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Getting into a car accident is a jarring experience, both physically and emotionally. In the aftermath, it is crucial to understand your rights and options, especially when it comes to insurance coverage. New York State operates under a "no-fault" insurance system, which has its own set of rules and benefits for those involved in car accidents. In this article, we will briefly review what New York's "no-fault" insurance covers and how it can assist you after a car accident.

Understanding New York's "No-Fault" Insurance

New York's "no-fault" insurance system, also known as Personal Injury Protection (PIP), is designed to provide prompt medical and financial relief to individuals involved in car accidents, regardless of who was at fault. This means that regardless of who caused the car accident, each party's own insurance company is responsible for covering certain expenses related to injuries and certain damages. All vehicles registered in New York State are required to carry no-fault insurance. As further described below, it covers a range of expenses, including medical bills, lost wages, and other necessary expenses resulting from the accident.

To qualify for benefits, the injured individual must file a claim within 30 days of the accident, providing notice to their insurance company. Seeking medical attention promptly after the accident is crucial. Failure to do so might jeopardize the ability to claim “no-fault” benefits.

Key Components of "No-Fault" Coverage

• Medical Expenses: "No-fault" insurance covers medical expenses related to injuries sustained in the car accident. This includes hospital bills, doctor's visits, rehabilitation, and other necessary treatments. It's important to note that there may be limitations on the amount and types of treatments covered, so consulting with a personal injury attorney can help you navigate this aspect.
• Lost Wages: If the car accident leads to an inability to work, "no-fault" insurance can cover a portion of your lost wages, generally up to a specified limit. This ensures that you can focus on your recovery without the added stress of financial instability.
• Essential Services: Reasonable and necessary expenses, such as transportation to medical appointments, may also be covered.
• Death Benefits: In tragic cases where a car accident results in a fatality, "no-fault" insurance can provide benefits to the deceased person's surviving family members. This can include funeral expenses and a portion of the deceased's lost wages.

Who is Covered by "No-Fault" Insurance?

"No-fault" insurance covers a broad spectrum of individuals who may be involved in a car accident. This includes:

• The policyholder (the person listed on the insurance policy).
• Family members residing in the policyholder's household.
• Passengers in the insured vehicle.
• Pedestrians or bicyclists who are struck by a motor vehicle.

Exceptions to "No-Fault" Coverage

While "no-fault" insurance provides essential coverage for most car accident victims, there are exceptions. For example, property damage claims are not covered, as they are typically handled separately through the at-fault party's insurance. It also does not apply to motorcycle accidents. If your economic losses (such as medical expenses and lost wages) surpass the limits of your "no-fault" benefits, you may also be able to pursue a lawsuit to recover the additional damages.

Importantly, “no-fault” insurance does not cover physical and emotional pain and suffering resulting from the car accident. However, in certain cases, you may be able to pursue a lawsuit against the at-fault party for damages beyond what "no-fault" covers. In cases involving “serious injuries” surpassing the threshold defined by New York law, the injured party may pursue a liability claim against the at-fault party for damages beyond what no-fault insurance covers. In New York, a "serious injury" must meet specific criteria outlined in the law. This could include significant disfigurement, bone fracture, permanent limitation of use of a body organ or member, or substantial limitation of a bodily function.

Conclusion

"No-fault" insurance in New York State serves as a safety net for car accident victims, ensuring prompt access to medical treatment and financial support. While it simplifies the process, understanding its limitations and exceptions is crucial for individuals seeking full compensation for their injuries. In case of a car accident, prompt action, including seeking medical attention and consulting with legal professionals, can significantly impact the outcome of a claim. By understanding the nuances of "no-fault" insurance coverage, car accident victims in New York can navigate the aftermath more effectively. Remember, every situation is unique, and seeking personalized legal advice is advisable to ensure full protection of your rights and entitlements under New York's "no-fault" insurance system.

If you or a loved one has suffered injuries in a car accident, it is imperative to consult with a knowledgeable personal injury attorney who can navigate the legal complexities and help you secure the compensation you deserve. Remember, time is of the essence, so don't delay in seeking legal advice to protect your rights and ensure a smoother path towards recovery.

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About the author: Peter J. Gregory is a partner with MCCM Personal Injury Lawyers in Rochester, NY.  He is a trial lawyer with extensive experience resolving disputes in state and federal trial courts. As a personal injury lawyer, Gregory focuses on advising clients who have been injured or lost loved ones in accidents caused by the carelessness or recklessness of others. Please feel free to contact him directly at pgregory@mccmlaw.com or (585) 512-3506.

This publication is intended as an information source for clients, prospective clients, and colleagues and constitutes attorney advertising. The content should not be considered legal advice and readers should not act upon information in this publication without individualized professional counsel.

About MCCM

McConville Considine Cooman & Morin, P.C. is a full-service law firm based in Rochester, New York, providing high-quality legal services to businesses and individuals since 1979.  With over a dozen attorneys and a full paralegal support staff, the firm is well-positioned to right-size services tailored to each client. We are large enough to provide expertise in a broad range of practice areas, yet small enough to devote prompt, personal attention to our clients.

We represent a diverse range of clients located throughout New York State and New England.  They include individuals, numerous manufacturing and service industry businesses, local governments, and health care professionals, provider groups, facilities and associations. We also serve as local counsel to out-of-state clients and their attorneys who have litigation pending in Western New York courts.  For more information, please contact us at 585.546.2500.