Why register? ...To Enhance Your Experience
+ Reply to Thread
Page 2 of 3 FirstFirst 123 LastLast
Results 21 to 40 of 48
  1. #21
    Forum Member ThNozzleman's Avatar
    Join Date
    Jun 2002
    Location
    Jefferson City, TN
    Posts
    4,334

    Default

    http://www.ins.state.ny.us/autocg02.htm

    1. No-Fault Benefits—Personal Injury Protection (PIP)

    No-Fault, also called Personal Injury Protection (PIP), is designed to pay promptly regardless of who might have been at fault or whether there was any negligence—for actual economic losses (meaning medical expenses, lost earnings, and other reasonable and necessary expenses related to injuries sustained), up to $50,000 per person ("basic No-Fault coverage"), to a driver or passenger injured in your car and to pedestrians injured by your car, because of its use or operation.



    The purpose of No-Fault insurance is to restore individuals hurt in auto accidents to health and productivity as swiftly as possible. Because of New York’s No-Fault law, lawsuits due to auto accidents can be brought only for economic losses that exceed No-Fault benefits and for non-economic damages (such as pain and suffering) only if a "serious injury" (as defined in the Insurance Law) is sustained.

    No-Fault is a personal injury coverage and does not pay for auto body repair of your car or damage to any other party’s motor vehicle or real or personal property. No-Fault is also primary to health insurance, which means it pays first in the event injury is due to an auto accident.

    Under this coverage, your insurer pays you and relatives living with you for economic losses arising from injuries sustained in motor vehicle accidents anywhere within the United States, its territories and possessions, or Canada. It also covers any passengers injured in accidents in New York State while in your vehicle, as well as any guest passengers who are New York State residents injured in your vehicle anywhere in the United States, its territories and possessions, or Canada, if they are not covered under another auto insurance policy in New York State.

    Pedestrians injured by motor vehicles in the State are also protected by No-Fault.

    Basic No-Fault auto insurance coverage includes:

    necessary medical and rehabilitation expenses (in accordance with established fee schedules);

    80% of lost earnings from work, up to a maximum payment of $2,000 per month for up to three years;

    up to $25 a day, for up to a year from the date of the accident, to reimburse other reasonable and necessary expenses resulting from the auto accident; and

    a $2,000 death benefit (in addition to the $50,000 basic No-Fault limit), payable to the estate of a person eligible for No-Fault benefits but killed in a motor vehicle accident.

    However, under most insurance policies, a person will be ineligible for No-Fault benefits, if:

    driving while intoxicated or impaired by use of a drug that contributes to the accident;

    intentionally causing his or her own injuries;

    riding an all terrain vehicle (ATV) or a motorcycle (as operator or passenger);

    injured while committing a felony;

    injured while in a vehicle known to be stolen; or

    an owner of an uninsured vehicle.


    Don't know if this helps...but if his name wasn't on the policy, what can you do?


  2. #22
    Forum Member
    Join Date
    May 2005
    Location
    Ohio
    Posts
    465

    Default

    The key to this whole thing is....

    " to a driver or passenger injured in your car and to pedestrians injured by your car, because of its use or operation. "

    Neither of those happened in this case.

  3. #23
    Forum Member ThNozzleman's Avatar
    Join Date
    Jun 2002
    Location
    Jefferson City, TN
    Posts
    4,334

    Default

    "Pedestrians injured by motor vehicles in the State are also protected by No-Fault."

    "Under this coverage, your insurer pays you and relatives living with you for economic losses arising from injuries sustained in motor vehicle accidents anywhere within the United States, its territories and possessions, or Canada."


    Seems to me he should be covered...IF his name was on the policy.
    Last edited by ThNozzleman; 05-12-2006 at 11:17 AM.

  4. #24
    Forum Member
    Join Date
    Oct 2005
    Posts
    735

    Default

    I hope for all the mutts that are siding with the insurance company find themselves in similar circumstances in the future.
    Just another one of the 99%ers looking up.

  5. #25
    Forum Member ThNozzleman's Avatar
    Join Date
    Jun 2002
    Location
    Jefferson City, TN
    Posts
    4,334

    Default

    I hope for all the mutts that are siding with the insurance company find themselves in similar circumstances in the future.
    Mister, you are WAY out of line, there.

  6. #26
    Forum Member
    Join Date
    Oct 2005
    Posts
    735

    Default

    Cry me a river you mutt
    Just another one of the 99%ers looking up.

  7. #27
    Forum Member ThNozzleman's Avatar
    Join Date
    Jun 2002
    Location
    Jefferson City, TN
    Posts
    4,334

    Default

    Cry me a river you mutt
    So...you're wishing physical, emotional, and financial damage on fellow firefighters, simply because of a legal interpretation? You're some kind of man, let me tell you.

  8. #28
    Forum Member
    Join Date
    Nov 2002
    Location
    NY
    Posts
    198

    Default

    The individual here hasn't been totally denied coverage. Workmans comp has paid his medical bills and is paying him a weekly pittance. What he is trying to collect is in addition to the workmans comp. NY has serious issues with the VFBL being up to date with it's payment amounts as well as workmans comp amounts. He's only looking to be able to live in the manner that he did before the accident. Unfortunatley lawyers and insurance companies are mainly out to cover their own interests for the sake of the almighty buck.

