What Does No-Fault Car Accident Insurance Cover In New York State?

by William Mattar | May 3rd, 2022

Are You Covered?No-fault vehicle insurance in New York is compulsory, compensating for certain economic losses including medical bills, lost wages, and other expenses. 

In New York, Who Is Eligible for No-Fault Benefits?

Pedestrians, drivers, passengers, and household relatives can qualify as “insureds” under a standard New York no-fault insurance policy. Generally speaking, the insurance policy issued for a vehicle driven or occupied by the injured person will be the primary no-fault insurance policy, followed by a policy issued to a resident-relative.

There is a hierarchy of coverage, which depends on the particular facts of the case. Read on to find out more.

Limitations on the Eligibility for New York’s No-Fault Benefits

No-fault coverage provides limited coverage for “basic economic loss,” which is defined to include “up to fifty thousand dollars per person” for medical expenses and lost wages, up to a maximum amount of $2,000 per month for up to three years from the date of the accident, and up to $25 a day to reimburse other reasonable and necessary expenses.

Many injured persons have medical expenses or lost wages that far exceed these figures. While those additional economic losses may not qualify as “basic economic loss,” the injured person can still make a claim for them. An attorney can assess the situation, and potentially recommend a claim against the at-fault motorist to help make up the difference.

There may also be additional insurance coverage, including Optional Basic Economic Loss (OBEL) and Additional Personal Injury Protection (APIP), which can help. 

When to File Insurance Claims for No-Fault in New York

After a car accident in New York, you must file a written claim with the applicable no-fault insurance company within 30 days. Sometimes a failure to comply with this time deadline can be excused, but it is a good idea to identify the applicable no-fault insurance companies and comply with the deadline by filing the prescribed form within 30 days.

How to File a Lawsuit for Personal Injury Against the Person Responsible

Those who have sustained a “serious injury” can file a lawsuit against the at-fault motorist to recover damages for pain and suffering.

According to the New York Insurance Law, a “serious injury” is defined as a personal injury that results in: 

  • death;  
  • dismemberment;  
  • significant disfigurement;  
  • a fracture;  
  • loss of a fetus;  
  • permanent loss of use of a body organ, member, function, or system;  
  • permanent consequential limitation of use of a body organ or member;  
  • significant limitation of use of a body function or system;  or
  • a medically determined injury or impairment of a non-permanent nature that prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less than 90 days during the 180 days immediately following the occurrence of the injury or impairment. 

Hurt in a Car? Call William Mattar.

It’s not always as easy to get the compensation you deserve. Some insurance firms have a reputation for not paying out on legitimate claims. 

If you were injured in a car accident, you can contact an experienced car accident attorney at William Mattar, P.C. by calling (716) 444-4444. We have the knowledge and experience to discuss your unique situation and see if we can help you.