New York No-Fault Regulations 11 NYCRR Subpart 65-3: Claims for Personal Injury Protection Benefits

11 NYCRR 65-3.14: Scope of coverage

Text of 11 NYCRR 65-3.14 (Insurance Regulation 68-C) as published by the New York State Department of Financial Services, checked against the Department's list of amendments through October 4, 2026.

This is an unofficial copy. The official text is in the New York Codes, Rules and Regulations. Decisions apply the version in force at the time of the claim, which may differ from the current text.

Decisions citing this section · Plain-text version (Markdown)

(a) An insurer shall be liable only for the payment of benefits for losses caused by the accident, including those caused by the aggravation of preexisting conditions.

(b) An insurer shall pay benefits to an applicant for losses arising out of an accident in the following situations:

(1) where coverage has been excluded for an applicant operating a vehicle while in an intoxicated condition or while the applicant’s ability is impaired by the use of a drug, if such intoxicated or drugged condition was not a contributing cause of the accident causing the injuries;

(2) where coverage has been excluded for an applicant operating or occupying a motor vehicle known to the applicant to be stolen, and the applicant is an involuntary operator or occupant of said vehicle;

(3) where there is no physical contact between the applicant and a motor vehicle or motorcycle which is the proximate cause of the injury;

(4) where the motor vehicle or motorcycle is used without the specific permission of the owner, but is not a stolen vehicle; or

(5) where the accident arises out of repairing, servicing or otherwise maintaining a motor vehicle or a motorcycle, other than in the course of a business, and for which no charge or fee is contemplated.

Historical note

Sec. filed Aug. 2, 2001 eff. Sept. 1, 2001.