Understanding The Basics of No Fault Insurance in New York State

No-fault insurance seems like a great idea on paper. Under a no-fault system, each driver pays for their own coverage to protect them in case of an accident. This way, your own investment in your insurance benefits you later, and you never have to rely on someone else to carry insurance.

In practice, no-fault insurance places a lot of restrictions on drivers and their right to sue. In New York, these restrictions can stop you from claiming full compensation for your injuries and block pain and suffering damages. To get full compensation, you may need to pursue a lawsuit – but your right to sue is also limited. It is important to work with a lawyer to navigate the aftermath of your car accident case.

For a free case review, call our Westchester car accident lawyers at The Martello Law Firm for a free case review. Our number is (914) 685-6950.

What Are No-Fault, PIP, and First-Party Benefits in New York?

A “no-fault” insurance system is a system where each driver carries “first-party benefits” called “PIP.” Understanding each of these terms is important to understand how your insurance works and what claims you can file after a car accident in NY.


A no-fault insurance system is one where each driver carries insurance to cover their injuries after an accident. It’s called a no-fault system because you do not need to prove fault before getting compensation from your insurance. Your insurance should cover you regardless of who caused the accident.

No-fault systems also limit your right to sue. Different states use different thresholds that you have to reach before you can sue. In New York, there is a “verbal threshold,” which uses a definition of “serious injuries” that you have to meet before you can sue.

Talk to our New Rochelle car accident lawyers about your no-fault coverage and whether or not an insurance claim will be the best path to recovery in your car accident case. Keep in mind that this no-fault system applies only to injuries, so if you are dealing with vehicle damage only, you will file an at-fault claim with the other driver’s insurance to get coverage.

First-Party Benefits

First-party insurance benefits are ones that are paid to the insurance customer directly. With first-party benefits, the policyholder gets benefits paid to them for injuries they suffered. Most first-party benefits are part of no-fault policies, so you do not need to prove who caused the accident before these policies pay out damages.

Many insurance systems use third-party benefits instead. In this setup, whoever is at fault has insurance to cover the damages they caused. There, the victim files a third-party claim with the at-fault party’s insurance.

With no-fault insurance systems like the one used in New York, paying more into your insurance for higher coverage ultimately helps you in the end. You (and your passengers) will reap the benefits of your policy, so paying for higher insurance generally helps you if you get injured in a car crash.

First-party benefits are sometimes available even in at-fault states, so if you were an out-of-state driver injured in a car crash in New York, you might still have MedPay or a similar first-party benefit that protects you.


PIP stands for personal injury protection. A PIP policy is a no-fault insurance policy that provides first-party benefits. This is the type of no-fault policy that you are required to carry as a driver in New York. That means that when we say “no-fault insurance,” we are usually talking about your PIP policy.

Under NY law, every driver is required to carry PIP coverage to cover “basic economic loss.” Under I.S.C. Law § 5102, that’s $50,000 worth of compensation for various medical expenses and lost wages. That includes coverage for diagnostic procedures (e.g., X-rays), psychiatric care, physical therapy, and other needs. It also includes lost earnings from work, which can include past wages lost during recovery and future lost earning capacity. Some other economic damages might also be included.

PIP also covers bike riders and pedestrians hit by the driver.

Summary of Benefits Available to No-Fault Insurance Claimants in New York

Those pursuing no-fault insurance benefits may recover multiple categories of economic damages. The car accident attorneys at our law firm can help fight for each of the following benefits in your claim:

Medical Expenses

First, no-fault insurance claimants may obtain payment for medical bills they incurred because of their car accident injuries. This form of compensation may reimburse claimants for past, current, and future expenses related to the harm they sustained. The followings are all examples of medical expenses that may be compensated:

  • Ambulance rides
  • Medical imaging
  • Surgical operations
  • Physical therapy
  • Psychiatric care
  • Prescription drugs
  • Dental care

Still, there are many other types of medical expenses that car accident victims can suffer. Our team of experienced lawyers can help recover fair payment for your medical bills after a crash.

Lost Income

Many car accident victims are unable to work while their injuries heal. Fortunately, no-fault insurance claimants in New York may also pursue payment for lost income that they suffered because of their injuries.

Limits of PIP and No-Fault Benefits in New York

It is important to understand that PIP does not cover any non-economic damages. That means that coverage for pain and suffering is not included in a PIP claim, and you cannot get these damages paid through no-fault insurance coverage. A lawsuit can, however, get you access to these damages – but there are other restrictions on PIP damages to be aware of.

Other restrictions may cut into how much money you ultimately receive when filing a no-fault insurance claim for first-party benefits with your PIP insurance. Namely, § 5102(b)(1) states that PIP coverage excludes 20% of your lost wages, so you can only claim up to 80% of the wages you lose when filing an insurance claim. Additionally, you may have to pay deductibles before you can get PIP payments, leading to additional out-of-pocket costs.

