“No-Fault” insurance benefits are those benefits that are paid by the insurance company of the car you were driving; a car you were a passenger in; or if you were struck by as a pedestrian, the car that struck you, regardless of whose fault the accident was.
First things first, not all U.S. States qualify as such. New York, however, is a “no-fault” insurance state, which means that insureds are generally reimbursed by their insurance company for damages regardless of who was responsible for causing the accident. Insureds can be reimbursed for medical costs and other losses that might arise after the accident.
These “no-fault” benefits include payment of medical bills, prescription drugs, lost wages, housekeeping and/or transportation to and from medical providers, all as the result of the accident.
“No-fault” applies to any driver, cyclist, passenger, or pedestrian injured by a motor vehicle in New York.
Generally, there are several conditions that you must satisfy in order to qualify for “no-fault” coverage in New York:
It should be noted that the insurance company has an interest in denying as many accident payouts as possible. For that reason, once you have started receiving treatment the “no-fault” insurance company will begin the process of “verifying” your injuries. In essence, the no-fault insurance company will attempt to show that you are not injured. If they are able to show that you are done treating, the insurance company can stop paying for your associated medical costs, lost earnings, etc.
Bear in mind that just because a “no-fault” auto insurance company must provide up to $50,000.00 in protection, this requirement does not mean they must pay out $50,000.00 worth of coverage. As stated above, it is in their best interests not to expend the maximum amount of coverage per accident.
Through this process of “verification,” in order to confirm that you are injured, the “no-fault” insurance company may send you to one of their own doctors for an “Independent Medical Examination” (IME). You MUST attend the IME if one is scheduled; if you fail to attend/reschedule the IME twice, the no-fault insurance company may retroactively deny your benefits. In other words, it is possible for the insurance company to deny benefits from the date when you were first injured, and then seek to obtain reimbursement for any amounts already paid for wages, treatment, or other related expenses. Appearing for your IME appointment is an important first step to ensure that your regular treatments with your medical providers are covered.
It is very important to note that the IME doctor is not your treating physician. Therefore, as a rule of thumb, while you must be truthful about your injuries, you should refrain from offering any unnecessary information to the IME doctor.
Once you arrive at your IME, you will be required to fill out paperwork. While you should complete the same to the best of your ability, do not hesitate to contact your attorney if something appears incorrect.
Before your IME, the IME doctor will have already reviewed all medical records associated with the incident. The insurance company will have provided these records to the doctor in advance. You will undoubtedly be asked about how the accident occurred, where, how your treatment is going, any complaints you have with regard to your treatment, if you were employed at the time of your accident, what your current employment is if any, and they will intimately how your sustained injuries are affecting your daily life. The IME doctor will also ask you about any past injuries or preexisting medical conditions.
Once your IME is complete, the IME doctor will note all findings in a formal report and provide that to your attorney, as well as opposing counsel. Please note that it is crucial that you fully understand each question before providing an answer, and that you ask for clarification if you do not understand, as your answers to the IME doctor’s questions will be noted in their report.
If the IME report concludes that particular treatments/specialties are already “resolved,” then the “no-fault” insurance carrier will deny your benefits for that particular specialty (e.g. pain management, psychiatry, orthopedics, neurology, chiropractic, acupuncture). A finding that an injury is “resolved” would conclude that no further treatment will benefit that resolved injury. Conversely, if the IME report finds that particular treatments or specialties are still “resolving,” then you will remain eligible for “no-fault” benefits with regard to those injuries.
If you are denied “no-fault” benefits for any of the abovementioned reasons, you have three (3) options with regard to the next steps:
The following motorists are generally NOT eligible for “no-fault” coverage:
In order to file for “no-fault” benefits in New York, follow these simplified steps below:
Yes! There is a very short timeframe in which you may apply for “no-fault” coverage. As an insured party, you only have thirty (30) days from the date of your accident, in order to file an application for these benefits with the insurance company.
You can read more about “no-fault” coverage FAQs on the New York State Department of Financial Services webpage located here, or by contacting our offices, PALERMO LAW P.L.L.C., for a free Personal Injury consultation.
