New York is one of 12 states that have no-fault rules for car accidents that do not result in serious injuries. Whether an injury results from a truck or a car accident, most victims of a motor vehicle accident are eligible for no-fault insurance benefits in New York regardless of who was to blame for the crash. Motorcycle operators qualify for compensation only if someone else was at fault for the accident.
Each car accident victim can make a claim under the no-fault insurance policy of the car they are in for compensation for losses, up to the policy limits. If an accident resulted in “serious” injuries, a car accident victim may also be able to recover compensation through a traditional personal injury insurance claim or lawsuit.
In New York, every driver is required to carry personal injury protection (PIP) coverage. Drivers must have at least $50,000 in basic PIP coverage, but are permitted to buy more if they wish.
When a motorist is involved in a crash, the PIP policy will provide payment of medical bills and will also cover 80 percent of lost wages up to $2,000 per month (or greater if the limits so provide) for up to three years if the injury results in missed work. If your household expenses increase after the accident, you can also receive up to $25 per day (or greater if the limits so provide)in benefits for up to one year after the accident. If the crash results in death, there is at least a $2,000 death benefit available.
PIP coverage is available to the person who bought the car insurance, to members of that person’s household, to anyone who owns or operates the vehicle belonging to the insured driver, and to any pedestrians injured by the operation of the vehicle belonging to the insured. Motorcycle, scooter and moped riders are not eligible to purchase no-fault insurance and are not covered by New York’s no-fault policies. Compensation for these riders must come from the party responsible for causing the accident.
If you have a valid PIP claim, your benefits may include:
- Lost wages.
- Medical expenses.
- Mileage reimbursement for transportation to and from medical providers.
- Death benefits in the event of a fatality.
When Can I Make a No-Fault Claim?
You can make a no-fault insurance claim for any losses resulting from the operation of a motor vehicle, unless:
- You were injured as a result of your own intentional act.
- You were hurt while driving drunk or on drugs.
- You were injured while committing a felony or evading police.
- You were operating your car in a race or speed test.
- You were driving or occupying a car you knew had been stolen.
Even these exclusions are not automatic, as New York’s no-fault law simply says that you may be excluded from no-fault coverage under these circumstances.
If you were involved in an accident, you must provide written notice to your insurance company and make a claim for compensation and benefits no more than 30 days after the accident, unless there is clear and reasonable justification for your delay in making a claim. If your claim extends beyond this 30-day period, then you may be barred from making a no-fault claim. To make your no-fault claim, you will need to complete the no-fault application, Form NF-2.
Problems Obtaining No-Fault Insurance Benefits
The average no-fault insurance claim pays out $8,690 in New York. Your claim should be covered in full by the insurance company so you can get the benefits you have paid for and deserve, and so you do not face financial hardship as a result of a car accident.
When you make a valid no-fault claim, the insurance company should begin paying benefits and should provide payment for all covered medical treatments, lost income and other losses that are included in your no-fault policy. Insurance companies sometimes deny legitimate claims, refuse to pay out the full amount due or otherwise engage in dishonest behavior that deprives you of the money you need and the coverage you deserve.
If your insurance company behaves in a dishonest way, you may be required to arbitrate your dispute in certain cases, especially if the amount of money being disputed is less than $2,000. In other situations, however, it may be possible to take legal action in court against the insurance company for bad faith if the company acted in an unfair and inappropriate manner in handling your claim. If the insurer is found to have acted in bad faith, the money you may recover may exceed the maximum coverage limit on your no-fault policy.
- N.Y. Department of Financial Services – Consumer Frequently Asked Questions No-Fault Insurance