No-Fault Benefits
Under New York law, you are entitled to compensation for economic losses simply by demonstrating you were injured as a result of a car accident. When a driver or passenger is injured, the vehicle owner's insurance company pays these benefits.
If the injured person is a pedestrian, the company insuring the car that struck the person will pay. No-Fault benefits are available even if the car was uninsured. Benefits may be obtained through New York Motor Vehicle Accident Indemnification Corporation or through the injured person's own or family member's insurance company.
No-Fault benefits include:
- Hospital and medical expenses up to $50,000.
- Lost wages equaling 80% up to $1000 per month for a period not exceeding three years Note: This is the minimum benefit required by New York law-other insurance policies may provide for more).
- Total coverage of $50,000 for lost wages and medical expenses (required by NY No Fault law)
No-Fault benefits are not available to any person who was driving while intoxicated or under the influence of drugs or if she intentionally caused her own injury. Similarly, these benefits are not available if the accident occurred while someone was committing a felony.
Making a claim for No-Fault benefits-Insurance information available
In order to obtain No-Fault benefits, you must fill out and file a written No-Fault application (currently Form NF-2) with the appropriate insurance company within 30 days of the accident. The 30-day filing deadline is critical.
If you were the driver or the passenger of a car involved in the accident, you should request the form from the insurance carrier covering the car that you were in at the time of the accident, even if it was the other car’s fault. If you were a pedestrian injured during the accident, you should request the form from the insurance carrier of the car or cars that were responsible for your injuries and to your own auto insurance carrier if you were covered by one during the accident. Whatever the case may be, specifically request that the insurance company send you the New York State No-Fault Application (they may not offer it to you over the phone and may not send it automatically).
By the end of the call, you should have been given a claim number and the contact information for an insurance company claim representative you or the medical provider can send the bills to. You may also contact this person if you feel you are not receiving the appropriate benefits.
It is extremely important that you file this form within the thirty days even if you feel initially that your injuries are minor, you have a comprehensive health insurance policy, or for any other reason. Note that their is no obligation associated with filing the form, even if you end up not filing a claim later on. While it may seem surprising, many health insurance policies do not cover injuries sustained in an auto accident and your injuries may not be apparent until much later.
If you do not receive your benefits, there is an arbitration procedure that can compel the insurance company to pay them. An arbitrator’s award can also include payment of interest and attorney's fees.
If the insurance company feels that medical payments are unnecessary, it can require that you attend a physical examination with a doctor it designates. If the doctor concludes that your medical treatment is no longer needed, or that you are able to work, your benefits will stop. If you disagree with this determination, you can request arbitration to test these findings. However, everyone's benefits will terminate when $50,000 has been paid.
You should consult with an attorney to make sure that your rights are protected and that you receive the benefits you are entitled to. You should contact us to schedule a free consultation.
Making a claim for No-Fault benefits – Insurance information unavailable
If you were a pedestrian and were the victim of a hit-and-run, were struck by an uninsured driver, or simply not able to obtain the insurance company information of the person who caused your injuries at the time of the accident, you should follow the following steps (See also section entited hit and run accidents, underinsured or uninsured motorists)
- Obtain a copy of the police report at the scene of your injury or from the investigating officer at the station. The report will contain a three-digit code that you should give to the insurance carrier of the car that caused your injuries once you discover the carriers name and to our own auto insurance carrier (if you had one).
- If you are running close to the deadline, and do not have the insurance carrier information of the person who caused your accident, you should rush a notice into the New York State Motor Vehicle Accident Indemnification Corporation (MVAIC), a state agency which acts as an insurance company when a driver is uninsured. It is important to understand that every effort should be made to discover whether the driver that caused your injuries had insurance and the name of the carrier. MVAIC is there to prevent a person from suffering catastrophic losses caused by an uninsured motorist. Hence, they investigate claims intensely and the process can be both bureaucratic and paperwork intensive. If you discover that the person who caused your accident does have insurance, and are able to obtain the carriers information, make sure to withdraw your claim.
- If you are claiming lost earnings and out of pocket expenses, certain additional steps should be taken to ensure payment of your claims. Please see the section entitled Gather Auto Accident Facts on this website.
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