New York is a no-fault insurance state, meaning this policy protects drivers, passengers and pedestrians injured in automobile accidents without assigning blame for their losses.
Insurance covers medical/health expenses, lost wages and any other reasonable and necessary expenses associated with an accident. To access these benefits, an examination under oath (EUO) must take place wherein an insurance carrier will ask questions about your accident and injuries sustained during it.
What Is No Fault Insurance?
New York operates under a no fault insurance system, meaning that drivers and passengers injured in car accidents will be reimbursed by their respective insurance company for medical costs and lost wages regardless of who caused the crash. This form of reimbursement is known as Personal Injury Protection (PIP), and all vehicle owners must carry at least $50,000 PIP coverage.
However, it is crucial that you fully comprehend the limits and exclusions of this form of insurance coverage as well as how to file a no fault claim correctly; an experienced New York no fault insurance attorney can provide guidance through this process.
New York law mandates that no fault benefits be applied for by filing an MV104A application with your No Fault Insurance Carrier, usually that covering either the car you were in at the time of an accident, or one which struck you if you are pedestrian. A written notice with enough details to identify you must be provided within 30 days following a crash – our car accident attorneys can provide this form and assist you with filling it out and filing it correctly.
When filing a no fault claim, you will be asked for a list of medical providers and facilities who treated your injuries. It is essential that only providers listed within the No Fault network treat your injuries; otherwise your claims could be rejected. In addition, proof of losses must also be provided such as pay stubs and tax returns as proof.
If your expenses exceed the limits of your No Fault coverage, third-party damages could be an option to recover additional amounts. Our experienced car accident attorneys can help determine if there are grounds to sue and prepare the appropriate legal action to pursue those liable in order to seek them.
How Does No Fault Insurance Work?
United States auto accident compensation systems generally fall into two broad categories: fault and no-fault. Fault systems mandate that those responsible must pay compensation to any injured parties who sustained economic and noneconomic damages from the collision, including economic and noneconomic losses. No-fault claims allow drivers to recover without needing to prove fault – although there are certain important considerations they should know prior to filing a no-fault claim in New York.
No-fault insurance (also referred to as personal injury protection (PIP) in New York is mandatory car insurance coverage that provides reimbursement of medical costs and lost wages following an accident. PIP also covers travel costs between doctor appointments, prescription medication costs, household help services and household help expenses. Usually the maximum no-fault benefits available will not exceed $50,000; however you may opt to purchase additional coverage of an increased limit.
To file a no-fault claim, an application must be sent directly to the no-fault insurance carrier – usually that of either your vehicle of travel or of the one which struck you as pedestrian – within 30 days after an accident occurred. Your no-fault application will contain an identification number which must appear on all subsequent communications with them to ensure proper tracking. Harding Mazzotti LLP can assist in this step and can provide the application and forms needed for filing it.
Once you have filed a no-fault claim, your insurance carrier may ask that you undergo a medical exam with one of their designated physicians. It is imperative that you attend this appointment and follow advice given from this physician since the results of this examination will determine whether or not no-fault will continue paying your medical expenses.
New York law also permits accident victims to file suit against third parties for pain and suffering damages in severe accidents deemed no-fault by medical providers, provided you can show that negligence by one party led directly to their crash and injuries sustained as part of an incident.
What Are the Benefits of No Fault Insurance?
No-fault auto accidents provide compensation to injured parties for financial losses due to car accidents, and are commonly known as personal injury protection (PIP). New York requires vehicle owners carry at least $50,000 worth of this coverage per person injured. Furthermore, pedestrians and bicyclists who are hit by vehicles also are covered under PIP coverage.
No-fault insurance provides benefits such as payments for medically related expenses, funeral costs and work loss as well as limited coverage of other reasonable and necessary expenses like household help, travel costs and prescriptions. Individuals covered include owners, occupants or drivers of motor vehicles; persons named insured on policies; immediate family members as well as any others who can prove they were considered “covered persons” at the time of an accident.
No-fault insurance does not provide coverage for injuries to children under 16 and does not award damages for pain and suffering or emotional distress, such as can be awarded through personal injury lawsuits. Instead, no-fault policies only allow claims for medical bills, lost wages and other economic losses related to an accident.
Additionally, in addition to your $50,000 PIP coverage, you could file claims for funeral costs and work loss benefits of up to $3,000 and $1,500 respectively. Medical bills and lost income should be submitted within 30 days after an accident; otherwise your claims could be reduced or denied altogether.
If you are receiving lost wage benefits, in order to continue getting them each month you must present a doctor’s note from an independent healthcare provider indicating why you can no longer return to work. Your physician might just write you one; however, the no-fault insurance company may require further documentation from them.
Once again, provide a copy of the police report to your insurance provider so they may review it to ascertain who caused the accident and, if applicable, determine that they do not possess adequate coverage, then recover losses from that individual.
How Can I File a No Fault Claim?
Whenever involved in a car accident, it is necessary to file a No Fault claim with the insurer of each vehicle involved in the incident. You will need to provide your No Fault insurance information (usually found on police accident reports) when receiving medical care services for injuries sustained as a result of this collision.
No-Fault provides coverage for medical bills and lost wages, in addition to non-medical expenses like transportation to medical appointments, household help, childcare costs or food. You should submit documentation of non-medical expenses as soon as possible following an accident and keep copies for your records.
New York may be a No-Fault state, but that doesn’t preclude you from bringing suit for injury-related damages against any driver at fault in court. Noneconomic losses (such as pain and suffering) cannot be claimed in New York without meeting specific thresholds under law.
To opt out of the No-Fault system and sue for noneconomic losses, a high threshold must be met set by the State. This threshold depends on the severity of your injuries; to make sure this happens as quickly as possible after a car accident it’s important to visit a physician as quickly as possible for evaluation of whether or not your injuries meet this criterion.
Your No-Fault insurance carrier requires that, once meeting their threshold, you also attend an Examination Under Oath (EUO). An attorney representing their carrier will ask questions related to how your injury happened and its treatment; failing to do so could result in the termination of No-Fault benefits.
No matter who was involved in a motor vehicle accident, applying for No-Fault benefits should always be your top priority. If the insurance carrier denies you No-Fault benefits improperly, filing an arbitration claim and having an independent arbitrator determine if denial was valid is another option available to you; Harding Mazzotti attorneys can help prepare and submit the necessary paperwork in your claim for No-Fault benefits.
