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Don't Ignore Loss Transfer Opportunities in MVA Claims

Workers' Compensation claims arising from motor vehicle accidents (MVAs) present complex legal issues for claims handlers. Many of these claims involve a third-party action filed by the claimant against a negligent driver involved in the accident. Most claims professionals know that when a MVA involving two “covered persons” occurs in New York State, there is no workers’ compensation lien for payments made in lieu of “first party benefits” as defined by the New York No-Fault Law.  The workers’ compensation carrier or self-insured employer (SIE) has lien and offset rights only for payments deemed outside the definition of “first party benefits”. Payments outside of "first party benefits" include: 1) combined payments of medical, indemnity and no-fault in excess of $50,000.00; 2) indemnity payments in excess of $2,000.00 per month; or 3) indemnity payments for lost time occurring after three years from the MVA.

Loss Transfer Arbitration allows the carrier or SIE to recover payments made in lieu of "first party benefits" even though the carrier or SIE does not have a lien against the third party recovery for those payments. Loss Transfer applies only in cases where at least one of the vehicles involved in an accident is used principally for the transportation of persons or property for hire or weighs in excess of 6500 pounds unloaded. In these cases, the carrier or SIE can pursue recovery up to $50,000.00 against the automobile carrier for the negligent party. 

Hamberger & Weiss handles Loss Transfer claims and Arbitration hearings across the state, as those hearings are now conducted via teleconference. Over the past 5 years, we have recovered nearly $5,000,000 in Loss Transfer reimbursement for our clients.

We also prepare third party consent letters associated with the settlement of the bodily injury claim. Although Loss Transfer and third party actions are separate legal matters there are overlapping legal issues that intertwine your lien, credit and Loss Transfer recoveries. Involving expert counsel in third party cases will maximize your Loss Transfer recovery and protect your consent, lien and credit/offset rights in the third party action.  Please contact Dan Bowers of our Loss Transfer practice group for assistance in these cases. For advice in regard to third party settlements generally, please contact Ron Weiss, Susan Duffy, or Dan Bowers.

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