Both the No-Fault statute (Ins. Law §5101, et seq.) and the corresponding no-fault regulations (11 NYCRR 65-1.1, et seq.) provide for basic personal injury protection (PIP) benefits of $50,000 for reimbursement of covered medical benefits, lost wages and other necessary expenses. The policy limits may be increased by the purchase of additional personal injury protection coverage (APIP), as provided by 11 N.Y.C.R.R. §65-1.3, and optional basic economic loss coverage (OBEL), as specified in Insurance Law §5102(a)(5). Owners of certain vehicles are required to maintain higher coverage. For example, owners of New York City vehicles for hire, taxis, black cars, limousines and commuter vans are required to maintain $200,000 in PIP coverage (35 RCNY §59A-12(b) and (c)).

When an insurer “has paid the full monetary limits set forth in the policy, its duties under the contract of insurance cease.” Countrywide v. Sawh, 272 A.D.2d 245 (2d Dept. 2000). As it is a coverage defense, an insurer’s contention that the coverage limits of the policy have been exhausted may be asserted despite the insurer’s failure to raise that defense in a timely denial-of-claim form. New York & Presbyt. Hosp. v. Allstate, 12 A.D.3d 579, 580 (2004).