No Fault Insurance Claims

Suffolk County | Long Island | New York City, NY

The New York legislature enacted no-fault insurance claims as a solution to prolonged litigation over fault and damage amounts in car accident cases. Under no-fault insurance, also called Personal Injury Protection (PIP), insurance companies are required to pay drivers, passengers, and pedestrians up to $50,000 in damages, regardless of who was at fault for the car accident. The State requires a minimum value of $25,000 coverage for all New York car insurance policies. Insurance companies do not offer no-fault insurance coverage to motorcyclists.

How No-Fault Insurance Works

If you are involved in a motor vehicle accident, your insurance company (not the other driver’s insurance company) pays for damages. No-fault insurance benefits include:

1. Medical bills – hospital, doctor, therapy, rehabilitation and other healthcare expenses incurred as a result of the accident.
2. Lost wages – Insurance companies compensate a maximum of $2,000 a month in lost wages, for up to three years. Lost wage compensation cannot be greater than 80% of lost income.
3. Other reimbursable expenses – household assistance and transportation services to receive medical care, etc., not to exceed $25 per day for more than one year.
4. Death benefit – when death is caused by a motor vehicle accident and the deceased qualified for no-fault insurance benefits, beyond the $50,000 maximum, $2,000 may be paid to the surviving family through the estate.

Claim Filing Deadlines

In 2002, the New York legislature passed stricter filing deadlines in an attempt to lessen no-fault insurance claims fraud. The following deadlines apply:

1. You have 30 days from the date of your car accident injury to file a no-fault insurance application form with your insurance carrier. (Pedestrians would file with the insurance carrier of the car that hit them and the insurance carrier that covers their own car.)
2. You have 90 days from the date of your car accident injury to file claims for lost wages. (Your employer must send evidence of income and lost wages resulting from your disability.)
3. Medical providers have 45 days from date of service to file doctor, therapy, and other medical service bills. (When receiving medical treatment you should provide your no-fault insurance information, not your healthcare insurance information.)

Seeking Legal Help

No-fault insurance laws are complex. At Rosenberg & Gluck, LLP, our personal injury lawyers have decades of experience managing no-fault insurance recoveries for car accident cases. A personal injury lawyer can help you file within the designated time limits. We provide invaluable assistance by ensuring all paperwork is correctly filled out, explaining necessary receipts and important documentation to save, as well as counseling you on situations encountered with insurance companies. Your insurance company may try to send you to their doctors and specialists. This is usually an attempt to prove your injury is not serious and further treatments would not benefit you, in an effort to cancel benefits.

No-Fault Threshold

Based on the seriousness of your injury, you may be entitled to benefits beyond those provided by the no-fault $50,000 limit, such as damages for pain and suffering under New York no-fault threshold laws. New York insurance law §5102(d) defines the serious injury threshold as:

1. Death
2. Dismemberment
3. Significant disfigurement
4. A fracture
5. Loss of a fetus
6. Permanent loss of use of a body organ, member, function or system
7. Permanent consequential limitation of use of a body organ or member
8. Significant limitation of use of a body function or system
9. A medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person's usual and customary daily activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment

Even with no-fault insurance, car accidents are heavily litigated. Litigation most commonly addresses wrongfully denied insurance claims, establishment of disputed serious injury, along with recovery of compensation that is greater than benefits provided under no-fault insurance.

Find out what you need to know about your accident and injury. Allow an experienced car accident attorney to help you obtain the compensation you deserve. Rosenberg & Gluck, LLP will take over your case, so you can concentrate on regaining your health.

Free Consultation/Contingency Based Fees

We take cases on a contingency basis, meaning no upfront, out-of-pocket expense, and there is a fee only if we recover on your behalf. If you are unable to travel, we will come to you. Weekend and evening appointments are available as needed. Call our Long Island law office at (888) 545-2993 today to schedule a free consultation.