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 65-1 - Prescribed Policy Endorsements › Section 65-1.3 - Requirements for additional personal injury protection coverage

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
					 additional personal injury protection endorsement (New York), set out in this
					 section, is approved and promulgated and all of the provisions thereof shall,
					 in accordance with section 2307 (b)  of the Insurance
					 Law, be deemed to be included in all additional personal injury protection
					 endorsements in force. This endorsement contains nonsubstantive changes from
					 the previously prescribed additional personal injury protection endorsement
					 (New York) and may be substituted for that endorsement when supplies of that
					 endorsement are exhausted. This endorsement may be combined with the Mandatory
					 Personal Injury Protection Endorsement (New York) and other coverages, with
					 appropriate language.
(b) The
					 endorsement set forth in this section may include the following provision,
					 together with appropriate schedule(s) of named individuals: "It is agreed that
					 the individual(s) named in this endorsement shall be deemed to be a named
					 insured under the Mandatory Personal Injury Protection Endorsement (New York)
					 and, to the extent applicable, this endorsement."
(c) Additional personal injury protection
					 endorsement.
ADDITIONAL PERSONAL INJURY PROTECTION ENDORSEMENT
(New York)
The Company agrees with the named insured subject to all
						of the provisions, exclusions and conditions of the Mandatory Personal Injury
						Protection (Endorsement) 
						14 (New York), not expressly
						modified in this (Endorsement) 
						14 as follows:
Additional Personal Injury Protection
The Company will pay additional first-party benefits to
						reimburse for extended economic loss on account of personal injuries sustained
						by an eligible injured person and caused by an accident arising out of the use
						or operation of a motor vehicle or motorcycle during the policy period. This
						coverage only applies to motor vehicle accidents within the United States of
						America, its territories or possessions, or
						Canada.15
Eligible Injured Person
Subject to the exclusions and conditions set forth below,
						an eligible injured person is:
(a) the
					 named insured and any relative who sustains personal injury arising out of the
					 use or operation of any motor vehicle;
(b) the named insured and any relative who
					 sustains personal injury arising out of the use or operation of any motorcycle
					 while not occupying a motorcycle;
(c) any other person who sustains personal
					 injury arising out of the use or operation of the insured motor vehicle while
					 occupying the insured motor vehicle; or
(d) any other person who sustains personal
					 injury arising out of the use or operation of any other motor vehicle (other
					 than a public or livery conveyance) while occupying such other motor vehicle,
					 if such other motor vehicle is being operated by the named insured or any
					 relative.
Exclusions
This coverage does not apply to personal injury sustained
						by:
(a) any person while occupying a
					 motor vehicle owned by such person with respect to which the coverage required
					 by the New York Comprehensive Motor Vehicle Insurance Reparations Act is not in
					 effect;
(b) any person while
					 occupying, or while a pedestrian through being struck by, a motor vehicle owned
					 by the named insured with respect to which additional personal injury
					 protection coverage is not provided under this policy;
(c) any relative while occupying, or while a
					 pedestrian through being struck by, a motor vehicle owned by such relative with
					 respect to which additional personal injury protection coverage is not provided
					 under this policy;
(d) any New York
					 State resident other than the named insured or relative injured through the use
					 or operation of a 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;
(e) any person while
					 occupying a motorcycle;
(f) any
					 person who intentionally causes his own personal injury; 
					 16
(g) any person as a result of operating a
					 motor vehicle while in an intoxicated condition or while his or her ability to
					 operate the 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
					 company has a cause of action against such person for the amount of first party
					 benefits that are paid or payable; 
					 17 or
(h) any person while:
(i) committing an act which would constitute
					 a felony, or seeking to avoid lawful apprehension or arrest by a law
					 enforcement officer; 
					 16
(ii) operating a motor vehicle in a race or
					 speed test;16
(iii) operating or occupying a motor vehicle
					 known to that person to be stolen; or 
					 16
(iv) 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;16