Section 227. Actionable injuries; subrogation  


Latest version.
  • 1. If an employee entitled to
      disability  benefits  under this article be disabled by injury caused by
      the negligence or wrong of a third party, such employee need  not  elect
      whether to take such disability benefits or to pursue his remedy against
      such  third  party,  but  may  take his benefits under this article. The
      carrier liable for payment of disability benefits under this article  or
      the chairman in case of benefits paid under section two hundred seven or
      two  hundred  thirteen shall have a lien on the proceeds of any recovery
      from such third party, whether by  judgment,  settlement  or  otherwise,
      after  the deduction of reasonable and necessary expenditures, including
      attorneys' fees, incurred in effecting such recovery, to the  extent  of
      the  total  amount  of  disability benefits provided by this article and
      paid, and to such extent such recovery shall be deemed for  the  benefit
      of  such  carrier or the chairman. Should the employee secure a recovery
      from such third party, whether by  judgment,  settlement  or  otherwise,
      such  employee  may apply on notice to such lienor to the court in which
      the third party action was  instituted,  or  to  a  court  of  competent
      jurisdiction  if no action was instituted, for an order apportioning the
      reasonable  and  necessary  expenditures,  including  attorneys'   fees,
      incurred   in  effecting  such  recovery.  Such  expenditures  shall  be
      equitably apportioned by the court between the employee and the  lienor.
      Notice  of  the commencement of such action shall be given within ninety
      days thereafter to the employer or carrier or to the  chairman,  as  the
      case  may  be.  The  foregoing rights, limitations, and procedures shall
      also apply to actions and recoveries under the employers' liability act,
      and section six hundred eighty-eight,  title  forty-six,  United  States
      code,  and  under  the maritime doctrine of wages, maintenance and cure.
      Any  of  the  foregoing  providers  of  disability  benefits  which  has
      recovered  a lien pursuant to the provisions hereof against the recovery
      of a person  injured  on  or  after  December  first,  nineteen  hundred
      seventy-seven  and  before  July  first, nineteen hundred seventy-eight,
      through the use or operation of a motor vehicle  in  this  state,  shall
      notify  such person by certified mail, in a manner to be approved by the
      chairman and the superintendent of insurance, of the responsibilities of
      an "insurer" (as defined in subsection (g) of section five thousand  one
      hundred  two  of the insurance law), to reimburse such person under such
      circumstances to the extent that the  recovered  lien  represents  first
      party benefits as defined in article fifty-one of the insurance law.
        1-a.  Notwithstanding any other provisions of this article the carrier
      liable for payment of disability benefits under  this  article,  or  the
      chairman  in  case  benefits are paid under section two hundred seven or
      section two hundred thirteen of this chapter shall not have  a  lien  on
      the  proceeds  of  any  recovery  received pursuant to subsection (a) of
      section five thousand one hundred four of the insurance law, whether  by
      judgment,  settlement  or  otherwise for disability benefits paid, which
      were in lieu of first party benefits which another  insurer  would  have
      otherwise been obligated to pay under article fifty-one of the insurance
      law.  The  sole  remedy of any of the foregoing providers to recover the
      payments in the situation specified in the preceding sentence  shall  be
      pursuant to the settlement procedures contained in section five thousand
      one hundred five of the insurance law.
        2.  If  such disabled employee has been paid disability benefits under
      this article but has failed to commence action against such other within
      six months prior to the expiration of the statute  of  limitations,  the
      carrier  or  the  chairman,  as  the case may be, may maintain an action
      against such third party. If the carrier or the chairman,  as  the  case
      may  be,  having paid disability benefits to a disabled employee, who is
      also a "covered person" (as defined in subsection (j)  of  section  five
    
      thousand one hundred two of the insurance law), and who was injured in a
      motor  vehicle  accident  in  this  state  on  and after December first,
      nineteen hundred seventy-seven and before July first,  nineteen  hundred
      seventy-eight, maintains an action against such third party, who is also
      a  "covered  person",  and  recovers, whether by judgment, settlement or
      otherwise, it shall advise the disabled employee, by certified mail,  in
      a  manner  to  be  approved  by  the  chairman and the superintendent of
      insurance,  of  the  responsibility  of  an  "insurer"  (as  defined  in
      subsection (g) of section five thousand one hundred two of the insurance
      law) to further compensate such disabled employee.
        2-a. Notwithstanding any other provisions of this article, the failure
      of  a  "covered  person"  (as  defined in subsection (j) of section five
      thousand one hundred two of  the  insurance  law),  who  has  been  paid
      disability  benefits  under this article for injuries arising out of the
      use or operation of a motor vehicle in this state, to commence an action
      against such other within six months prior  to  the  expiration  of  the
      statute  of  limitations, shall not operate to permit the carrier or the
      chairman to institute an action  against  such  other  third  party  for
      recovery  of  disability benefits paid which were in lieu of first party
      benefits which an insurer would have otherwise  been  obligated  to  pay
      under  article fifty-one of the insurance law unless such third party is
      not a "covered  person".  The  sole  remedy  of  any  of  the  foregoing
      providers  to  recover  the  payments  in the situation specified in the
      preceding sentence when the other party is a "covered person"  shall  be
      pursuant to the settlement procedures contained in section five thousand
      one hundred five of the insurance law.
        3.  A  compromise  of  any  such cause of action by the employee in an
      amount less than the benefits provided by this  article  shall  be  made
      only  with  the  written  consent of the carrier or the chairman, as the
      case may be.