What Is No-Fault & What Does It Cover?
By Ross Cellino
If you were injured in a car accident in New York, no-fault insurance may help cover some of the costs that follow. Medical bills, time off work, and other accident-related expenses can add up quickly after a crash.
Understanding how no-fault insurance works can help you know what may be covered, where to file a claim, and what steps to take next. If you have questions about your rights after a crash, schedule a free case evaluation online or call us at 888-888-8888 to speak with a member of our team.
Key Takeaways About No-Fault Insurance
- No-fault insurance generally covers certain financial losses after a motor vehicle accident, regardless of who caused the crash.
- New York requires no-fault coverage as part of an auto insurance policy.
- Basic no-fault coverage provides up to $50,000 per person for qualifying economic losses.
- Coverage may include medical treatment, a portion of lost wages, and certain necessary expenses.
- No-fault insurance generally does not pay for pain and suffering.
- Strict deadlines apply when filing a no-fault claim.
What Is No-Fault Insurance?
No-fault coverage, also known as Personal Injury Protection (PIP), is a form of auto insurance that helps pay certain injury-related expenses without requiring you to prove who caused the crash.
In New York, basic no-fault coverage applies to drivers and passengers injured in an insured vehicle. It can also cover pedestrians injured by that vehicle.
For example, if another driver hits your vehicle, you may receive no-fault benefits for qualifying medical expenses and lost income through the insurance covering the vehicle you were in. You generally do not have to wait for the insurance companies to decide who was at fault before seeking these benefits.
What Does No-Fault Insurance Cover?
In New York, basic no-fault insurance can provide up to $50,000 per person for certain accident-related expenses.
Coverage may include medical expenses, lost wages, and other necessary expenses related to your injuries.
Medical Expenses
No-fault insurance may pay for reasonable and necessary medical care related to your injuries.
Covered services can include:
- Hospital treatment
- Doctor visits
- Surgery
- Ambulance services
- X-rays and diagnostic testing
- Prescription medication
- Physical and occupational therapy
- Rehabilitation
It’s important to tell your medical providers that your injuries resulted from a car accident so they know the treatment may be billed through no-fault insurance.
Lost Wages
If your injuries prevent you from working, no-fault insurance may also provide benefits for part of your lost income.
Under current New York law, lost earnings benefits are generally limited to 80% of lost income, up to $2,000 per month for no more than three years from the date of the accident.
Other benefits, including certain disability or workers’ compensation payments, can affect the amount available.
Other Necessary Expenses
No-fault coverage may also reimburse certain additional expenses caused by your injuries.
No-fault benefits can provide up to $25 per day for these expenses for up to one year after the accident. Depending on the circumstances, this could include transportation to medical appointments and other recovery-related services.
The New York Department of Financial Services specifically identifies household help and transportation to medical providers as examples of expenses that may qualify.
What Does No-Fault Insurance Not Cover?
No-fault insurance does not cover every expense or loss that’s caused by an accident. Basic no-fault benefits do not cover:
- Vehicle repairs
- Damage to personal property
- Pain and suffering
- The full amount of lost income in every case
- Expenses unrelated to your accident injuries
Damage to your vehicle or other property is typically handled through a separate part of the insurance claim.
Pain and suffering is also handled differently. In New York, you must have an injury that meets the state’s “serious injury” standard before you can seek compensation for pain and suffering from the at-fault driver.
Who Pays Your No-Fault Benefits?
The insurance company responsible for the claim depends on your role in the accident. If you were a driver or passenger, you usually file your no-fault claim with the insurer covering that vehicle. If you were a pedestrian, you usually file with the insurer of the vehicle that hit you.
Different rules may apply in accidents involving motorcycles, uninsured vehicles, or rideshare vehicles.
How Long Do You Have to File a No-Fault Claim in New York?
No-fault claims come with strict deadlines.
In most cases, written notice of the claim must be submitted within 30 days of the accident. New York regulations also require medical bills to be submitted within 45 days of treatment and lost wage claims within 90 days.
There are exceptions for late filings, but you may need to show a clear reason for the delay. Starting the claim early can help you avoid missing an important deadline.
Can You Still File a Personal Injury Claim?
Receiving no-fault benefits does not necessarily prevent you from filing a personal injury claim against the at-fault driver.
In New York, you usually need to meet the state’s serious injury threshold to seek compensation for pain and suffering. This can include broken bones, significant disfigurement, or injuries that cause significant or lasting limitations.
Whether you qualify depends on your injuries, medical records, and the details of the accident.
Questions About No-Fault Insurance After a New York Car Accident?
Navigating no-fault insurance after an accident can be difficult, especially when it comes to understanding what is covered, where to file a claim, and which deadlines apply.
If you were injured in an accident and have questions about no-fault insurance or whether you may have a personal injury claim, schedule a free case evaluation online or call us at 888-888-8888 to speak with a member of our team.
Content checked by the personal injury attorney Ross Cellino
Ross Cellino
As a family man and a trial attorney, I pride myself on winning cases and serving the community. With over 35 years of experience, I understand the function of a jury, how juries arrive at conclusions, and the role that the jury plays in administering justice. I know how to win cases. You can find us in Manhattan, Buffalo, Melville, Rochester, Brooklyn, The Bronx, Queens and other locations throughout New York.
