The New York no-fault insurance law was passed by the Legislature in 1974, creating a dual system for compensating individuals involved in motor vehicle accidents. This law can be confusing, but we can guide you through your legal options.
At the Law Office of Cohen & Jaffe, LLP, we help people who have been injured in car accidents. Our lawyers have more than 100 years of combined experience. We offer free consultations so that you can learn how no-fault insurance applies to your case. Our Long Island no-fault insurance lawyer can handle your claim or lawsuit.
What is No-Fault Insurance Coverage?
Motorists are required by law to obtain no-fault insurance before they can register a vehicle in New York. This type of insurance, known as personal injury protection (PIP), generally applies no matter how an accident happened or who caused it.
Regardless of fault, every automobile insurance policy in New York provides for the payment of first-party benefits of up to $50,000 for “basic economic loss” for covered persons injured in car accidents. You cannot file a lawsuit against the at-fault party to recover non-economic losses, like pain and suffering, except if you suffered a “serious injury” as defined by the statute.
Who is Covered Under New York’s No–Fault Insurance Law?
In New York, no-fault automobile insurance covers:
- Pedestrians injured by motor vehicles
- Operators, occupants, and owners of motor vehicles
- Anyone entitled to first-party benefits, including the named insured and their household members
Insurance companies may include express provisions in their policies that exclude coverage for:
- Drivers who are operating under the influence of alcohol or drugs
- People who are committing felonies
- Those who intentionally injure themselves
- Anyone who is knowingly a passenger in a stolen car
- Anyone who is injured while racing or fleeing the police
Motorcyclists and anyone riding with them are not covered under no-fault insurance. However, they may be entitled to file a personal injury claim for compensation. Pedestrians hit by motorcycles are covered by no-fault insurance.
No-Fault Benefits for Long Island Victims
No-fault insurance has the purpose of restoring individuals injured in car accidents to good health as quickly as possible. It protects injured people and their family household members against economic loss resulting from motor vehicle crashes.
Your no-fault insurance coverage may pay for:
- Accident-related medical expenses
- Lost wages up to $2,000
- Other reasonable and necessary expenses, such as transportation to your doctor and household help
- Death benefits in fatal crashes
The minimum limit for no-fault insurance in New York is $50,000, though car owners can buy optional additional protection above the mandatory $50,000. This is referred to as additional personal injury protection (APIP).
No-fault insurance does not pay for repairing your car or for damage to the other driver’s car, nor does it cover personal property loss or damage.
If you suffer personal injury in a motor vehicle accident, you are entitled to no-fault benefits to cover your hospital and doctor bills. All accident-related medical bills will be paid regardless of who caused the accident.
Further, any doctor or hospital willing to accept no-fault insurance is not permitted to charge you an additional fee for treatment. If you receive any medical bills, you should send them to our Long Island no-fault insurance lawyer‘s office immediately so they can submit them to the insurance carrier in a timely fashion.
Transportation to and from Your Doctor’s Appointments
No-fault insurance also entitles you to reimbursement for your transportation expenses to and from your doctor with a maximum of $25 per day for a period of one year from the date of the accident. If you are using a taxi, get a receipt stating the date and address of the doctor you visited.
If you are using private transportation, such as your own car or the car of a relative or friend, you must submit a mileage form indicating the name of the doctor, the address you departed from, the doctor’s address, the dates of treatment, and the round-trip mileage.
You should send this form to your lawyer’s office in a timely fashion so that they can submit it to the insurance carrier.
If you are unable to perform your usual household duties and need someone to help you, your doctor can recommend home-care services. No-fault insurance will reimburse you a maximum of $25 per day for a period of one year from the date of the accident.
You must submit a note from your doctor authorizing these services and a paid receipt from the home-care service provider.
In addition to medical expenses, no-fault insurance will reimburse you for lost wages if you are unable to work because of injuries sustained in the accident. Your lost wages are to be paid as follows:
- If you are entitled to disability coverage from your employer, your disability insurance carrier will pay you after the first week at a rate of half your gross salary up to a maximum of $170 per week for 26 weeks. To obtain these benefits, you must within 20 days file an application for disability with your disability carrier. Please follow through on this so that you do not lose any of the benefits to which you are entitled.
- No-fault insurance will pay 80 percent of your salary up to $2,000 per month with a set-off for what you are entitled to receive from disability. Please note that if you are entitled to receive disability benefits from your employer but fail to apply for these benefits, the no-fault set-off will still apply.
If you are not entitled to disability benefits, obtain a letter from your employer or written proof and bring it to your lawyer’s office immediately. The no-fault carrier will deduct disability from your wage benefit check, whether you collect disability or not. We must prove to them that you are not entitled to disability benefits in order to avoid the deduction for disability benefits.
In addition, in order to obtain your no-fault benefits for lost wages in the shortest amount of time, you must obtain a disability note from your doctor and send it to your lawyer’s office. Your doctor must provide you with an updated disability note every 30 days.
If you lost a loved one in an accident on Long Island, your no-fault insurance will provide $2,000 in death benefits. These benefits are paid in addition to the $50,000 basic no-fault limit.
Issues that Can Arise with No-Fault Insurance Claims
The no-fault insurance carrier and your attorney’s office will at some time notify you that the insurance carrier has arranged for their doctor to examine you. If you do not appear at the examination, all of your no-fault benefits will be immediately terminated.
If you have any unpaid medical bills, transportation expenses, household service expenses, disability notes, or other documentation, make sure that you submit them to your attorney immediately, or your no-fault carrier may deny payment.
Civil Lawsuits for Serious Injuries Suffered in Car Accidents
If you are injured in a car accident in New York, you may bring a civil lawsuit for damages only in certain situations, such as when your economic losses are greater than your no-fault benefits or for non-economic damages, such as pain and suffering, but only in cases of “serious injury.”
“Serious injury” is defined under Insurance Law 5102(d) as an injury that results in:
- Significant disfigurement
- A fracture
- Loss of a fetus
- Permanent loss of use of a body organ, member, function or system
- Permanent consequential limitation of use of a body organ or member
- Significant limitation of use of a body function or system
- A non-permanent injury or impairment that prevents the victim from performing their normal daily activities for no less than 90 days during the 180 days immediately after the accident that caused the injury.
You Have a Deadline for Filing a Lawsuit
If you do decide to take legal action against a liable driver, a state-imposed deadline will apply. According to CVP § 214, you only have three years, starting from the date of the accident, to file a personal injury lawsuit. If you lost a loved one in an accident, EPT § 5-4.1 only gives you two years from their death to take legal action.
It is crucial that you begin working on your case as soon as possible. Insurance claims entail their own time-consuming process, and if you choose to pursue a lawsuit, you will have less time to file the necessary paperwork. If you try to file past the statute of limitations, the court may dismiss your case.
Do not let a negligent party get away with causing your losses without a fight. As long as you reach out to us in time, we can help you abide by relevant deadlines and give your case the chance it deserves.
We are Here to Fight for Your Rights
Car accidents can cause great financial strife for a victim and their family, but you may be eligible for compensation. You also have the right to legal representation. At the Law Office of Cohen & Jaffe, LLP, we can help you seek fair compensation through no-fault insurance coverage, a personal injury lawsuit, or a wrongful death lawsuit.
Our lawyers can act swiftly and diligently to protect your rights and fight for the compensation you deserve. We handle car accidents on Long Island and nearby areas, including Nassau County, Suffolk County, and Queens. Discuss your case and learn about your legal options during a free consultation. Call us at (516) 358-6900.
For a free legal consultation with a no-fault insurance lawyer serving Long Island, call 516-358-6900