Julia Mastrotto is an Associate Attorney at Palermo Law PLLC. Her area of focus is personal injury law with a heavy focus on automobile and premises liability matters.
Julia represents clients in personal injury matters zealously and with the objective of helping those who have been injured, to obtain the justice and compensation that they deserve. She finds the field meaningful, in that she enjoys bringing a sense of relief and comfort to people who have been injured.
As crazy as it seems, we are nearing the two-year anniversary since the covid-19 coronavirus disease was declared a global pandemic. So much has happened since then and many lives have changed permanently as a result. We have seen waves of high viral threats where each person has had to take precautionary measures in their personal and professional lives. We have also seen waves of calm, where the infection rate is very low along with high immunity from vaccines, and during those times a lot of our lives were seemingly back to normal.
We’re in an interesting time right now where we are seeing higher infection rates than ever before with the omicron variant, but the effects of this variant are less threatening than ones we’ve seen in the past. Because of this, things aren’t necessarily closing down like they used to, but precautionary measures are being taken. This affects many facets of life. For those pursuing a personal injury case on Long Island, the process to resolution is being affected for a number of reasons.
The biggest factor affecting personal injury cases in Suffolk County are court delays for cases going to trial. Less courts are open than usual because of covid. Only one or two courts are open per floor in order to maintain social distancing. So while trials are happening now, they are happening at a reduced rate.
In the beginning of the pandemic, all trials came to a complete halt. Fortunately, this isn’t the case anymore. While the courthouse was open after only a month of lockdown, trials were still suspended until April of 2021. So on top of having less trials happening at once, there is a yearlong waitlist that is still trying to catch up.
Aside from trials being pushed back, everything else in the litigation process is taking longer to happen. For example, decisions on motions and requests for conferences are taking longer to get a response. The courts are extra busy because of how much everything has been pushed back. On top of that, people who have the virus or have been exposed are quarantined at home, reducing the staff at the Suffolk County courthouses.
To try and combat the backup, the courts have started a mediation process to try and get more of the cases settled faster. This has helped to a degree. For more straightforward cases, a mediation procedure can be resolved through this process without needing to go to trial.
There are many instances where this route is not possible. So ultimately, a plaintiff should expect a delay of several months (around 6 to 12 months) for a trial as a result of covid. Cases are being settled. But in the cases where a trial is needed for an adequate resolution, there will be a delay.
Steven Palermo is the managing partner for Palermo Law, Long Island’s Personal Injury Law Firm. He has been helping people receive compensation for their injuries for over 21 years. He focuses on cases involving car accidents, truck accidents, construction accidents and slip and fall injuries.
His book The Ultimate Guide to Handling New York Car Accident Claims details the ins and outs of a car accident claim in a simple, easy-to-read manner.
If you ever get into a car accident, when it completely wasn’t your fault, you might assume that the other driver has to pay for any injuries that occurred as a result. But that’s not really the case in New York, at least initially.
New York is a “No-fault state” which means when a motor vehicle accident occurs, regardless of who is at fault, no-fault insurance will cover financial losses for the accident. New York is one of twelve states that have No-Fault laws and will apply to any pedestrian, bicyclist, driver, and even a passenger of a motor vehicle.
Action on your part is needed to redeem No-Fault benefits. To qualify for No-Fault insurance, you need to file a claim with the appropriate insurance carrier within 30 days of the accident. If you don’t meet this deadline, your claim may be denied.
Additionally, to qualify for No-Fault insurance, certain conditions must be met. New York No-Fault is strictly for New York, so the accident has to have occurred in New York, the vehicle involved has to be registered in New York, and the vehicle has to have insurance issued from a New York Insurance carrier. On top of that, No-Fault does not cover motorcycles. So the injured party has to be either a pedestrian, bicyclist, driver, or passenger of a vehicle other than a motorcycle.
