New York is one of 12 no-fault auto insurance states in the U.S. This means both drivers involved in an accident file claims through their own insurance carrier, regardless of fault. Understanding how no-fault insurance works in New York is critical for all motorists in the state. This guide will explain the key provisions, benefits, and requirements of New York’s no-fault system.
What is No-Fault Auto Insurance?
With a no-fault auto insurance system, accident victims recover economic losses from their own insurer, no matter who caused the accident. Economic losses include medical bills, lost income, and other out-of-pocket expenses up to the policy limits.
The main difference from a traditional “at-fault” insurance system is that neither driver has to prove fault or take legal action to receive compensation for losses. However, there are still situations where filing a liability claim against the at-fault driver makes sense in a no-fault state.
No-fault auto insurance has three main objectives:
- Allow prompt reimbursement of economic losses
- Reduce litigation between drivers
- Lower car insurance costs
New York implemented its no-fault insurance system in 1974. Currently, 12 states and Puerto Rico have some form of no-fault auto insurance laws.
Key Provisions of New York’s No-Fault Law
New York’s no-fault insurance system contains several key provisions drivers should understand:
Personal Injury Protection (PIP) Coverage
Also called “no-fault” benefits, this mandatory coverage pays for medical treatment, lost earnings (up to 80%), and other reasonable expenses caused by an accident, up to policy limits. PIP does not cover vehicle damage.
Split Liability Thresholds
Drivers can only file lawsuits for pain and suffering if they meet the “serious injury” threshold under no-fault law. There is no threshold for economic losses – those can always be claimed.
Direct Compensation
Drivers make injury claims with their own insurer, not the at-fault driver’s insurer. Fault still determines who reimburses insurers.
Property Damage Liability
At-fault drivers are still liable for damage to other vehicles or property, covered by required liability insurance.
Out-of-State Accidents
New York no-fault benefits apply to accidents occurring in other no-fault states. Accidents in non-no fault states follow that state’s rules.
No-Fault Insurance Benefits in New York
New York’s no-fault system provides the following first-party benefits after an auto accident:
- Up to $50,000 for medical treatment, rehabilitation services, and loss of earnings
- Reimbursement of up to 80% of lost income, not to exceed $2,000 per month for up to 3 years
- Up to $25 per day for up to 1 year to reimburse reasonable expenses like transportation and home services
- $2,000 death benefit if the insured dies in a car accident, in addition to the $50,000 limit
These no-fault benefits are paid by your own auto insurance company, not the at-fault driver’s insurer. You also do not have to prove fault to receive no-fault benefits.
However, your insurer can later recover these costs from the at-fault driver’s insurance company. Your premiums should not increase due to filing a no-fault claim after an accident you did not cause.
New York No-Fault Car Insurance Requirements
In addition to state-mandated liability coverage, drivers in New York must carry the following no-fault coverages:
- Personal Injury Protection (PIP): $50,000 per person for medical costs, lost wages, and other expenses
- Additional PIP: Optional added PIP limits up to $150,000 total
- Basic Economic Loss (BEL): $50,000 total limit for combined economic losses
Liability requirements include:
- Bodily Injury: $25,000 per person / $50,000 per accident
- Property Damage: $10,000 minimum
- Uninsured Motorist: Same as liability limits
So at a minimum, a New York auto policy must include $50,000 in PIP and $25,000/$50,000 bodily injury liability limits. Higher optional limits are available. Carrying adequate coverage is essential when driving in a no-fault insurance state like New York.
How No-Fault Claims Work in New York
After an auto accident, here is the basic no-fault claim process in New York:
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Notify your insurance carrier of the accident and related injuries/losses. Provide any evidence like medical records and pay stubs.
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Your insurer will open a no-fault claim and send you instructions, forms, claim number, and contacts.
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Complete the claim form (NYS Form NF-2) and submit it to your insurer within 30 days of the accident. Include medical authorizations.
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Your insurer will request details from medical providers and your employer to verify losses. Continue providing this documentation.
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You will receive reimbursement payments from your insurer as losses are verified, up to the PIP limits. Coordination of benefits applies.
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The no-fault claim remains open for treatment related to accident injuries until you reach maximum recovery.
Your insurer must follow strict claim handling and payment guidelines under New York’s no-fault regulations. However, claim disputes can still arise in complex cases. Hiring an attorney familiar with these rules can help maximize your recovery.
Limitations of the No-Fault System in New York
While New York’s no-fault auto insurance system provides valuable protections for accident victims, there are some limitations to understand as well:
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No coverage is provided for damage to vehicles or other property – must claim through at-fault driver’s liability insurance
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No compensation for pain, suffering, or inconvenience – need to prove “serious injury” and file liability claim
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Fraudulent claims may result in reduced or denied benefits
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Benefits only apply to accidents occurring within the U.S., its territories and Canada
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Pedestrians and motorcycles are not covered by PIP under no-fault
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Drunk drivers have limited no-fault benefits for emergency treatment only
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Benefits are reduced by amounts recovered from Workers Comp, SSD, etc.
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Disputes over medical necessity of treatment or delay tactics by insurers
For these reasons, accident victims may need to file a liability injury claim against the at-fault driver in certain situations, even in a no-fault state like New York. An experienced attorney can advise when this makes sense.
When to File a Liability Claim in a No-Fault State
In some cases, injured drivers may need to take legal action against the at-fault motorist in New York, despite having their own PIP coverage. Reasons to consider a liability claim include:
- Disputed no-fault claim was denied
- Accident injuries exceed the $50,000 PIP limit
- Significant lost income exceeds the monthly/duration limits
- Permanent disability or impairment occurred
- Scarring, disfigurement, or severe pain and suffering
- At-fault driver was uninsured/underinsured
Liability claims become necessary when losses are not fully covered by your PIP benefits in a no-fault accident. An attorney can help prove fault and damages in these situations.
No-Fault Threshold for Lawsuits in New York
Under New York’s no-fault system, accident victims can only file lawsuits for pain and suffering damages if they meet the “serious injury” threshold in the law. This threshold helps reduce frivolous lawsuits.
The following injuries are considered “serious” enough to warrant a liability claim for non-economic damages like pain and suffering:
- Death
- Dismemberment
- Fracture
- Loss of a fetus
- Permanent loss of bodily function
- Permanent disfigurement
- Disability for 90+ days
If your injuries meet this threshold, you can take legal action against the at-fault driver for economic and non-economic damages exceeding your no-fault benefits. An attorney can help prove your injuries are “serious.”
Is New York a No-Fault Divorce State?
New York is not a no-fault state when it comes to divorce. New York requires spouses to establish fault grounds for divorce, such as:
- Adultery
- Abandonment for 1+ years
- Imprisonment
- Cruel and inhuman treatment
- Irreconcilable differences for 1+ years
The only exception is if both spouses agree to a conversion divorce after living separately under a separation decree for 1+ years. Otherwise, one spouse must prove the other’s fault. An experienced divorce attorney can provide guidance on New York’s divorce laws.
The Pros and Cons of No-Fault Insurance
No-fault auto insurance in New York has advantages and disadvantages to consider:
Pros
- Guaranteed coverage for injuries and losses in all accidents
- No need to determine fault or take legal action
- Faster claim payments directly from your insurer
- Potentially lower liability premiums
Cons
- Limited compensation, need to prove serious injury for pain/
What is No Fault Coverage in New York
FAQ
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