No Fault Insurance And Workers Compensation

Prerequisites to Registration

Insurance mandatory. Must purchase insurance including no fault insurance and liability insurance. The act provides 50k in first party benefits plus minimum liability coverage if the insured is sued by a third party in tort action. SOL begins running on tdate of accident.

Workers Compensation:

Workers Compensation:

Injuries

• Accidental injuries arising out of and in course of employment; disease/infection naturally arising and unavoidable; death; occupational disease resulting in disability or death; horseplay on the job is covered.

Benefits

• Benefits: 2/3 average weekly wage. Death: specified statutory benefit. No pain/suffering or punitive damages. An employee can sue an employer for negligence if the injury was not work related.

Exclusive

• Employee injured on job and employer provides workers' compensation coverage: exclusive remedy is under workers' compensation law. Employee cannot sue employer/co-worker

Covered

• Employees of business, trade, or occupation carried on by the employer for profit excluding farm laborers.

Fault

• Recover without regard to fault unless intoxicated, intentionally hurt themself; or voluntary participation in off-duty athletics.

No Fault Coverage

1) serious injury or a loss greater than basic economic loss. (2) use or operating motor vehicle (3) Policy owner; authorized driver; passengers in owner's car; or pedestrian (4) Cannot recover if drunk, drag racer, car thieves/felons. (5) applies to use of auto anywhere in NY or in any other state. (6) negligence not a bar to recovery.

Payment

Benefits paid as loss is incurred. Must be paid within 30 days after claimant presents proof of fact and amount of loss.

Deductions

Benefits reduced by: (i) 20% deduction from loss of earnings provisions for income tax (ii) Employee injured who gets first party benefits under employee's policy - amount reduced by amount recovered/recoverable under workers' compensation. (iii) no fault principle means that award is not diminished by contributory negligence.

Third party

Employee injured because of employer and third party's negligence. Has workers compensation claim against employer and ordinary common law tort action against third party. The third party can only seek contribution from the employer if the employee sustained a grave injury. No double recovery for the same injury.

First party Benefits

First Party Benefits are for Basic Economic Loss: All necessary medical expenses; lost wages up to $2k monthly for 3 years; $25 a day miscellaneous. Does not include any loss incurred on account of death, estate can recover 2K for death except for occupants of another motor vehicle or a motorcycle. No pain and suffering.

Insruance

INsurance

Tort actions still permitted

Injured can pursue tort action based on ordinary negligence against covered person if economic loss exceeds basic economic loss (50K) or serious injury. Covered v. non-covered: Can sue for all damages, including basic economic loss, pain and suffering.