Saturday, October 5, 2013

Motorcycle injury accidents . See Regulation 68

 

Motorcycle injury accidents are not  covered with  No Fault. Regulation 68 states any person while occupying a motorcycle are excluded from No Fault coverage...


 

Billing for Motorcycle cases are most often billed to their  private insurance carriers unless we are told by the patient that they have purchased MEDPAY coverage with their auto carrier .    
 

  Some patients  have purchased additional MEDPAY coverage with their auto insurance carrier, however, this is not done very often as such coverage is known to be expensive and  for limited payable amounts  of up to $1,000.00,$5,000.00 or $10,000.00 policy max. Motorcycles are not NF cases.   Whenever someone calls to say they got hurt on their motorcycle ,they should be asked if they purchased an additional policy to cover motorcycle injuries.  If there is MEDPAY ,this can be billed first and then   private insurance can be billed next when  the medpay coverage becomes exhausted. 
 
 
 

If there wasn't a medpay coverage purchased by the patient, then billing for Motorcycle cases should go directly to the private insurance carriers.    

 
 
 
 
Please read from Regulation 68  Section (e) under Exclsuions concerning Motorcycle injuries :
 
 
 
Exclusions

This coverage does not apply to personal injury sustained by:

(a) any person while occupying a motor vehicle owned by such person with respect to

which the coverage required by the New York Comprehensive Motor Vehicle Insurance

Reparations Act is not in effect;

(b) any person while occupying, or while a pedestrian through being struck by, a motor

vehicle owned by the named insured with respect to which additional personal injury

protection coverage is not provided under this policy;

(c) any relative while occupying, or while a pedestrian through being struck by, a motor

vehicle owned by such relative with respect to which additional personal injury protection

coverage is not provided under this policy;

(d) any New York State resident other than the named insured or relative injured

through the use or operation of a motor vehicle outside of New York State if such resident is

the owner of a motor vehicle for which the coverage required by the New York

Comprehensive Motor Vehicle Insurance Reparations Act is not in effect;

(e) any person while occupying a motorcycle;

(f) any person who intentionally causes his own personal injury; {Footnote 13}

(g) any person as a result of operating a motor vehicle while in an intoxicated condition

or while his or her ability to operate the vehicle is impaired by the use of a drug (within the

meaning of section 1192 of the New York Vehicle and Traffic Law) except that coverage

shall apply to necessary emergency health services rendered in a general hospital, as

defined in section 2801(10) of the New York Public Health Law, including ambulance

services attendant thereto and related medical screening. However, where the person has

been convicted of violating section 1192 of the New York Vehicle and Traffic Law while

operating a motor vehicle in an intoxicated condition or while his or her ability to operate

such vehicle is impaired by the use of a drug, and the conviction is a final determination, the

Company has a cause of action against such person for the amount of first party benefits

that are paid or payable {Footnote 14}; or
 
 
 
 
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