As long as you meet the requirements above, you are eligible for No-Fault benefits. Even if you are in a single-vehicle accident, where you hit an object off the road or lose control because of a pothole, you are eligible for reimbursement for medical bills and lost wages through No-Fault. No-Fault benefits include payment of medical bills, prescription drugs, lost wages, housekeeping and/or transportation to and from medical providers, all as the result of the accident for up to $50,000.
No-Fault will cover all medical expenses associated with injuries you’ve incurred from your accident, usually without the need for referrals or pre-authorization. Unfortunately, not all healthcare providers accept No-Fault coverage. For No-Fault to cover lost wages, you must provide proof of disability from a medical provider and proof of employment. No-Fault will cover 80% of your lost wages up to $2,000 dollars a month. Additionally, any out-of-pocket expenses including transportation to medical providers, medications, and any other costs you make “out of pocket” that are directly related to the treatment for your injuries can be compensated. No-Fault will cover these out-of-pocket expenses for up to $25 a day.
It’s important to understand that No-Fault only covers your accident-related expenses up to $50,000 dollars. Once that $50,000 is exhausted, your claim will be discontinued. The only exception is if you have purchased Additional Personal Injury Protection (APIP). Additional PIP is an optional coverage that is usually not expensive. If no Additional PIP benefits are available, you may make a claim to your standard health insurance to pay for your medical expenses. You may also be eligible for Federal Social Security Disability benefits.
In many cases, serious accidents result in bills far exceeding $50,000 or even the APIP coverage. In addition to the above, you can also sue the party responsible for the accident, in order to recover the costs that you paid which exceed your policy limit. This is so you can receive the full amount as a result of the accident, including future lost wages and pain and suffering.
Steven Palermo is the managing partner for Palermo Law, Long Island’s Personal Injury Law Firm. He has been helping people receive compensation for their injuries for over 21 years. He focuses on cases involving car accidents, truck accidents, construction accidents, and slip-and-fall injuries.
His book The Ultimate Guide to Handling New York Car Accident Claims details the ins and outs of a car accident claim in a simple, easy-to-read manner.
Although winter weather can be very pretty, it is very dangerous in places like Long Island. Life only slows down a little bit when there is snow on the forecast, and snow and ice can be extremely hazardous for Long Islanders for a number of reasons. In addition to the danger that it brings to drivers on the roads, winter weather can contribute to pedestrians slipping and falling and resulting in serious injury. What’s scary about slipping on snow and ice is that when someone is slipping and falling, they are falling on hard pavement or hard ice.
These kinds of injuries require extensive medical treatment, which can result in exorbitant medical bills. Additionally, an injury from a slip and fall often takes a long time to recover, meaning the person may have to miss a lot of time working at their job. This is why work is involved for every property owner to ensure this does not happen when there is snow or ice on the ground. You’re not only preventing a slip or fall from a passerby but properly removing snow and ice can protect your own household from having a devastating injury. Ultimately, property owners are obligated to maintain a level of safety.
In New York State, property owners are obligated to clear their property of hazardous snow and ice in a reasonable amount of time. The word reasonable is a subjective timeframe, and understandably so because no snowstorm and no property are the same. In a case where someone is recovering losses from slipping and falling on someone’s driveway, an experienced attorney will help make the determination as to what is a reasonable amount of time. So homeowners are responsible for adequately clearing their driveways after a storm. Owners of public buildings also need to clear entryways, parking lots, steps, and ramps in a reasonable amount of time to ensure safety for any pedestrians that are on the premises.
Additionally, public sidewalks that are in front of a property in the state of New York are not the responsibility of the property owner to clear snow and ice. This means no matter how much time has passed, a public sidewalk in front of a residence or business is not the owner’s liability unless it has been previously established specifically by way of a statute or ordinance. However, if a property owner has made a sidewalk more unsafe (for example by piling snow on top of the sidewalk), then they would be liable if an injury occurs.
