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How Does No-Fault Insurance Work in NY?

How Does No-Fault Insurance Work in NY?

New York is a no-fault state. But what does that mean,  and how does no-fault insurance work in NY? To obtain a license plate and drive legally on public roads, all car owners must register their vehicle with the state. Part of the registration process requires car owners to provide proof of financial responsibility. This means car owners must show that they have the funds set aside to cover the cost of an accident out of their own pocket. The vast majority of New Yorkers do not have this money set aside and so, they show proof of financial responsibility by purchasing no-fault auto insurance.

Below, our New York car accident lawyer explains more about the benefits and limitations of no-fault auto insurance. No-fault insurance generally means that an accident victim cannot sue the at-fault party for their injuries and other losses. However, there are some scenarios when accident victims can file a personal injury claim to recover additional compensation. If you’d like to schedule a free consultation to see if you have a solid case, contact us today.

What Is No-Fault Auto Insurance?

As the name implies, no-fault auto insurance is available for accident victims, even if they were partly or wholly to blame for an accident. No-fault insurance is sometimes called personal injury protection (PIP) and the minimum required amount for all drivers in New York is $50,000 for every person who is hurt. Certain individuals can claim these benefits without proving that another person was negligent and caused the crash.

Benefits of No-Fault Insurance

No-fault insurance does hold many benefits for all drivers. These benefits cover most of your economic losses after an accident. Economic losses are those that have an actual dollar value such as medical expenses, lost income, and burial expenses.

Medical expenses make up a large portion of PIP benefits. These can include:

  • Surgical interventions, nursing care, and x-rays
  • Ambulance expenses
  • Cost of prescription medication
  • Dental costs
  • Prosthetic devices
  • Occupational and physical therapy
  • Psychiatric treatment
  • Rehabilitation
  • Any non-medical care that is chosen over traditional medical treatment for religious reasons
  • Any professional medical services that are necessary within one year of the accident if the procedure is necessary due to injuries related to the accident

PIP benefits also include payments of up to $25 a day for other expenses related to the accident. For example, if you incur transportation costs from going to a doctor’s appointment, you can claim up to $25 a day for this expense. Additionally, if you could not perform household services for medical reasons due to the accident, you can also claim this payment.

You can also claim up to 80 percent of your lost wages if you cannot return to work right away after the crash. There are no taxes on these benefits, which is why 20 percent of the wages are withheld. Lastly, if the accident was fatal, PIP benefits also provide for all funeral and burial expenses.

It is important to note that PIP benefits provide coverage for up to $50,000 per injured person. However, that amount takes into consideration payments from all sources. For example, if you were hurt at work and received workers’ compensation, this amount will be reduced from your PIP benefits.

Who Is Covered by No-Fault Benefits?

No-fault insurance covers the following individuals:

  • The owner named in the insurance policy covering the vehicle
  • Any passenger involved in the crash
  • Any member of the household of the insured if they were hurt as a pedestrian

In addition to the above individuals, a person may also be covered if they are a member of the household of the insured and they were injured as a passenger in another vehicle in which the driver was not properly insured.

Who Is Not Covered by No-Fault Benefits?

As with most laws, there are exceptions to the no-fault rules. Individuals who are not covered under the law include:

It is important to note that the law allows insurance companies to make their own exclusions, and many do. You must review your policy so you know who is covered by it, and who is not.

Time Limit on No-Fault Insurance Claims

Under New York’s no-fault laws, written claims must be submitted to the insurer within 30 days of the accident. This time limit is rarely extended. Only if you can show written proof that there is a clear and valid justification for the failure of filing on time will the insurer extend the time limit. This is a very high burden of proof to establish.

Within your written statement, you should include as many details as possible. You should include the date and time of the crash, and as many details surrounding the circumstances leading up to the collision. The benefits will not provide coverage for any property damage, as they are only meant to cover personal losses sustained during an accident.

When to File a Personal Injury Lawsuit

Through PIP benefits, you can receive coverage for medical expenses and lost income fairly quickly. These benefits, however, only cover your economic losses and not your non-economic losses. If your injuries are severe enough to meet the serious injury threshold in New York, you can file a personal injury lawsuit against the at-fault driver. The law defines a serious injury as:

  • A total disability that is sustained for at least 90 days
  • Broken bones
  • Permanent loss of a function of a bodily system or bodily organ
  • Loss of a fetus
  • Disfigurement
  • Dismemberment
  • Death

Our Team Can Help with Your Case

Whether you need to file a PIP claim or a personal injury lawsuit against another party, our team at Silberstein, Awad & Miklos can help. Our seasoned attorneys can advise you of your legal options and help you determine which path is right for you.

If you’re ready to start building your case, contact us today to schedule a free no-obligation consultation.