New York State No-Fault law requires that every motor vehicle provide personal injury protection coverage in order that persons injured in a motor vehicle accident receive benefits regardless of who caused the accident or who was at fault. During this stressful time, it is difficult to understand the very complicated insurance laws and regulations, particularly those involving No-Fault benefits. Without a thorough understanding of New York States insurance laws and regulations, reimbursement of expenses can be difficult to obtain. Our experienced staff will guide each client through the maze of regulations and complete all procedures for our clients, only after signing our Retainer and formally becoming a client of our firm.
TIPS FROM OUR STAFF:
You must file a New York State disability form with your employers disability carrier thirty (30) days from the date of your accident or the date you become disabled as a result of the accident. If you do not do this, you may lose a portion or all of your disability benefits.
If you were injured in the course of your employment when the accident happened, you must file for Workers Compensation benefits through your employer. The workers compensation company will pay you a portion of your earnings and the No-Fault carrier will pay you a portion totaling eighty (80) percent of your gross earnings, or up to $2,000 per month. When you receive papers from workers compensation, you must give a copy to your attorney.
The No-Fault insurance company is entitled to have you examined by a doctor it chooses. This is called an independent medical exam. Often after the exam, the No-Fault company will deny your claim, refusing to pay you for your medical expenses. If your doctor believes you need treatment, you should still continue your medical care regardless of the denial. Failure to continue treatment will falsely lead the defendants insurance company to conclude that you have fully recovered and are no longer injured.
What to do after the denial?
If you have private health insurance, arrange for the company to pay your medical bills. Even though your own health insurance is paying, you must tell the doctors, hospitals and therapists to continue to submit the bills to the No-Fault company or your attorney can submit them for you. An arbitrator may eventually decide about bills that have been submitted to the No-Fault company and denied, but the company may decide only on those bills submitted. You must continue to get disability notes from your doctor and submit them to protect your lost wage claim.
If you are paying the medical bills out of your own pocket, the instructions above also apply. The bills should be sent to the No-Fault company, even though it is going to deny the bills.
If you do not have any insurance and cannot afford to continue treatment, speak to your doctor concerning your continued treatment on a lien basis. These additional medical lien expenses would become part of the damages being claimed in your underlying case against the defendant.
The No-Fault carrier will tell you how to fight or arbitrate the denial. You MUST NOT ARBITRATE THE NO-FAULT DENIAL UNTIL AFTER YOUR LAWSUIT IS RESOLVED. Failure to follow this advice can destroy your lawsuit.
IMPORTANT SUGGESTIONS TO FOLLOW:
- Never discuss your case or injury with anyone outside of your attorneys office. Refer all questions about your case to your attorney.
- Always keep copies of every document you mail to the No-Fault company. For instance, documents such as bills, lost wage forms, mileage statements, etc., should always be copied and kept for your own files.
- Immediately advise your attorney of any new doctor or hospital visits. Send the doctor's card with your name and file number written on the back to your attorney.
- Immediately advise your attorney if you stop treating.
- Never sign anything for anyone without first showing your attorney.
- Do not leave the New York State disability form with your doctor or your employer. You have only thirty (30) days from the date of the accident or the date you become unable to work to send this form to your employers insurance company.
Lozner & Mastropietro is dedicated to representing victims of automobile and motor vehicle accidents. If you or a loved one has been injured as a result of an automobile or motor vehicle accident or you simply need more information, please contact us at 1-718-615-0044 or click Tell Us About Your Case.