committing an act which would constitute a felony or while seeking to  avoid  lawful  apprehension  or arrest by a law enforcement officer.  (g)  A  company  authorized  to  provide  the  insurance  specified in paragraph three of subsection (a) of section one  thousand  one  hundred thirteen  of this chapter or a corporation organized pursuant to article forty-three of this chapter  may,  individually  or  jointly,  with  the  approval  of  the  superintendent  upon  a  showing  that the company or corporation is qualified to provide  for  all  of  the  items  of  basic economic  loss  specified  in paragraph one of subsection (a) of section five thousand one hundred two of this article, provide coverage for such items  of  basic  economic  loss  to the extent that an insurer would be required to provide under this article. Where a policyholder  elects  to be  covered under such an arrangement the insurer providing coverage for the automobile shall be furnished with the names of all persons  covered by  the  company  or  corporation under the arrangement and such persons shall not be entitled to benefits for any of the items of basic economic loss specified  in  such  paragraph.  The  premium  for  the  automobile insurance   policy   shall  be  appropriately  reduced  to  reflect  the elimination of coverage for such items of basic economic loss.  Coverage by  the automobile insurer of such eliminated items shall be effected or restored upon request by the insured and payment of the premium for such coverage. All companies and corporations providing coverage for items of basic economic loss pursuant to the  authorization  of  this  subsection shall  have only those rights and obligations which are applicable to an insurer subject to this article.  (h) Any policy of insurance obtained to satisfy the financial security requirements of article six or eight of  the  vehicle  and  traffic  law which  does  not  contain  provisions complying with the requirements of this article, shall be construed as if  such  provisions  were  embodied therein.