  9. #29
    Forum Member
    Join Date
    May 2005
    Location
    Ohio
    Posts
    465

    Default

    So, because I am a firefighter, I should expect insurance companies to make exception for me even if I am not covered under their policy?

    Sounds reasonable.

  10. #30
    Forum Member
    Join Date
    May 2005
    Location
    Ohio
    Posts
    465

    Default

    Quote Originally Posted by ThNozzleman
    "Pedestrians injured by motor vehicles in the State are also protected by No-Fault."

    "Under this coverage, your insurer pays you and relatives living with you for economic losses arising from injuries sustained in motor vehicle accidents anywhere within the United States, its territories and possessions, or Canada."


    Seems to me he should be covered...IF his name was on the policy.

    The pedestrians in this case are pedestrians hit by YOUR car.

    "to a driver or passenger injured in your car and to pedestrians injured by your car, because of its use or operation."

  11. #31
    Forum Member
    Join Date
    Oct 2005
    Posts
    735

    Default

    No, not FFers, just mutts
    Just another one of the 99%ers looking up.

  12. #32
    Forum Member ThNozzleman's Avatar
    Join Date
    Jun 2002
    Location
    Jefferson City, TN
    Posts
    4,334

    Default

    No, not FFers, just mutts
    I believe that anyone who would write something as stupid as you did deserves the title FAR more. Wishing physical harm on someone? C'mon...get a grip.

  13. #33
    MembersZone Subscriber
    Join Date
    Feb 2005
    Location
    Rochester, NY
    Posts
    135

    Thumbs up

    Quote Originally Posted by REVANANT
    The individual here hasn't been totally denied coverage. Workmans comp has paid his medical bills and is paying him a weekly pittance. What he is trying to collect is in addition to the workmans comp. NY has serious issues with the VFBL being up to date with it's payment amounts as well as workmans comp amounts. He's only looking to be able to live in the manner that he did before the accident. Unfortunatley lawyers and insurance companies are mainly out to cover their own interests for the sake of the almighty buck.
    Larry,

    You are absolutely correct!!! He would not have to had to hire a lawyer if Utica National wasn't trying to pull a fast one. The biggest problem with the situation is Utica National. They are claiming that he is not a listed member. However, every year Utica National is given a list by the department with names and driver's license numbers of EVERY member. Utica has come back and said that we cover the department but not the members. That makes absolutely no sense and that is what we are fighting over. From what we are being told, this is the same coverage for every fire department that has Utica National Insurance. Talk with a claims representative at Utica. Not the underwriters. Our agent and underwriter told us that we would be covered. The claims department is the one denying it. Currently our agent is busting his behind trying to help us fight this. For the sake of your members, check your policy!!!

    Noz,

    Thanks for throwing a copy of the NYS insurance law up there. I think you clarified the coverage I mentioned earlier very well.

  14. #34
    Forum Member ThNozzleman's Avatar
    Join Date
    Jun 2002
    Location
    Jefferson City, TN
    Posts
    4,334

    Default

    Noz, thanks for throwing a copy of the NYS insurance law up there. I think clarified the coverage I mentioned earlier very well.
    That's the way I read it...but I'm far from being a lawyer.

  15. #35
    Forum Member
    Join Date
    May 2005
    Location
    Ohio
    Posts
    465

    Default

    Yankee...

    I am not familiar with Utica. Can you please tell us what the insurance policy does (or is supposed to) cover? Is it the autos themselves? Firefighter injuries? Something else? I'll do some research on my own too when I get a chance.

    PFDTruck18...

    You are being unreasonable and losing my respect quickly. You have done nothing to contribute to this discussion except blast others unnecessarily. Excuse me for wanting the facts before making a blanket statement about something I can't prove.

  16. #36
    Truckie SPFDRum's Avatar
    Join Date
    Mar 1999
    Location
    St Paul, MN
    Posts
    2,513

    Default

    Excuse me for wanting the facts before making a blanket statement about something I can't prove.
    Yet
    So, because I am a firefighter, I should expect insurance companies to make exception for me even if I am not covered under their policy?
    Reads much like a statement...
    In the Navy we called you know it alls sea lawyers.
    In the fire service you are called mutts.
    My posts reflect my views and opinions, not the organization I work for or my IAFF local. Some of which they may not agree. I.A.C.O.J. member
    "I ask, Sir, what is the militia? It is the whole people. To disarm the people is the best and most effectual way to enslave them."
    George Mason
    Co-author of the Second Amendment
    during Virginia's Convention to Ratify the Constitution, 1788
    Elevator Rescue Information

  17. #37
    Forum Member
    Join Date
    Oct 2005
    Posts
    1,154

    Default

    WebFire -- under NY Law, from what I googled last night, you're covered by your or the policy of someone else in the same household if you're struck by a vehicle as a pedestrian under no-fault. Your / your households policy, if any, also covers you if you're injured while riding on a bus(!). Jane the 12 year old could be crossing the street and be struck by a hit-and-run...Mom & Dad's no-fault insurance pays.

