New York Personal Injury Protection

Loss Transfer

Loss Transfer cases are filed to recover No-Fault Payments made to an injured party as a result of an accident or occurrence involving a vehicle that weighs over 6,500 lbs. unloaded, or, is a vehicle-for-hire used principally for the transportation of persons or property (including livery). Loss transfer liability is based on the New York Pure Comparative Negligence Law.

Example:
A driver and/or passenger in a personal automobile sustains an injury as a result of an accident with a taxi, limousine or commercial truck (weighing more than 6,500 lbs. unloaded). The driver's carrier pays the claim(s) and files arbitration against the taxi's automobile liability carrier (or cab company if self- insured) if a settlement cannot be negotiated. The arbitrator will apportion liability and consider damages, if contested.
 

Priority of Payment

Priority of Payment disputes are submitted pursuant to Section 65-3.12(b), which states:
"If a dispute regarding priority of payment arises among insurers who otherwise are liable for the payment of first-party benefits, then the first insurer to whom notice of claim is given pursuant to section 65-3.3 or 65-3.4(a) of this Subpart, by or on behalf of an eligible injured person, shall be responsible for payment to such person. Any such dispute shall be resolved in accordance with the arbitration procedures established pursuant to section 5105 of the Insurance Law and section 65-4.11 of this Part."

Example:
There is a one-vehicle accident in which a pedestrian is injured. The injured pedestrian makes a no-fault claim with the Applicant Company (his or her own carrier or that of a resident relative). The Applicant Company files arbitration and names the primarily responsible carrier, e.g. the insurer of the vehicle that struck the pedestrian. The arbitrator looks to the policy, and/or contracts, and to the law to determine who should have paid for the loss.