New York No Fault – Personal Injury Protection Explained By David Worby on February 15, 2021

A significant portion of the cases handled by the White Plains accident lawyers at Worby Vecchio Edelman involve automobile accidents. The issue of how victims of automobile accidents are covered for accident related medical treatment is an often complex area. We turn this month to the subject of No Fault Insurance.

Consider this scenario. You are driving to the local supermarket, and are fully stopped at a red light. There are a few vehicles in front of you, with a good amount of distance separating you from the vehicle directly ahead. You are wearing your seat belt, your hands are on the steering wheel, and you are paying full attention to the situation around you. Before the light turns green, you see a vehicle coming directly at you from behind, its driver seemingly oblivious to your presence. You have nowhere to go, so you brace yourself for the imminent heavy impact.

How are the Expenses From Your Auto Accident Going to be Paid?

In short, you have done nothing wrong. The appellate Courts of the State of New York all agree that in virtually all such cases, the driver that hit you is 100% at fault for the accident and the resulting injuries. We will address in a future column your claim against the driver for pain and suffering. The question which we focus on now is more immediate in nature – what are your medical expenses and lost earnings going to be, and how are those damages going to be paid?

No Fault Insurance for Motor Vehicle Accidents

You may think that the insurance company for the offending vehicle is required to pay your out of pocket expenses. That logical thought is nevertheless incorrect. In the mid-1970s, New York enacted the Comprehensive Motor Vehicle Insurance Reparations Act, the formal name for its system of No Fault Insurance for motor vehicle accidents. Pursuant to that Act, found in Article 51 of the New York Insurance Law, the insurance company for the vehicle in which the injured party was situated at the time of the accident pays for that person’s medical expenses. In cases where a pedestrian (which includes a bicyclist), is struck by a vehicle, the insurance company for that vehicle pays the expenses.

It seems unjust, but regardless of which vehicle bears responsibility for the accident, your own insurance company pays your medical expenses.

The No Fault system has two essential goals. The first is to bring immediate relief to any victim of a motor vehicle accident, such that that person’s medical expenses and a portion of their lost earnings can be paid without regard to fault. Since the insurance company for the occupied vehicle must pay these expenses, that party is able to obtain medical treatment without costly and extensive litigation. The second goal was to restrict a party’s right to litigate a damages case where the injured party did not sustain a Serious Injury.

New York No Fault Insurance has its critics, and there are aspects of the system which deserve criticism. We’ll leave that issue to the side and cover the basic tenets of the system. Each New York insurance policy is required to provide $50,000 per person in No Fault (also known as Personal Injury Protection, or simply “PIP”) coverage. That coverage pays for medical expenses, partial lost earnings, and related expenses, such as transportation to a doctor or other medical provider such as a physical therapist.

Additional Personal Injury (APIP)

Your carrier might offer a No Fault limit higher than $50,000. We recommend that you obtain this Additional Personal Injury Protection (also known as “APIP”) coverage. For a very small additional premium, that additional $50,000 can be valuable in the event of a very serious injury.

If you receive medical treatment immediately following a motor vehicle accident, try and provide the medical provider with insurance information for the vehicle which you occupied. Sometimes that information will not be readily available, such as if you were a passenger in a friend or relative’s vehicle. If you were in your own vehicle, though, provide your automobile insurance information, and not your medical insurance information. This will make things less complicated later on, such as if your medical policy contains a reimbursement provision. In most instances, the first $50,000 of No Fault benefits paid is not reimbursable to any insurance carrier, even if you recover money in a subsequent lawsuit.

Motorcycle Accidents and No Fault Insurance

We also give you this word of caution: motorcycles are not covered by No Fault insurance, so none of the above provisions applies if you were the operator of or passenger on a motorcycle at the time of the accident. In that case, your medical insurance would cover you for accident related medical expenses, but not for lost earnings.

You Must Make a Claim within 30 Days of the Accident

Finally, one more bit of advice. Pursuant to an insurance regulation promulgated in 2002, you must make a claim for No Fault insurance benefits within 30 days of the date of the accident. If you do not do so, you run the risk of the carrier denying coverage.

Contact our White Plains Accident Lawyers

The above explanations offer only a basic overview of the New York No Fault system; it may seem simple enough, but it is actually fraught with complexities, which cannot be covered in a simple blog entry. Call the White Plains accident lawyers at Worby Vecchio Edelman LLP if you’ve been involved in a motor vehicle accident. We can help you navigate the system, answer your questions, and handle the insurance details. Being involved in any type of accident can be a real shock. Let us help you recover from the trauma. We offer a free, no obligation consultation, and we don’t charge a fee unless we recover money on your case.