Understanding No-Fault Auto Insurance in New York: What It Means for Your Injury Claim

Understanding No-Fault Auto Insurance in New York: What It Means for Your Injury Claim

New York follows a no-fault auto insurance system, which often causes confusion for accident victims. After a motor vehicle accident, many people are unsure who pays their medical bills, whether fault matters, and when they can pursue a lawsuit. Hill & Moin regularly assists vehicle accident victims throughout New York City who are navigating no-fault insurance claims and serious injury cases.

Understanding New York’s no-fault insurance system is essential to protecting your rights and maximizing your recovery after a car accident.

What Is No-Fault Auto Insurance in New York?

New York is a no-fault state, meaning that after most car accidents, each injured person first turns to their own insurance company for coverage—regardless of who caused the crash.

This system is designed to:

• Provide quick access to medical care
• Reduce lawsuits for minor injuries
• Cover basic economic losses without proving fault

Under New York law, drivers are required to carry personal injury protection (PIP coverage).

What No-Fault Benefits Cover

No-fault benefits—also called basic no-fault or PIP coverage—typically pay for:

• Accident-related medical expenses
• Medical bills from approved medical providers
• Prescription drugs
• Physical therapy
• Lost wages and lost earnings (up to a limit)
• Necessary transportation to medical appointments

These benefits are paid by the no-fault insurer, not the at-fault driver’s insurance company.

What No-Fault Insurance Does NOT Cover

While no-fault coverage helps with immediate costs, it has important limits.

No-fault insurance does not cover:

• Pain and suffering damages
• Non-economic damages
• Property damage to your vehicle
• Losses above the basic economic loss limit

To recover these damages, you must meet New York’s serious injury threshold.

What Is the Serious Injury Threshold?

Under New York law, accident victims may only file a personal injury lawsuit against the at-fault driver if they suffered a serious injury.

The serious injury threshold includes injuries such as:

• Significant limitation of use of a body function
• Permanent consequential limitation
• Fractures
• Traumatic brain injuries
• Serious disfigurement
• Injuries preventing normal activities for 90 of the first 180 days

Meeting this threshold allows victims to seek compensation beyond no-fault benefits.

When Fault Matters in New York Car Accidents

Although New York uses a no-fault system, fault still matters once the serious injury threshold is met.

If you qualify:

• You may file a personal injury claim against the at-fault driver 
• Liability insurance may cover additional damages
• You may seek compensation for pain and suffering

This is where fault insurance and no-fault insurance intersect.

Filing a No-Fault Insurance Claim

After an accident occurs, injured parties must file a no-fault application quickly—typically within 30 days.

Key steps include:

• Notifying your insurance carrier
• Submitting medical bills
• Providing medical records
• Complying with insurer requests

Failure to meet deadlines can jeopardize no-fault benefits.

Medical Providers and No-Fault Insurance

Medical providers often bill the no-fault insurer directly. However, disputes can arise if the insurance company questions:

• Whether treatment was necessary
• Whether injuries were accident-related
• Whether providers were authorized

Legal guidance can help resolve denied or delayed payments.

Lost Wages and No-Fault Benefits

No-fault insurance can cover lost wages if injuries prevent you from working. These lost wage claims are subject to weekly and total limits.

If injuries cause long-term disability or lost earning capacity, additional compensation may require a lawsuit against the at-fault party.

What Happens If No-Fault Coverage Is Exhausted?

If medical expenses or lost earnings exceed no-fault limits, accident victims may pursue:

• A personal injury lawsuit (if the serious injury threshold is met)
• Additional coverage under other insurance policies
• Claims against uninsured vehicles in certain situations

This often requires detailed analysis of insurance coverage and fault.

No-Fault Insurance vs Fault Insurance

Unlike fault insurance states, New York’s no-fault system limits lawsuits for minor injuries. However, once a serious injury is established, traditional fault-based claims apply.

Understanding how no-fault insurance works is critical to knowing when you can pursue full compensation.

Common Mistakes in No-Fault Claims

Accident victims often make mistakes that hurt their claims, including:

• Missing deadlines
• Failing to submit medical records
• Assuming no-fault covers pain and suffering
• Not consulting an attorney early

Insurance companies may deny benefits or undervalue claims without proper advocacy.

Why Legal Representation Matters in No-Fault Cases

No-fault cases may appear simple, but they often involve:

• Insurance disputes
• Serious injury claims
• Medical documentation challenges
• Coverage denials

An experienced personal injury law firm can:

• Handle the no-fault insurer
• Preserve your right to sue
• Maximize compensation
• Navigate New York’s insurance laws

No-Fault Auto Insurance in New York City

Hill & Moin represents accident victims throughout New York City who are dealing with no-fault insurance, serious injuries, and complex claims. Local experience with New York’s insurance law and courts makes a meaningful difference.

Speak With Hill & Moin About Your No-Fault Injury Claim

If you were injured in a New York car accident, understanding your no-fault insurance rights is critical to your recovery. Hill & Moin helps accident victims pursue all available benefits and compensation under New York law.

We offer a free consultation to review your case, explain your options, and determine whether you may pursue a personal injury claim beyond no-fault benefits. Contact Hill & Moin today to protect your rights and your future.