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23 Cards in this Set

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  • Back
What is No-Fault Insurance in NY?
NY No Fault Insurance is a scheme designed to divert small stakes auto cases from the courts and let injured people have a simple and straightforward claim against an insurance company.
How does no-fault insurance work?
All injured parties in auto cases will simply look to their insurers. You don't need to prove fault, so even a faulty party can recover.
What is the task on the bar with respect to no-fault insurance?
Determine: 1) When you have a valid no-fault claim against your insurance company; 2) When your right to sue in negligence is barred (These are mutually exclusive)
What is the underlying assumption of the scheme?
Doesn't work unless people have insurance; therefore, auto insurance in NY is mandatory.
What types of insurance coverage do you need in NY?
1) Liability coverage (for big accidents); and 2) No-fault coverage (for small accidents).
What types of damages does no-fault scheme apply to?
Only to personal injuries, NOT to property damage. NOTE: can also have collision insurance for property damage, or you can bring a negligence claim for property damage.
Who can claim a no-fault claim in a small accident?
1) Owner of car; 2) Any other authorized driver's of driver's car; 3) Any passengers in driver's car; 4) Any pedestrian hit by driver.
Who can NEVER claim no-fault?
1) Drunk drivers; 2) People engaged in drag racing; 3) Car thieves and fleeing felons.
What is the dividing line b/t big and small accidents?
Either of two circumstances: 1) First, basic economic loss - if you have only basic economic loss, it's a no-fault claim and if you have more than that, you go to court. 2) Serious injury - defined qualitatively.
What is basic economic loss?
$50,000 or less.
How is basic loss calculated?
By adding together: 1) Medical expenses + 2) 80% of lost earnings to a maximum of $2000/month + 3) Miscellaneous charge of $25/day. If sum is less than $50,000, you have a no-fault claim; but if it's more than $50,000, you can file a negligence claim.
What does serious injury include?
1) Death; 2) Dismemberment; 3) Significant disfigurement; 4) Serious fracture; 5) Total and permanent loss of a bodily organ or function.
What do no-fault payments NOT include?
No-fault payments do NOT include any payments for paind and suffering.
Where does NY no fault insurance cover you?
It is portable - it follows you whereever you go. So, if you are a NY party and you have an accident out of state, you will have a claim.
What is worker's compensation?
Worker's Compensation is a statutory insurnace scheme and it becomes the exclusive remedy of covered employees injured on the job.
How does workers' comp work?
Individuals in the workforce who get hurt at work get automatic recovery through their boss. In effect, therefore, the employer is strictly liable. But, the flip side is that the injured worker cannot bring a tort suit. The worker's comp remedy is the EXCLUSIVE remedy.
What are the positive attributes of workers' comp?
Get money quick; don't have to show fault.
What are the negative attributes of workers' comp?
Can't get pain and suffering or punitive damages.
Who is covered?
Almost all employees, but there are some limitations: 1) Doesn't cover independent contractors; 2) Teachers and other white collar workers at non-profit organizations are not covered by worker's comp - they can sue in tort, but don't get the workers' comp benefits; 3)Part-time household employees (e.g., babysitter, weekly cleaning person); 4) Clergy members.
What kind of injuries does it cover?
Pretty much any injury on the job, but there are some exceptions: 1) An injury that is solely due to the intoxication of the EE is not covered; 2) If you intentionlaly injure yourself on the job; 3) Any injuries that take place in voluntary, off-duty athletic activity are not covered; 4) (Half-exception) Horse-play
What is the rule for horse-play?
1) Where the injury takes place with frivolous recreational activity at the job site, it's covered; 2) BUT, if horse-play is so far off from teh job, you can't recover (e.g., three guys on cleaning crew at industrial bakery playing hide and seek and one guy goes in mixer and they turn it on - not covered)
What do you get under workers' comp?
1) All out of pocket medical expenses; 2) 2/3 of lost salary; 3) If fatal accident, you get a death benefit specified by statute plus funeral expenses.
What is the implication of the fact that worker's comp is an exclusive remedy?
Can't sue the employer, but you remain free to sue anybody else. E.g., if you get hurt by a machine at work, you can sue the manufacturer. The only people you can't sue are: 1) Your OWN boss; 2) Your co-workers (UNLESS they acted outside the scope of employment, or they acted intentionally)