What Is Personal Injury Cover?

Personal Injury Cover

In other countries, like the UK, personal injury cover is part of a car insurance policy that may cover medical costs, lost earnings, and other expenses if you are injured in a car accident. If you tragically lose your life, personal injury cover (also called personal accident cover) could pay a lump sum to your surviving family members.

In the US, the equivalent is Personal Injury Protection (PIP). In the State of New York, a minimum of $50,000 of no-fault coverage, or PIP insurance, is required. Drivers operating rideshare vehicles must have a minimum of $75,000 coverage. However, the actual expenses of serious accidents often far exceed these figures.

While Personal Injury Protection (PIP) should be your first port of call for help, you may have the right to explore all available legal avenues after a car accident. At Cellino Law, our experienced New York car accident attorneys are available 24/7 to provide free consultations to car crash victims. 

How Personal Injury Protection (PIP) Works in Manhattan

PIP insurance covers you in the following vehicle accident scenarios:

  • When driving your own vehicle
  • As a passenger in another person’s vehicle
  • As a bus passenger
  • As a pedestrian
  • As a cyclist
  • When struck by an MTA train, bus, or subway as a pedestrian

PIP also covers injuries to passengers in your car at the time of the accident.

However, there are exceptions. For example, in New York, PIP does not pay out if you were either riding or operating a motorcycle at the time of the accident. PIP payments are also reduced if you receive benefits such as Social Security Disability Insurance or workers’ compensation.

What does PIP cover in New York?

PIP covers almost all medical costs associated with a car accident. These include:

  • Hospital fees
  • Surgery costs
  • Dental expenses
  • Diagnostic services
  • Mental health services
  • Ambulance costs
  • Rehabilitation expenses

If your injuries mean you cannot work, PIP may also cover a portion of your lost earnings. It will pay 80 percent of your monthly earnings or $2,000 per month, whichever is lower. This could be paid out for up to 3 years, or up to the policy limit.

PIP can also pay $25 per day for help with routine chores. Therefore, if you can no longer take care of your home, cook meals, or do the laundry, you can use the $25 per day to pay for those expenses.

New York insurance policies require drivers to submit written proof of loss of earnings within 90 days. Insurers must pay out within 30 days, so it is best to submit these forms as promptly as possible.

Should I get optional PIP benefits?

While New York requires all drivers to have a minimum of $50,000 in PIP coverage, many opt to buy a higher level of coverage. One way to do this is by purchasing optional basic economic loss (OBEL) coverage.

OBEL is typically inexpensive and provides an additional $25,000 in no-fault insurance benefits. This could be very helpful if your injuries mean you cannot work for an extended period. You can also purchase additional PIP, which will vary in cost depending on your personal circumstances, location, and driving history.

Why Manhattan Drivers Need Personal Injury Protection (PIP) Insurance

Aside from being required by law, Empire State drivers need PIP because New York is a no-fault state. This means that, no matter who was responsible for causing the accident, you must file a claim with your insurer to cover your medical expenses.

Claiming medical expenses in New York

You will likely be required to provide your insurer with a recorded statement about the accident. The adjusters may also ask you to complete a medical exam by a physician of their choice. The insurance company could deny your claim if these and other terms are not met.

It is important to note that the amount of coverage you take out when you buy PIP insurance is the maximum amount you can claim in medical expenses. For example, if you take out the minimum $50,000 coverage, you can only claim up to $50,000 from the insurance company. 

Granted, your expenses could total up to much more. The National Safety Council (NSC) reported that, in 2021, the average economic cost associated with a disabling injury was $155,000.

If your expenses exceed $50,000 or the limit of any optional PIP coverage you have purchased, you can file a claim with your personal health insurance provider for help with certain expenses. Some people may qualify for Federal Social Security Disability benefits. 

For medical expenses, you must submit written proof to your insurer within 45 days after the start of treatment. This should explain the nature of your injuries, their seriousness, and the required treatment.

Can you sue in a no-fault state?

When there is a shortfall between your PIP coverage and your expenses, it is natural to wonder whether it is possible to sue for damages after a car accident in New York.

The simple answer is yes, but only in certain cases. First, your losses must also exceed the $50,000 PIP threshold. Second, you must have sustained a serious injury under Section 5102(d) of New York Insurance Law

This detailed statute covers the following injuries and more:

  • Death
  • Loss of a limb/limbs
  • Fractures
  • Loss of an unborn child
  • Permanent limitation of use of an organ or member
  • Non-permanent injury affecting daily activities for a minimum of 90 out of 180 days after the accident

Once your accident happens, the clock starts ticking on when you can make a claim. Under New York State’s statute of limitations, you must file a lawsuit within 3 years. 

Never hold back from pursuing your rights just because you are unsure whether your injury qualifies under this law. Our Manhattan car accident attorneys have extensive experience fighting for the rights of car accident victims and can provide the advice you need.

What damages can I pursue?

Manhattan law allows you to pursue both economic and non-economic damages. Economic damages include:

  • Medical expenses
  • Lost wages/business opportunities
  • Rehabilitation costs
  • Property damage

Non-economic damages are the intangible losses you may suffer after a serious accident, such as:

Manhattan has no cap on non-economic damages in car accident cases. If we agree to take on your case, our car accident attorneys will explore all possible options. They will tenaciously fight for your rights, using all their resources to try to secure the best possible settlement on your behalf.

Need More Than Personal Injury Cover? Trust Cellino Law to Fight Your Case

PIP is a valuable form of insurance that provides coverage and peace of mind in many situations. However, if someone else’s negligence on the road caused serious injuries, you may have the right to pursue more compensation beyond PIP alone.

Over the last 60 years, Cellino Law has won the trust of generations of New Yorkers. We have supervised over $2 billion in settlements, helping thousands of clients rebuild their lives.

We are here to help in your hour of need, and you can trust us to use all our resources to fight for you. Contact us today for a free case consultation with an experienced New York car accident attorney.



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