2023 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  (provided  that treatment is
rendered pursuant to a referral); (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.