If the slip and fall happen in New York City, then the rules for the property owners are more strict. New York City has some very specific snow removal rules for buildings within its boroughs. The goal of these laws is to ensure the safety of the residents, employees and passersby. New York City’s Department of Sanitation requires that snow be removed no later than four hours after the end of snowfall, or not later than 11 a.m. if the snowfall ended after 9 p.m. the night before. This is due to the increased number of pedestrians in the city, making the risk of a slip and fall injury much more likely. They also cannot shovel snow into the streets, and if a hazardous area can’t be cleared, there should be warning signs to alert pedestrians.
Not only do property owners need to clear their driveway, but they are required to do so adequately. This means driveways and walkways must be reasonably cleared and safe for passersby. Steps must be taken to make sure snow and ice are removed.
Here are 5 steps to making the best of the salt or ice melt you use on your driveway:
Steven Palermo is the managing partner for Palermo Law, Long Island’s Personal Injury Law Firm. He has been helping people receive compensation for their injuries for over 21 years. He focuses on cases involving car accidents, truck accidents, construction accidents and slip and fall injuries.
His book The Ultimate Guide to Handling New York Car Accident Claims details the ins and outs of a car accident claim in a simple, easy-to-read manner.
No doubt many of us are shocked that 2021 is already coming to an end. Many of us are happy to wave this year goodbye, having another full year of dealing with the covid-19 pandemic. While many may be excited to celebrate the new year with their friends and family, unfortunately, plans for New Years should be approached with caution.
With the Omicron variant being the dominant variant of covid in the US, it is now spreading like wildfire among both the vaccinated and unvaccinated. In fact, New York has seen a spike in cases unlike ever before. Although this mutation of the virus is the most contagious, the saving grace is that it is the least deadly. Many are contracting and spreading the virus without knowing they are sick, so it’s important that the pandemic is still kept in mind when making plans this year.
If you are seeing people outside of your home on New Years’, do what you can to ensure it is covid-safe. Even though those who are vaccinated are getting covid, they still have greater resistance and a lesser chance of spreading it than those who are unvaccinated. So if you are having people over, it would be a good idea to make sure everyone is vaccinated.
Even better would be to get tested before New Years to make sure you and your friends are negative. Because the numbers are higher than ever, it is very difficult to find and schedule a PCR test. However, it may be possible to get a rapid test before New Year’s Eve, by visiting the link here.
Ultimately, if your plans are to go somewhere public like a bar or lounge on New Years, bear in mind that even if the establishment is checking for proof of vaccination, you are taking a risk of getting covid. This is a personal choice you would have to decide for the safety of yourself and your household.
On average, driving accidents rise during the holidays, so it’s crucial to have a safe ride on a night when so many people are out and about. New Years is a holiday that often involves a lot of drinking, so it’s important to ensure ahead of time that driving after a night of drinking is not an option. Don’t assume you’ll be able to hail a cab. Know your options in advance and decide whether you’ll take public transportation, use a ridesharing service, or carpool with your friends.
If you are a designated driver, then it’s extra important to use defensive driving maneuvers while on the road. Even though you are sober, there is a chance other drivers aren’t. Here are some tips if you think you are sharing the road with a drunk driver:
Set a reasonable curfew with your kids for their New Year’s Eve festivities. If they’re old enough to drive, be sure they understand the dangers of driving on the holiday. Encourage them to stay in one location instead of hopping from party to party.
New Year’s Day is the most active holiday for car thefts. If you must leave your car somewhere overnight, be sure it’s locked and try to pick it up as early as possible the next day.
Both guns and fireworks frequently make “celebratory” appearances at New Year’s Eve parties. But it might not be a good idea with the holiday crowds. Even though many people do it, it is illegal to use fireworks in the state of New York. Not only could you get a hefty fine, but if someone else gets injured you are now liable for injuring someone doing something illegal.
Steven Palermo is the managing partner for Palermo Law, Long Island’s Personal Injury Law Firm. He has been helping people receive compensation for their injuries for over 21 years. He focuses on cases involving car accidents, truck accidents, construction accidents and slip and fall injuries.
His book The Ultimate Guide to Handling New York Car Accident Claims details the ins and outs of a car accident claim in a simple, easy-to-read manner.