NY Ins L § 5102 (2021)
2021 New York Laws ISC - Insurance Article 51 - Comprehensive Motor Vehicle Insurance Reparations 5102 - Definitions.

§ 5102. Definitions. In this chapter:  (a) "Basic  economic  loss"  means,  up  to fifty thousand dollars per person of the following combined items, subject to  the  limitations  of section five thousand one hundred eight of this article:  (1)  All  necessary  expenses  incurred  for:  (i)  medical,  hospital (including services rendered in compliance with article forty-one of the public health law, whether or not such services are rendered directly by a hospital), surgical, nursing, dental, ambulance,  x-ray,  prescription drug   and  prosthetic  services;  (ii)  psychiatric,  physical  therapy (provided that  treatment  is  rendered  pursuant  to  a  referral)  and occupational  therapy and rehabilitation; (iii) any non-medical remedial care and treatment rendered in accordance with  a  religious  method  of healing  recognized  by  the  laws  of  this  state;  and (iv) any other professional  health  services;  all  without  limitation  as  to  time, provided that within one year after the date of the accident causing the injury  it  is  ascertainable that further expenses may be incurred as a result of the injury. For the  purpose  of  determining  basic  economic loss,  the expenses incurred under this paragraph shall be in accordance with the limitations of section five thousand one hundred eight of  this article.  (2)  Loss  of earnings from work which the person would have performed had he not been injured, and reasonable and necessary expenses  incurred by such person in obtaining services in lieu of those that he would have performed  for income, up to two thousand dollars per month for not more than three years from the date of the accident causing  the  injury.  An employee  who  is  entitled  to  receive  monetary payments, pursuant to statute or  contract  with  the  employer,  or  who  receives  voluntary monetary  benefits paid for by the employer, by reason of the employee's inability to work because of personal injury arising out of the  use  or operation  of  a  motor  vehicle, is not entitled to receive first party benefits for "loss of earnings  from  work"  to  the  extent  that  such monetary  payments  or  benefits  from the employer do not result in the employee  suffering  a  reduction  in  income  or  a  reduction  in  the employee's level of future benefits arising from a subsequent illness or injury.  (3)  All  other  reasonable  and  necessary  expenses  incurred, up to twenty-five dollars per day for not more than one year from the date  of the accident causing the injury.  (4) "Basic  economic  loss"  shall  not  include  any loss incurred on account of death; subject, however, to the provisions of paragraph  four of  subsection  (a)  of  section five thousand one hundred three of this article.  (5) "Basic economic loss" shall also include an additional  option  to purchase,  for an additional premium, an additional twenty-five thousand dollars of coverage which the insured or his  legal  representative  may specify   will   be  applied  to  loss  of  earnings  from  work  and/or psychiatric, physical or occupational therapy and  rehabilitation  after the  initial  fifty  thousand  dollars  of  basic economic loss has been exhausted. This optional additional coverage shall be made available and notice with explanation of such coverage shall be provided by an insurer at the first policy renewal after the effective date of this  paragraph, or at the time of application.  (b) "First  party  benefits"  means payments to reimburse a person for basic economic loss on account of personal injury arising out of the use or operation of a motor vehicle, less:  (1) Twenty percent of lost earnings computed pursuant to paragraph two of subsection (a) of this section.  (2) Amounts recovered or recoverable on account of such  injury  under state  or federal laws providing social security disability benefits, or workers' compensation benefits, or  disability  benefits  under  article nine  of the workers' compensation law, or medicare benefits, other than lifetime  reserve  days  and provided further that the medicare benefits utilized herein do not result in a reduction of such  person's  medicare benefits for a subsequent illness or injury.  (3) Amounts deductible under the applicable insurance policy.  (c) "Non-economic   loss"   means   pain  and  suffering  and  similar non-monetary detriment.  (d) "Serious injury" means a personal injury which results  in  death; dismemberment;  significant  disfigurement; a fracture; loss of a fetus; permanent loss of use of a  body  organ,  member,  function  or  system; permanent  consequential  limitation  of  use of a body organ or member; significant limitation of use  of  a  body  function  or  system;  or  a medically  determined  injury  or  impairment  of a non-permanent nature which prevents the injured person from performing substantially  all  of the  material  acts  which  constitute such person's usual and customary daily activities for not less than ninety days during  the  one  hundred eighty  days  immediately  following  the  occurrence  of  the injury or impairment.  (e) "Owner"  means  an  owner  as  defined  in  section  one   hundred twenty-eight of the vehicle and traffic law.  (f) "Motor  vehicle" means a motor vehicle as defined in section three hundred eleven of the vehicle and traffic law and also includes fire and police vehicles. It shall not include any motor vehicle not required  to carry financial security pursuant to article six, eight or forty-eight-A of the vehicle and traffic law or a motorcycle, as defined in subsection (m) hereof.  (g) "Insurer" means the insurance company or self-insurer, as the case may  be,  which provides the financial security required by article six, eight, or forty-four-B of the vehicle and traffic law.  (h) "Member of his household" means a spouse, child or relative of the named insured who regularly resides in his household.  (i) "Uninsured motor vehicle" means a  motor  vehicle,  the  owner  of which  is  (i)  a  financially  irresponsible  motorist  as  defined  in subsection (j) of section five thousand two hundred two of this  chapter or (ii) unknown and whose identity is unascertainable.  (j) "Covered  person"  means any pedestrian injured through the use or operation of, or any owner, operator or occupant  of,  a  motor  vehicle which  has  in  effect the financial security required by article six or eight of the vehicle  and  traffic  law  or  which  is  referred  to  in subdivision  two of section three hundred twenty-one of such law; or any other person entitled to first party benefits.  (k) "Bus" means both a bus and a school bus as defined in sections one hundred four and one hundred forty-two of the vehicle and traffic law.  (l) "Compensation provider" means the state  insurance  fund,  or  the person,  association, corporation or insurance carrier or statutory fund liable  under  state  or  federal  laws  for  the  payment  of  workers' compensation  benefits  or disability benefits under article nine of the workers' compensation law.  (m) "Motorcycle" means any  motorcycle,  as  defined  in  section  one hundred  twenty-three  of  the  vehicle  and  traffic  law, and which is required to carry financial security pursuant to article six,  eight  or forty-eight-A of the vehicle and traffic law.