With all of these restrictions on what PIP pays, you might have to turn to an alternate route to recovery with the help of your Mount Vernon car accident lawyer.

Suing for Damages in New York’s No-Fault Insurance System

When you are covered by a PIP policy, you cannot sue unless your injuries meet the “serious injury” threshold. This applies to both covered drivers and passengers. Since PIP also covers cyclists and pedestrians, they face the same restrictions.

People who are covered by PIP can sue when they meet the definition of a “serious injury” under § 5102(d). This includes any disfigurement, permanent injury, loss of a body part, broken bone, or other specific injuries listed in that statute. Additionally, any injury serious enough to interrupt your activities for 90 of the next 180 days after the injury should also qualify as sufficiently “serious” to allow a lawsuit.

Motorcycle riders are not beholden to the no-fault system. This usually allows motorcycle riders to sue for injuries after their accidents.

Proving that Your Injury is Serious Under New York’s No-Fault Insurance Laws

During your free case review, our car accident attorneys can help determine if your injury qualifies as serious under New York’s no-fault insurance laws. Each of the following factors may be analyzed:

Medical Records

Proper documentation of your injury is necessary to prove that you suffered serious harm. Therefore, you should seek medical attention for any car accident injuries as soon as possible. If you wait to let your injuries heal on your own, it may inhibit your ability to bring a case against another driver.

Gaps in Medical Treatment

Gaps in your medical treatment may be used to assert that your injury is not serious. If you have a valid reason for a gap in your medical treatment, then our lawyers can help prove that the gap was justified.

Pre-Existing Injuries

Additionally, pre-existing injuries may be used to complicate your serious injury claim. If you had pre-existing injuries or illnesses prior to suffering your accident, then you may have to acquire a report from your doctor stating that your pre-existing injuries are not linked to the harm suffered because of your crash. Our attorneys can help you obtain such a report.

How to Recover No-Fault Insurance Benefits in New York

In the aftermath of a car accident, it can be hard to know what to do to recover payment for the damages you incurred. Still, there are certain steps you must take in order to obtain fair compensation. Fortunately, our car accident attorneys can provide you with guidance every step of the way.

Report Your Accident to the Police

If you suffered a car accident that caused an injury in New York, then you must dial 911 and report your crash to the authorities. Those who fail to report injurious accidents may be charged with hit-and-runs and can be prevented from recovering payment for the harm they sustained. Furthermore, after reporting your crash, a police officer will come to the scene to draft an accident report. These reports usually provide information that is very valuable to lawyers and insurance companies when assessing damages and determining how crashes occurred.

Report Your Accident to Your Insurance Company

You will have to provide written notice informing your insurance company of your accident within 30 days of your collision. Waiting to inform your insurer of your crash could force you to miss out on no-fault insurance benefits. If you suffered car accident injuries while riding as a passenger, then you should file your claim with the insurer of the car you were in when your collision happened.

The written statement you provide to your insurance company should include a detailed explanation of how your crash happened and the damages it caused. Still, you should not apologize or admit fault for your accident. You may need to step outside of no-fault insurance coverage in order to recover fair compensation. In that case, any statement you made that might be construed as an admission of fault could be used against you. Our car accident attorneys can help when drafting your written statement and reporting your accident to your insurer.

Will Your Vehicle’s Damage Be Covered by a No-Fault Insurance Claim in New York?

New York’s no-fault car insurance rules only apply to damages related to plaintiffs’ injuries. Generally, reimbursement for vehicle damage is the responsibility of at-fault motorists. Drivers in New York must carry a minimum of $10,000 in insurance coverage for collision damage. Accordingly, claims for property damage are usually made against defendants’ insurance policies.

Unfortunately, many car accidents cause property damage that exceeds the limits of negligent drivers’ coverage. Furthermore, in some instances, insurance companies dispute the extent of damage suffered by plaintiffs or argue that damage was not caused by the crashes at issue. In such cases, victims may have to file lawsuits against at-fault parties and their insurers in order to obtain the payment that is deserved. The support of our car accident attorneys can be very helpful when you are pursuing compensation for property damage caused by a collision.

Under C.V.P. Law § 214, you will typically have three years from the date of your accident to file such a claim. Still, crucial evidence needed to support your case can deteriorate quickly. You should get in touch with our law firm as soon as possible after your collision. Our team of experienced lawyers can help gather evidence and bring your lawsuit to court in a timely manner.

How Our Lawyers Can Help When Filing a No-Fault Insurance Claim in New York

Filing a no-fault insurance claim in New York can be a tiresome and frustrating endeavor. The experienced car accident attorneys at our law firm will help explain the process and obtain the benefits available to you. Furthermore, our lawyers can review your case and determine if you should seek additional damages by filing a lawsuit against another driver. Our team will fight for the maximum amount of compensation available in every case.

Call Our New York Car Accident Lawyers Today

If you were hurt in a car accident, call the Yonkers car accident attorneys at The Martello Law Firm today at (914) 685-6950 for a free case review.

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