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 65-2 - Rights And Liabilities Of Self-insurers › Section 65-2.3 - Exclusions

Current through Register Vol. 46, No. 28, July 10, 2024
The requirement for payment by a self-insurer of
						first-party benefits does not apply to personal injury sustained by:
(a) the self-insurer (who is a natural
					 person) or relative while occupying, or while a pedestrian through being struck
					 by, any motor vehicle owned by the self-insurer with respect to which the
					 coverage required by the New York Comprehensive Motor Vehicle Insurance
					 Reparations Act is not in effect;
(b) any relative while occupying, or while a
					 pedestrian through being struck by, any motor vehicle owned by the relative
					 with respect to which the coverage required by the New York Comprehensive Motor
					 Vehicle Insurance Reparations Act is not in effect;
(c) the self-insurer (who is a natural
					 person) or relative while occupying, or while a pedestrian through being struck
					 by, a motor vehicle in New York State, other than the self-insured motor
					 vehicle, with respect to which the coverage required by the New York
					 Comprehensive Motor Vehicle Insurance Reparations Act is in effect;
(d) the self-insurer (who is a natural
					 person) or relative while not occupying a motor vehicle or a motorcycle when
					 struck by a motorcycle in New York State with respect to which the coverage
					 required by the New York Comprehensive Motor Vehicle Insurance Reparations Act
					 is in effect;
(e) any New York
					 State resident other than the self-insurer or relative injured through the use
					 or operation of the self-insured motor vehicle outside of New York State if
					 such resident is the owner or a relative of the owner of a motor vehicle
					 insured under another policy providing the coverage required by the New York
					 Comprehensive Motor Vehicle Insurance Reparations Act;
(f) any New York State resident other than
					 the self-insurer or relative injured through the use or operation of the
					 self-insured motor vehicle outside of New York State if such resident is the
					 owner of a motor vehicle for which the coverage required by the New York
					 Comprehensive Motor Vehicle Insurance Reparations Act is not in
					 effect;
(g) any person in New York
					 State while occupying the self-insured motor vehicle which is a bus or school
					 bus, as defined in sections 104 and 142 of the New York Vehicle and Traffic
					 Law, but only if such person is a named insured or relative under any policy
					 providing the coverage required by the New York Comprehensive Motor Vehicle
					 Insurance Reparations Act; however, this exclusion does not apply to the
					 operator, an owner, or an employee of the owner or operator, of such bus or
					 school bus;
(h) any person while
					 occupying a motorcycle;
(i) any
					 person who intentionally causes his own personal injury;
(j) any person as a result of operating a
					 motor vehicle while in an intoxicated condition or while his or her ability to
					 operate such vehicle is impaired by the use of a drug (within the meaning of
					 section 1192 of the New York Vehicle and Traffic Law) except that coverage
					 shall apply to necessary emergency health services rendered in a general
					 hospital, as defined in section 2801(10) of the New York Public Health Law,
					 including ambulance services attendant thereto and related medical screening.
					 However, where the person has been convicted of violating section 1192 of the
					 New York Vehicle and Traffic Law while operating a motor vehicle in an
					 intoxicated condition or while his or her ability to operate such vehicle is
					 impaired by the use of a drug, and the conviction is a final determination, the
					 self-insurer has a cause of action against such person for the amount of first
					 party benefits that are paid or payable; or
(k) any person while:
(1) committing an act which would constitute
					 a felony, or seeking to avoid lawful apprehension or arrest by a law
					 enforcement officer;
(2) operating
					 a motor vehicle in a race or speed test;
(3) operating or occupying a motor vehicle
					 known to him to be stolen; or
(4)
					 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.