No Fault Insurance New York

What is No-Fault Insurance?

New York is a “No-Fault” state, which means that all motor vehicles are required to have a specific type of insurance to pay for the medical bills (such as: ambulance, hospital, X-rays/MRIs, surgeries, physical/occupational therapy) and loss of wages of its occupants regardless of who is at fault for the accident.  Those injured in the vehicle do not have to prove anyone was negligent to receive No-fault insurance benefits. 

New York state law outlines that the vehicle’s driver, passenger(s), as well as pedestrians and cyclists hit by the vehicle all receive the benefit of the vehicle’s No-Fault insurance coverage.

Importantly, motorcycles and motorcyclists are not covered by No-Fault insurance and specifically excluded from coverage.  If you were on a motorcycle (driver or passenger), No-Fault insurance does not apply. You will need to use your private health / medical insurance to cover your bills and sue the at-fault party for damage compensation to recover those costs.  Our car accident attorneys can help you determine the best possible course of action to recover those costs. 

Where is my No-fault Insurance coverage listed?

Your automobile insurance company should send you a Declaration page or “DEC” sheet with your insurance policy information (and typically a bill) at least once a year. 

On your Declaration page, there will be a section typically called “Personal Injury Protection” that lists the type of coverage you have and whether you have more than the State required minimum. 

How much No-Fault Insurance coverage do I have? 

The minimum amount of No-Fault insurance coverage required by New York State law is $50,000 to cover both medical expenses and lost wages. 

The amount of coverage you have will be listed as “Basic PIP” or “Mandatory PIP” on your insurance policy’s Declaration page.  

You can (and should) opt for more than $50,000 to protect you and your family.  Medical bills after a car accident will begin to pile up quickly. Lost income resulting from your inability to work could seriously impact your finances. The amount of No-Fault insu

rance coverage you have covers both of these costs, which can add up quickly.  

You can increase your No-Fault insurance coverage from $50,000 up to $175,000 per person through coverages such as: 

  • Optional Basic Economic Loss (“OBEL”) ($25,000 per person)
  • Additional Personal Injury Protection (“A-PIP”) ($100,000 per person)   

No-Fault insurance will cover 80 percent of lost wages with a monthly maximum amount of  $2,000 for up to three (3) years from the date of your accident or until your No-Fault coverage is exhausted. The amount you receive for wages is not taxable, which is why only 80% of your monthly wages is paid. The monthly maximum amount can be increased from $2,000 to $3,000 if you opted for additional No-Fault coverage (OBEL and A-PIP).  

How do I file a No-Fault Insurance claim after an accident? 

Reporting any accident immediately to your automobile insurance company is the critical first step.  

If you are a pedestrian or cyclist hit by a vehicle, you must report the accident to the vehicle’s insurance company that injured you. If you have the Police Accident report from the accident, there is a box with “Ins. Code” listed.  The officer will list a three digit code in it to identify who the insurance company for the vehicle is. 

There is a specific process that must be followed to file a claim or No-Fault coverage could be denied.  Submitting a completed No-Fault application (or Form NF-2) within 30 days of the accident is required or the No-Fault coverage could be denied. Keep a copy of the completed No-Fault application you submit. 

After your application is submitted, the insurance carrier will provide you with a No-Fault claim number. Always be sure to provide any doctor or health care provider with your No-Fault insurance claim number so it can be billed (paid for) correctly. Think of this claim number as your private health insurance ID number for billing purposes.

Even if you have private health insurance (including Medicare and/or Medicaid), they should not be billed. No-Fault insurance must pay first unless it has been exhausted or cut off.  

How Kammholz Rossi – Car Accident Attorneys can help? 

At Kammholz Rossi PLLC, we bring almost 50 years of combined legal experience, trial savvy and investigative diligence to your case. We understand the various types of insurance that are relevant in your unique case and how they may work together to maximize your claim. We are here to help you recover as quickly and completely as possible.

Please call our team in Rochester to schedule a free consultation with an experienced car accident lawyer

We will help you determine the best possible course of action with your claim. We are available at 585-684-8545 and by email. We look forward to speaking with you soon.