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What Does No-Fault Insurance Cover in New York?

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.

Requirements for No-Fault Benefits

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.

What No-Fault Insurance Will Cover

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.

Your Options Once No-Fault is Exhausted

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.

About the Author

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.