New York officially became one of 12 no-fault insurance states back in the 1970s, and the main goal for implementing this law was to protect drivers by making sure that insurance companies would cover general costs associated with car accidents no matter who is responsible for the accident’s occurrence.

This law helps to expedite the compensation process for people who are injured in car accidents across New York because they won’t necessarily have to dispute who’s at fault before being paid for expenses like medical bills, lost wages and other medical needs associated with the accident.

How Much Do No-Fault Laws Cover?

Every New York insured vehicle will be provided a maximum of about $50,000 in no-fault coverage for everyone who was within the insured vehicle at the time of the accident.

No-fault insurance will help cover up to 80% of an individual’s gross wages that someone may lose because of an accident-induced injury, but the maximum provided ends up being $2,000 per month. No-fault payments are not taxable, which is why the state exempts 20% of an individual’s monthly gross wages.

No-fault laws in New York are designed to help people receive compensation from insurance companies for any type of legitimate economic losses, and this often includes hospital and ambulance expenses, prescription drugs, doctor bills, diagnostic tests, physical therapy and lost wages.

One of the main things that no-fault laws don’t cover is pain and suffering, which is something an individual would have to make an additional claim for against the at-fault party of the accident. Bodily injury claims are separate and distinct from no-fault claims, and they typically are the result of someone suing another party for their injury on top of pain and suffering. Bodily injury claims have different rules and laws associated with them, including coverage, standards of proof and available compensation from insurance companies.

Who’s Eligible for New York’s No-Fault Benefits?

You must meet the following criteria to be able to receive New York’s no-fault insurance benefits:

  • Your insurance policy was either sold within New York, or was issued by an insurance provider that is licensed within New York.
  • Your vehicle must be a compact car, truck, bus or taxi.
  • Only the people involved (drivers/passengers) in an insured vehicle receive coverage, including bicyclists and pedestrians struck by an insured vehicle.
  • The accident must take place within New York.
  • The person(s) injured in a crash must be a driver or passenger within an insured vehicle, or a pedestrian/bicyclist struck by an insured vehicle.
  • The insured vehicle needs to be registered within New York.

Who’s Not Eligible for No-Fault Insurance?

The following are typically not covered by no-fault insurance:

  • Motorcyclists and motorcycle passengers
  • Operators and passengers of scooters or Vespas
  • Those who get in an accident within their vehicle, and don’t have auto insurance.
  • Those with out-of-state insurance policies, or with policies from an insurance provider that isn’t licensed within New York.
  • Drivers who were injured/involved with an accident while under the influence of alcohol or drugs.

Filing a No-Fault Claim

There are many strict steps that must be followed correctly when filing a no-fault insurance claim. Although the whole purpose of the no-fault law was to help expedite the compensation process, insurance companies have made this entire procedure very difficult by taking advantage of any mistakes a claimant may make in order to deny coverage.

This can include very minor mistakes like missing a filing date, a doctor’s appointment, or incorrectly entering out a form. Sometimes insurance providers will even deny claims that are perfectly filled out simply because one of their doctors doesn’t think you require treatment.

It’s crucial that everyone adheres to the following steps to avoid being denied benefits:

  • Complete the no-fault application, or NF-2 form, provided from your insurance company. You can also always request this form as well. This form may come from the other party’s insurance carrier. If you were a pedestrian/cyclist struck by a car and you own a car, you can also send this application through your own insurance company.
  • File the application, and make sure you do so within 30 days of the accident’s occurrence. If you fail to meet this strict deadline then your entire application is deemed void.
  • Send the application to the correct insurance provider, and this can include the company of the car that struck yours, your insurance company, or the company associated with the vehicle you were riding in. There are incidents in which some drivers are uncooperative in providing this type of information, which is why you must always call the police and have them file an official accident report.
  • Submit all forms. You also must submit all medical bills and lost wages forms within a timely manner. Medical bills typically must be submitted within 45 days of treatment, and lost wages must be submitted within 90 days of the accident’s occurrence.

Why Contact a Lawyer?

No-fault laws have dramatically changed into very adversarial insurance disputes, and these rules are regularly changing making it more and more difficult for injured people to comply with every single necessary insurance element.

Our team at Siler & Ingber, LLP won’t charge you for handling any no-fault aspects of your case while simultaneously handling your personal injury litigation, and all of us are familiar with no-fault regulations. We understand those subtle nuances of New York insurance companies and can help you navigate through any of their attempts to deny your benefits.

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