What Does “No Fault” Really Mean for Accident Victims?

Most New York drivers have probably heard the term “no fault” at some point, but based on the calls I receive to my office, I know that this is a term that has led to a lot of confusion.  Here are a few of the common questions I have received.

What is no fault?

Personal Injury Protection, commonly known as “no fault coverage” is included in every motor vehicle insurance policy sold in New York State.  This applies to drivers and passengers, pedestrians and bicyclists, but specifically excludes motorcyclists.  This coverage provides reimbursement for medical payments, lost wages and other miscellaneous expenses caused by the accident, regardless of who is at fault.  The minimum required coverage for an insurance policy sold in New York State is $50,000.

Do I need to apply for no fault benefits right away?

There is a 30 day time limit on no fault applications. It is never a good idea to wait and see if your injuries get better.  Filing the application with the insurance company does not obligate you to proceed with a claim, but it does protect your rights if a claim is needed.  Your health insurance may not provide coverage for accident related injuries, which could leave you uncovered and at risk.

Where do I send my no fault application?

According to the law, written notice with enough detail to identify the eligible injured person, along with the information relating to the time, place and circumstances of the accident must be provided by each eligible person.  You should file the claim with the insurance company which covers the vehicle in which you were an occupant (either as a passenger or driver or,  if you were a pedestrian, with the car that struck you. If you do not know the vehicle that struck you or if the vehicle was uninsured, you may file a claim with the insurer of a household family relative who had an auto policy at the time of the accident. If there was no auto policy in the household, you should file a claim with the Motor Vehicle Accident Indemnification Corporation (MVAIC).

Does that mean I cannot file a lawsuit for my injuries if I have applied for no fault benefits?

This is one of the areas of greatest confusion.  No fault laws are not designed to limit your compensation, but rather to guarantee a minimum of coverage for every injured person.  In New York State, if you suffer serious, life-changing injuries, you are entitled to seek compensation that is outside the scope of no fault coverage.  For more information about your rights as an accident victim, see our Motor vehicle Accidents Page.

What if my no fault claim is denied?

If your no fault claim is denied, you have several options.  First you can present a copy of your denial letter to your health insurance company and request that they cover your injuries.  If you do not have health insurance and cannot afford your medical treatment, talk to your doctor about continuing treatment on a lien basis, which means that your medical expenses would be added to any separate lawsuit filed as a result of the accident.

When you receive your denial letter, it will include instructions for how to appeal the decision to an arbitrator.  Speak to an attorney before taking any further steps.  If you are filing a lawsuit for damages above no fault coverage, it is vitally important that all of your activities are coordinated and that you understand your options.

Good advice after any serious accident.

If you’ve been the victim of a motor vehicle accident, your first concern should always be to seek the medical attention you need.  New York State’s no fault laws are designed to ensure that a minimum amount of coverage is available to every accident victim, but this is only guaranteed if you take the proper steps to receive compensation.  These laws do not limit your right to seek compensation if your injuries are serious and your losses exceed the coverage offered by no fault.

It is always a good idea to consult with an experienced Motor Vehicle Accident Attorney to be sure that you are justly compensated for your injuries and that your rights are protected.  Attorney Gregory W. Bagen has been serving the Putnam County community from his office in Brewster for 40 years.  If you or a loved one is an accident victim and suffered serious injuries, give Greg a call and take advantage of a free confidential consultation. Once he knows what happened, he can give you the facts about the law that you need to make an informed decision about how to proceed. If you do have a case, he’ll fight to get you the compensation you need to move past this terrible tragedy.

Remember, there are NO UPFRONT FEES and you PAY NOTHING unless you receive compensation.

Sources: https://www.dfs.ny.gov/consumers/auto_insurance/nofault_faqs