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Understanding No-Fault Insurance in New York and How It Affects Car Accident Claims

One person is answering question about no fault insurance.

In New York, understanding the state’s no-fault insurance system is crucial for anyone involved in a car accident. The no-fault law (New York Insurance Law 5102) determines who is liable to pay for your damages and how much you can receive. At Rusk, Wadlin, Heppner & Martuscello, LLP, our goal is to help injury victims in the Hudson Valley get the full amount of compensation due to them when they have been seriously injured by a negligent driver. Below we discuss important aspects of New York’s no-fault insurance law, including when it applies and when it doesn’t. For help after a car crash in the Hudson Valley, contact Rusk, Wadlin, Heppner & Martuscello, LLP to speak with an experienced and successful Kingston car accident lawyer.

What Is No-Fault Insurance?

New York is a no-fault insurance state, which means that regardless of who caused the accident, your insurance company is responsible for covering your medical expenses and certain other losses. The primary purpose of this system is to reduce the number of personal injury lawsuits and ensure that individuals receive prompt payment for their out-of-pocket expenses. Key benefits of New York’s no-fault insurance scheme include:

  1. Medical Expenses: No-fault insurance covers all reasonable and necessary medical expenses resulting from the car accident, including hospital bills, surgeries, rehabilitation, and medication, subject to your policy limits, which are $50,000 on a basic policy.
  2. Lost Wages: If your injuries prevent you from working, no-fault insurance can cover a portion of your lost wages, typically up to 80% of your income, subject to a maximum limit.
  3. Other Expenses: This insurance can also cover other reasonable expenses related to the accident, such as transportation to medical appointments and household help.

To take advantage of the benefits provided by no-fault insurance, it is essential to follow the correct procedures when filing a claim. You must notify your insurance company of the accident as soon as possible, ideally within 30 days. Fill out and submit a no-fault application form (Form NF-2) provided by your insurance company. This form requests information about the accident, your injuries, and your medical treatment. When submitting your form, include all relevant documentation, such as medical bills, proof of lost wages, and any other expenses related to the accident.

When Can You Sue for Additional Compensation?

While no-fault insurance covers many expenses, it does not compensate for pain and suffering or other non-economic damages. However, you may be able to file a personal injury lawsuit against the at-fault driver if your injuries meet certain criteria. New York law allows car accident victims to sue for additional compensation if they suffer a “serious injury.” According to New York Insurance Law § 5102(d), a serious injury includes:

  • Dismemberment
  • Significant disfigurement
  • Bone fracture
  • Loss of a fetus
  • Permanent loss or limitation 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
  • Substantial disability for 90 days or more within the 180 days immediately following the accident

If your injuries meet any of these criteria, you can pursue a claim for pain and suffering, emotional distress, and other non-economic damages. In these situations, the burden falls on you to prove the other driver’s fault and the extent of your injuries, and legal representation is highly recommended to handle this legal process successfully.

Even no-fault claims can still present challenges, including denial of claims, delayed payments, and insufficient coverage. Insurance companies may deny claims if they believe the injuries are not severe enough or if there are discrepancies in the documentation. Insurers sometimes delay payments by making repeated requests for documentation and putting off a determination, making it difficult for accident victims to cover their medical expenses and other costs. Additionally, the coverage limits of no-fault insurance may not be sufficient to cover all the expenses related to a severe accident.

How Rusk, Wadlin, Heppner & Martuscello, LLP Can Help

At Rusk, Wadlin, Heppner & Martuscello, LLP, we understand the complexities of New York’s no-fault insurance system and are dedicated to helping car accident victims navigate their claims. Our experienced attorneys can help ensure your no-fault claim is filed correctly and advocate on your behalf if your claim is denied or if payments are delayed. If you meet the serious injury threshold, our lawyers will help you pursue additional compensation through a personal injury claim or lawsuit.

Contact Us After a Car Accident in the Hudson Valley

If you or a loved one has been seriously injured in a car accident in the Hudson Valley, contact Rusk, Wadlin, Heppner & Martuscello, LLP today for a free consultation. Our knowledgeable attorneys are here to provide the guidance and support you need to secure the compensation you deserve. Call 845-331-4100 in Kingston, 845-236-4411 in Marlboro, or toll-free throughout the Hudson Valley at 800-566-4101. Let us help you navigate this process and protect your rights every step of the way.

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