    My guess is there could also be a claim against the person's personal auto insurance as well...which is where the lawyers get really deeply involved because you try and play two insurance companies against each other

    My policy (in CT) isn't no-fault, but has similiar uninsured / underinsured coverage and specifically mentions it reduces the payout by the amount of worker's compenstation. And that's on a personal policy for a motor vehicle not normally used for business.

    I'd also suspect Worker's Comp is playing into this great big grey area mess -- your policy normally covers anyone in your car. However, you can't sue you're employer for injuries if you're receiving worker's comp since that's normally a no-fault system that is in lieu of any other liability for the injuries by the employer.

    =========
    Insurance is an area many fire companies -- and myself -- don't have as good of a handle on as they should.

    I also won't sign any worker's comp paperwork until I can consult a lawyer -- one of our members got into a mess because he signed paperwork from our town's carrier that locked him into a lower reimbursement rate then what under statutes he could have collected. And that paperwork was from the municipal self-insurance pool my town participates in, so it's not like "profit" was a direct concern.

  18. #38
    Forum Member
    Join Date
    May 2005
    Location
    Ohio
    Posts
    465

    Default

    Quote Originally Posted by SPFDRum
    Yet

    Reads much like a statement...
    In the Navy we called you know it alls sea lawyers.
    In the fire service you are called mutts.
    Did you notice the question mark at the end of my "statement"? My "statement" was in respone to PFD. You must have misread my "statement." I was ASKING if I was supposed to do that, because that is the mentality of many here.

    I certainly don't believe that one should support something based solely on the fact that someone is a firefighter. Firefighters are human too. They shouldn't be exempt from following the rules everyone that everyone must follow.

    Whether he is covered or not is the question. But if he isn't, he isn't. Exception shouldn't be made just to be nice to a firefighter.

    And, BTW, I am not saying he shouldn't be. I am merely saying that based on what we know as facts to this point, we don't know that he should be (or shouldn't). So rather than just saying "That is BS he should be covered, but I can't say why...", I decided to get more facts and determine if he truly is supposed to be covered.

    Why is this so hard to comprehend?
    Last edited by WebFire; 05-12-2006 at 01:56 PM.

  19. #39
    Forum Member
    Join Date
    May 2005
    Location
    Ohio
    Posts
    465

    Default

    Quote Originally Posted by Dalmatian190
    WebFire -- under NY Law, from what I googled last night, you're covered by your or the policy of someone else in the same household if you're struck by a vehicle as a pedestrian under no-fault. Your / your households policy, if any, also covers you if you're injured while riding on a bus(!). Jane the 12 year old could be crossing the street and be struck by a hit-and-run...Mom & Dad's no-fault insurance pays.

    My guess is there could also be a claim against the person's personal auto insurance as well...which is where the lawyers get really deeply involved because you try and play two insurance companies against each other

    My policy (in CT) isn't no-fault, but has similiar uninsured / underinsured coverage and specifically mentions it reduces the payout by the amount of worker's compenstation. And that's on a personal policy for a motor vehicle not normally used for business.

    I'd also suspect Worker's Comp is playing into this great big grey area mess -- your policy normally covers anyone in your car. However, you can't sue you're employer for injuries if you're receiving worker's comp since that's normally a no-fault system that is in lieu of any other liability for the injuries by the employer.

    =========
    Insurance is an area many fire companies -- and myself -- don't have as good of a handle on as they should.

    I also won't sign any worker's comp paperwork until I can consult a lawyer -- one of our members got into a mess because he signed paperwork from our town's carrier that locked him into a lower reimbursement rate then what under statutes he could have collected. And that paperwork was from the municipal self-insurance pool my town participates in, so it's not like "profit" was a direct concern.
    Thank you Dalmation.

    Well, it does seem weird to me, but that law is the law. So now we just need to find out what type of policy this is and if this law applies to it.

  20. #40
    Forum Member ThNozzleman's Avatar
    Join Date
    Jun 2002
    Location
    Jefferson City, TN
    Posts
    4,334

    Default

    In the fire service you are called mutts.
    Good grief.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. ISO Company Personnel
    By FIRE549 in forum Firefighters Forum
    Replies: 20
    Last Post: 05-16-2007, 06:15 PM
  2. 2004 IAFC report on the voluteer fire service
    By HeavyRescueTech in forum Volunteer Forum
    Replies: 0
    Last Post: 09-02-2004, 09:55 AM
  3. How old is your FD?
    By Adze in forum Firefighters Forum
    Replies: 63
    Last Post: 07-14-2001, 11:27 AM
  4. Thermal Imaging SOG's
    By wtfd92 in forum Firefighters Forum
    Replies: 23
    Last Post: 06-27-2001, 08:41 PM
  5. State Farm Withdraws From ISO
    By F02 in forum Firefighters Forum
    Replies: 52
    Last Post: 03-11-2001, 11:27 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts