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Benefits

Cap. 231, s. 5 · Revised Edition 2020

(1) Notwithstanding anything in any enactment, rule of law or the common law and without prejudice to any claim or action for damages made as a result of negligence, the insurer of a person who was using a motor vehicle at the time of an accident involving the said vehicle out of which any bodily injury arose shall, irrespective of whether such person be negligent or not, pay as benefits to the injured third party all reasonable expenses incurred as a result of that injury for necessary medical, surgical, dental, hospital and nursing services up to an amount not exceeding five thousand dollars. (2) If such bodily injury within twenty days following an accident totally disables an employed third party and prevents him from engaging in any occupation for wages or profit for which he is suited having regard to his skill and ability the insurer shall pay to such injured third party a disability allowance of forty dollars a week for the duration of that total disability or one hundred and four weeks whichever period is the shorter. (3) If such bodily injury within twenty days following an accident, substantially and continuously disables a housewife from performing regularly her household tasks and duties the insurer shall pay such injured housewife a disability allowance of twenty dollars a week for the period of that total disability 12 (Third Party Risks) or twenty-six consecutive weeks whichever period is the shorter. (4) Where such bodily injury caused by an accident as herein mentioned results in the death of the third party the insurer shall promptly pay as indemnity burial and funeral expenses not exceeding four hundred dollars, and if the deceased third party is survived by a spouse or a dependant the insurer shall in addition pay death benefits based on the age and the status of the deceased third party as follows, Status of Deceased Surviving Dependent Parents Spouse Child under 4 years - - 500 4-12 years - - 1000 12-16 years 1500 1000 1500 over 16 years 2500 1000 1500 (5) In addition to the benefits mentioned herein, the insurer shall also pay a supplemental death benefit of one thousand dollars for each surviving dependant other than the first where the deceased third party is survived by a spouse and one or more dependants or by more than two dependants. (6) (a) Except with respect to weekly benefits, payment of all benefits payable under this Act shall be made by the insurer within sixty days after receipt of proof of the claim; (b) in the case of weekly benefit payments, the insurer shall pay within four weeks after it has received proof of the claim; (Third Party Risks) 13 (c) continuing weekly payments shall be made by the insurer within each consecutive four- week period, while the insurer remains liable therefor, if the third party furnishes proof of continuing disability whenever required to do so. (7) Subject to subsection (8) of this section, no person shall commence an action or proceeding against the insurer for recovery of any claim for benefits under this section, after the expiration of twelve months from the date of the last benefit payment received by him or after the expiration of twelve months from the date of accident, whichever is the longer period of time. (8) The provisions of this subsection shall not be a bar to any action or proceeding where the delay is shown to have been due to any handicap resulting from the injury suffered or as due to the actions of the insurer. (9) (a) The insurer, upon making payment of any benefits to an injured third party under this section, is subrogated to all rights of the insured to recovery of the amount of those benefits from any other person; and the insurer may bring an action in the name of the to enforce its of subrogation or recovery. (b) The insured shall co-operate with the co- insurer in all acts of subrogation or recovery, all the costs of which shall be paid by the (c) The insurer has complete authority to commence, carry on, or conclude any subrogation or recovery proceeding. 14 (Third Party Risks) (10) Where more than one motor vehicle is involved in any accident out of which any bodily injury or damage to property was caused to a third party, the injured third party shall be entitled to claim the benefits set out in this section from the insurers of either vehicle and such insurer shall be liable to pay the full benefits due to the claimant. (11) Where more than one motor vehicle is involved in any accident out of which any bodily injury or damage to property was caused to a third party and the insurer against whom a claim is made by the injured third party is not the person liable to pay the said claim, such insurer shall nevertheless pay the said claim and shall himself be entitled to recover the said sum from whoever shall be liable therefor. (12) Where any claim is made for any benefit under this section, the insurer may have and the claimant shall afford the insurer or its medical representative full opportunity of having the claimant examined and may obtain a report thereon when, and as often as is reasonably necessary throughout the time required to recover from an injury or to conclude any claim; and all of any such examinations shall be at the expense of the (13) Where any insurer of any person who was using a motor vehicle at the time of an accident involving the said vehicle does not pay any benefit claimed within ten days of the making of the claim, the claimant may report the said matter to the Supervisor of Insurance and the Supervisor of Insurance may, if he is satisfied that the claim is proper and justified, make an order against the insurer to pay the said claim. (14) Where the Supervisor of Insurance makes an order against any insurer to pay a claim, the insurer shall comply with the said order and may, after having complied therewith, appeal to the Supreme Court against such order. (Third Party Risks) 15 (15) The Supreme Court procedure applicable to appeals from inferior courts shall apply to such appeals.
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