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can no fault insurance in NYS deny medical benefits to an ...
Sent to Legal Experts February 26 06:03 PM

can no fault insurance in NYS deny medical benefits to an injured driver if a hospital test shows alcohol? Occurred in a parking lot with no one else involved and no ticket was issued.

 

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New York

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is there recourse if no fault does deny medical bill claims. Can his private insurance deny him benefits too? isn't drinking a disease?

Customer (name blocked for privacy)
Status:  Closed   Value: $9
Answer
February 26 7:39 PM (1 hour and 36 minutes and 19 seconds later)
         
ACCEPTEDCheck Mark

Hi and welcome,

Unfortunately, yes. Section 5103 of the NY Insurance law mandates that Insurance companies provide no fault insurance coverage but...

"(b) An insurer may exclude from coverage required by subsection (a)hereof a person who:
(1) Intentionally causes his own injury.
(2) Is injured as a result of operating a motor vehicle while in an
intoxicated condition or while his ability to operate such vehicle is
impaired by the use of a drug within the meaning of section eleven
hundred ninety-two of the vehicle and traffic law."

Rich Licata



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Reply
February 26 10:10 PM (2 hours and 30 minutes and 52 seconds later)
         
can our private medical insurance deny coverage if no fault rejects the claim?
Customer (name blocked for privacy)
Answer
February 26 10:16 PM (5 minutes and 30 seconds later)
         
ACCEPTEDCheck Mark

Unless there is a similar clause in the health policy...no. And generally....when No-Fault denies claims for any number of reasons in NY...health insurance customarily pays claims.

Rich Licata



To request me for NEW QUESTIONS IN THE FUTURE, just begin with "THIS IS FOR RVLAW"


THIS IS FOR INFORMATION ONLY. NO ATTORNEY-CLIENT RELATIONSHIP EXISTS. CONSULT A LAWYER IN YOUR STATE FOR LEGAL ADVICE
Picture
rvlaw -- Lawyer (JD) -- 99% Positive Feedback on 3940 Legal Accepts
NYC Trial Atty. 30 yrs.- pers. inj., contracts, real estate, criminal, estates, matrimonial.
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