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By Shabnam Mashmasarmi, Esq., Empire Injury Advocates, PLLC
After a car accident in New York, no-fault insurance pays up to $50,000 per person for medical bills, 80% of lost wages (up to $2,000 a month), and up to $25 a day for other necessary costs. It pays no matter who caused the crash, and you must apply within 30 days. Empire Injury Advocates, PLLC in the Bronx helps drivers, passengers, and pedestrians file these claims and figure out whether they can also sue the other driver.
What is no-fault insurance in New York?
Every car registered in New York must carry personal injury protection, often called PIP or no-fault coverage. The idea is simple: after a crash, your own insurance company pays your basic medical bills and part of your lost income right away, without waiting to decide who was at fault. The rules come from New York Insurance Law § 5102 and the state’s no-fault regulation, known as Regulation 68.
No-fault covers the driver and passengers in the car. It also covers pedestrians and bicyclists hit by a car. If you ride the bus, take a cab, or walk across the Grand Concourse, you can still be covered.
What does New York no-fault insurance pay for?
The basic policy covers what the law calls “basic economic loss,” up to $50,000 per person. That includes:
- Medical and rehab costs: doctor and hospital visits, physical therapy, chiropractic care, X-rays and MRIs, and prescriptions. Providers are paid under New York’s fee schedule.
- Lost earnings: 80% of your gross wages, up to $2,000 a month, for up to three years after the accident.
- Other reasonable and necessary expenses: up to $25 a day for up to one year, for things like travel to medical appointments or help with household chores you cannot do while hurt.
- Death benefit: an additional $2,000 if someone dies from their injuries.
Some people buy more coverage than the minimum, called additional PIP or optional basic economic loss. Check your declarations page, or ask us to look at it with you.
What does no-fault not cover?
No-fault has real limits, and this is where people get surprised:
- Pain and suffering. No-fault never pays for it. You can only get it by bringing a claim against the at-fault driver.
- Damage to your car. That goes through the other driver’s property damage coverage or your own collision coverage.
- Lost wages above $2,000 a month. If you earn more, the difference is not covered by no-fault.
- Costs above $50,000. Serious injuries can pass that limit quickly.
- Motorcycle riders. New York no-fault does not cover people riding a motorcycle. They need to look at other coverage.
Whose insurance pays if I was a passenger or pedestrian?
Which policy pays depends on a few facts: whether you own a car, whether you live with a relative who does, and which car you were riding in or were hit by. In most cases it is either your household’s own auto policy or the policy on the vehicle involved in the crash. Confirm the right company early, so your application reaches it within 30 days.
If the car was uninsured, or the driver drove off, you may be able to claim through the Motor Vehicle Accident Indemnification Corporation (MVAIC). MVAIC has its own forms and deadlines, so file as soon as you can.
What are the deadlines for a no-fault claim?
The deadlines are short, and insurance companies enforce them:
- 30 days from the accident to file your written application for benefits, usually a form called the NF-2.
- 45 days from each treatment for your doctor or clinic to submit the bill.
- 90 days to send proof of lost wages, usually a form your employer fills out.
A late filing can be excused if you have a reasonable reason, but you should not count on it. If anyone was hurt, you also have to report the crash to the New York DMV within 10 days on form MV-104.
If a city vehicle was involved, such as a sanitation truck or police car, there is a separate 90-day deadline to serve a notice of claim on the city. Our guide to New York injury claim deadlines explains how that works.
Can I sue the other driver in New York?
Yes, but only in certain cases. You can sue the at-fault driver for pain and suffering if you have a “serious injury” under Insurance Law § 5102(d). The law lists specific injuries, including:
- A fracture (broken bone)
- Significant disfigurement
- Permanent loss of use of a body organ, member, function, or system
- A permanent consequential limitation, or a significant limitation, of use of a body function or system
- An injury that kept you from doing substantially all of your usual daily activities for at least 90 of the 180 days after the accident
You can also sue for economic losses above what no-fault pays, such as wages over the $2,000 monthly cap or medical costs over $50,000. In most cases you have three years from the accident to file that lawsuit under CPLR 214. If you were partly at fault, New York’s pure comparative fault rule reduces your recovery by your share instead of barring it.
Whether an injury meets the threshold usually comes down to medical proof. Keep every appointment, follow your treatment plan, and tell your doctors about every symptom, even ones that seem small.
What should I do in the first week after a Bronx car accident?
- Get medical care, and tell every provider that your injuries came from a car accident.
- Get the police report number from the NYPD precinct that responded.
- Call your own insurance company to open a no-fault claim and write down the claim number.
- Keep every receipt, pay stub, and letter from an insurance company.
- Do not give a recorded statement to the other driver’s insurer, and do not sign a release, before speaking with a lawyer.
We put together a longer checklist of 5 things you should do after a car accident in New York.
How Empire Injury Advocates helps with no-fault claims
Empire Injury Advocates, PLLC is a personal injury firm at 340 East 149th Street in the Bronx. Our team helps clients file the no-fault application on time, follow up when bills go unpaid, and challenge denials. We also look at whether your injuries meet the serious injury threshold, and if they do, we handle the claim against the driver who caused the crash. Our staff speaks Spanish.
Learn more on our Bronx car accident lawyer page or our Bronx personal injury lawyer page.
Frequently asked questions
Does no-fault pay if the accident was my fault?
Yes. No-fault benefits are paid regardless of who caused the crash.
How long does no-fault pay lost wages?
Up to three years from the date of the accident, at 80% of your earnings with a cap of $2,000 a month, within the $50,000 total.
What if my no-fault claim is denied?
You can challenge a denial through no-fault arbitration or in court. Keep the denial letter and every document you sent.
Do I need a lawyer for a no-fault claim?
Not always. A lawyer helps most when benefits are denied or cut off, when injuries are serious, or when you may have a case against the other driver.
Talk to a Bronx car accident lawyer
If you were hurt in a crash and have questions about your no-fault claim, call Empire Injury Advocates, PLLC at (917) 633-4335 or send us a message for a free case evaluation. Hablamos español.
This article is for informational purposes only and does not constitute legal advice. Contact an attorney for guidance specific to your situation.