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 65-3.12 - Sources of mandatory personal injury protection benefits

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
					 Institution of claims for first-party benefits-priority.
(1) Subject to paragraph (9) of this subdivision, an applicant who
					 is an operator or occupant of an insured motor vehicle, or any other person,
					 not occupying another motor vehicle or a motorcycle, who sustains a personal
					 injury arising out of the use or operation in New York State of such motor
					 vehicle, shall institute the claim against the insurer of such motor
					 vehicle.
(2) An applicant who is
					 neither an operator nor an occupant of a motor vehicle or a motorcycle, and who
					 sustains a personal injury arising out of the use or operation in New York
					 State of more than one insured motor vehicle or insured motorcycle shall
					 institute the claim against the insurer of any one of such motor vehicles or
					 motorcycles unless the insurers agree among themselves that one of them will
					 accept and pay the claim initially.
(3) An applicant who is a named insured or a
					 relative of a named insured, other than the occupant of a motorcycle, and who
					 sustains a personal injury arising out of the use or operation of a motor
					 vehicle outside of New York State, shall institute the claim against the
					 insurer of the named insured or the insurer of the relative. Where there is
					 more than one insurer which would be the source of benefits, the insurers may
					 agree among themselves, if there is a valid basis therefor, that one of them
					 will accept and pay the claim initially. If there is no such agreement, the
					 provisions of subdivisions (b) and (e) of this section shall apply.
(4) An applicant who is a named insured or a
					 relative of a named insured, other than the occupant of a motorcycle, and who
					 sustains a personal injury arising out of the use or operation of an uninsured
					 motor vehicle in New York State, shall institute the claim against the insurer
					 of the named insured or the insurer of the relative. Where there is more than
					 one insurer which would be the source of benefits, the insurers may agree among
					 themselves, if there is a valid basis therefor, that one of them will accept
					 and pay the claim initially. If there is no such agreement, the provisions of
					 subdivisions (b) and (e) of this section shall apply. If there is no such
					 insurer and the accident occurs in New York State, then an applicant who is a
					 qualified person as defined in article 52 of the Insurance Law shall institute
					 the claim against the MVAIC.
(5) An
					 applicant who is neither an operator nor an occupant of a motor vehicle or a
					 motorcycle, and who sustains a personal injury arising out of the use or
					 operation in New York State of an insured motorcycle, shall institute the claim
					 against the insurer of the motorcycle.
(6) An applicant who is a named insured or a
					 relative of a named insured, other than the occupant of a motor vehicle or a
					 motorcycle, and who sustains a personal injury arising out of the use or
					 operation of an uninsured motorcycle in New York State shall institute the
					 claim against the insurer of the named insured or the insurer of the relative.
					 Where there is more than one insurer which would be the source of benefits, the
					 insurers may agree among themselves, if there is a valid basis therefor, that
					 one of them will accept and pay the claim initially. If there is no such
					 agreement, the provisions of subdivisions (b) and (e) of this section shall
					 apply. If there is no such insurer and the accident occurs in New York State,
					 then an applicant who is a qualified person as defined in article 52 of the
					 Insurance Law shall institute the claim against the MVAIC.
(7) An applicant who is a named insured or a
					 relative of a named insured, other than the occupant of a motor vehicle or a
					 motorcycle, and who sustains a personal injury arising out of the use or
					 operation of a motorcycle outside of New York State shall institute the claim
					 against the insurer of the named insured or relative. Where there is more than
					 one insurer which would be the source of benefits, the insurers may agree among
					 themselves, if there is a valid basis therefor, that one of them will accept
					 and pay the claim initially. If there is no such agreement, the provisions of
					 subdivisions (b) and (e) of this section shall apply.
(8) An applicant who is a New York State
					 resident and who is neither a named insured or relative under any mandatory
					 personal injury protection endorsement nor the owner of an uninsured motor
					 vehicle and who sustains a personal injury arising out of the use or operation
					 of a New York insured motor vehicle outside of New York State shall institute
					 the claim against the insurer of such motor vehicle. Where there is more than
					 one insurer that would be the source of benefits, the insurers may agree among
					 themselves, if there is a valid basis therefor, that one of them will accept
					 and pay the claim initially. If there is no such agreement, the provisions of
					 subdivisions (b) and (e) of this section shall apply.
(9) An applicant, other than an operator,
					 owner, or employee of the owner or operator of a bus or school bus, who, while
					 an occupant of such bus or school bus, sustains a personal injury arising out
					 of the use or operation in New York State of such bus or school bus, shall
					 institute the claim against the applicant's own insurer. If the applicant does
					 not have an insurer, the applicant shall institute the claim against the
					 insurer of the bus or school bus.
(10) An applicant who is an operator, owner,
					 or employee of the operator or owner of a bus or school bus, and who, while an
					 occupant of such bus or school bus, sustains a personal injury arising out of
					 the use or operation of such bus or school bus, shall institute the claim
					 against the insurer of such bus or school bus.