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This entry was published on 2014-09-22
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"No-fault" benefits to qualified persons
Insurance (ISC) CHAPTER 28, ARTICLE 52
§ 5221. "No-fault" benefits to qualified persons. (a) The terms "basic
economic loss", "first party benefits", "non-economic loss", "serious
injury", "motor vehicle", "insurer", "uninsured motor vehicle" and
"covered person", as used in this section, shall have the same meaning
given them in section five thousand one hundred two of this chapter.

(b) (1) Notwithstanding the provisions of this article, the
corporation shall also provide for the payment of first party benefits
to a qualified person for basic economic loss arising out of the use or
operation in this state of an uninsured motor vehicle.

(2) A qualified person who has complied with all the applicable
requirements of this article shall be deemed to be a covered person and
shall have only such rights as a covered person may have under article
fifty-one of this chapter.

(3) The corporation shall have only those rights and obligations which
are applicable to an insurer subject to article fifty-one of this

(4) No payment for non-economic loss shall be made pursuant to this
article to a covered person unless such person has incurred a serious
injury, as such terms are defined in section five thousand one hundred
two of this chapter.

(5) The corporation shall not duplicate any element of basic economic
loss provided for under this section or any section of article fifty-one
of this chapter. No payments of first party benefits for basic economic
loss made pursuant to this section shall diminish the obligations of the
corporation under this article for the payment of non-economic loss and
economic loss in excess of basic economic loss.

(6) If a controversy arises between the corporation and an insurer
concerning the obligation to pay first party benefits, payment of first
party benefits by the corporation shall not be stayed pending resolution
of the controversy. Any such controversy shall be solely resolved by
submission to mandatory arbitration pursuant to procedures promulgated
or approved by the superintendent. Such procedures shall, to the extent
practicable, be those applicable to insurers pursuant to section five
thousand one hundred five of this chapter.

(c) The corporation shall continue to comply with the plan of
operation approved by the superintendent, which provides for the
economical, prompt and fair payment of first party benefits to qualified
persons in substantially the same manner as is required of insurers and
self-insurers by article fifty-one of this chapter and regulations of
the superintendent. The plan may provide for the corporation to utilize
the service of authorized insurers in the payment of claims for first
party benefits. Amendments to the plan of operation may be made on the
initiative of the directors, subject to the approval of the
superintendent, or shall be made at the direction of the superintendent.