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New York’s No-Fault Insurance Law Protects Injured Parties

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New York State’s 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. This “no-fault insurance” provides reimbursement of a portion of the injured person’s economic or financial losses, which includes medical expenses, lost earnings and other reasonable expenses, such as prescriptions, travel expenses and household help. No-fault benefits are limited in most cases to $50,000 unless the insured purchased additional benefits.

To collect no-fault benefits, a claim must be filed within 30 DAYS OF THE ACCIDENT. Failure to file within this time period could lead to a reduction or a loss of benefits. The claim should be filed with the insurance company of the vehicle in which the victim is an occupant or with the vehicle that struck you, if you are a pedestrian. Once the insurance company has paid the entire $50,000 of benefits (or more if purchased), the company will pay no more benefits. An injured person can submit bills not paid by the No-Fault insurance company to their private health insurance. Click here for a no-fault claim form (NF-2) (PDF).

If your injury occurs in an uninsured vehicle, or the vehicle that struck you is uninsured, a no-fault claim should be filed with your own vehicles insurance company as well as with the auto insurance company of any family member in your household. If you or your family members did not have any auto insurance policies at the time of the accident, you may still file a claim for No-Fault benefits with the New York State Motor Vehicle Accident Indemnification Corporation (MVAIC).

There are exceptions in which a person injured in a motor vehicle accident will not be covered under the no-fault law. Motorcycle drivers and their passengers are not covered, although pedestrians injured by a motorcycle may file for no-fault benefits. Uninsured drivers are not covered by no-fault if the accident occurs in an uninsured vehicle. Also, no-fault benefits will be denied to anyone whose alcohol or drug use caused the accident, or who intentionally caused the accident.

Frequently Asked Questions About New York’s No-Fault Law

Who is eligible to receive no-fault benefits?

Anyone who is injured in a motor vehicle accident or hit by a car. It does NOT apply to people on a motorcycle but does apply to pedestrians struck by a motorcycle or motor vehicle.

How do I file my no-fault benefits?

Our staff will complete the application for our retained clients. A no-fault application must be filed with the no-fault insurance company within 30 days of the date of the accident. After the no-fault application is filed, the insurance company is responsible for medical bills, lost earnings and other reasonable and necessary expenses. The no-fault company is responsible for sending the appropriate forms to the doctors, hospitals and your employer as listed on the application.

How long can the insurance company take before they compensate me?

The no-fault company can take up to 30 days from the date it receives all appropriate documentation. The no-fault company is required to pay 80% of your lost earnings, up to a maximum amount of $2,000 per month. The no-fault insurance company is responsible for paying lost earnings up to three years from the date of the accident (subject to restrictions) or until $50,000 in combined benefits (medical and/or wage, etc.) have been paid, whichever occurs first.

How long will New York State disability pay me if I am unable to work?

Disability will pay you for twenty-six (26) weeks (not including the first week you are disabled); assuming of course, you are actually disabled and your doctor and employer verify your disability.

Who will pay me if I am unable to work after New York State disability payments stop?

The no-fault insurance company will continue to pay lost earnings up to three years from the date of the accident as long as your doctor has said that you are unable to work because of the injury from your accident or until you have exhausted $50,000 in combined lost earnings and medical payments.

What will the no-fault insurance company pay if the injuries should result in death?

The no-fault insurance company is required to pay a death benefit in the amount of $2,000.

What do I do with medical bills for treatment rendered as a result of the accident to my child or other family members who are not pursuing a personal injury claim?

You, on behalf of your child, as well as other family members, on their own behalf, are still required to file for no-fault benefits within 30 days from the date of the accident, even if not pursuing a personal injury claim.

The parents or guardian of a child under eighteen (18) remain legally responsible for any medical bills incurred for treatment rendered to the child as a result of the accident. The general rule in New York is that a child under the age of eighteen (18) is not responsible for his or her own medical treatment.

Medical bills must be submitted as soon as received. Failure to do so could lead to non-payment by the health insurance company for failure to meet time limits. A no-fault company will not pay any bill submitted after 45 days from date of treatment.

The injury attorneys at 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 917-920-9431 or click Tell Us About Your Case.

Frequently Asked Questions: Automobile and Motor Vehicle Accidents