Understanding No-Fault Insurance

Posted: September 2, 2014

Person reviewing insurance policyIf you have been injured in a motor vehicle accident, you may be looking into no-fault insurance coverage. At first glance, the concept of no-fault benefits may seem complicated. However, no-fault is essentially a form of insurance that provides limited insurance coverage no matter who is at fault for the accident. New York is one of twelve states with no-fault insurance laws.

What is No-Fault Insurance?

No-fault insurance covers certain economic losses after an accident, regardless of whether you are at fault for the accident. These losses can include medical bills, lost wages, and other “necessary and reasonable expenses” resulting from accident injury, up to $50,000. This type of coverage may also be referred to as personal injury protection (PIP) on your auto insurance policy.

If you’ve been injured or are unable to work following a car accident, it is important to file a no-fault insurance application as soon as possible, but no later than 30 days after the accident. An accident lawyer can help you understand no-fault benefits and get started on your claim.

Independent Medical Examinations 

Receiving your no-fault benefits may require you to undergo an independent medical examination (IME) requested by the no-fault insurance company. The purpose of an IME is to verify that treatment or missed time from work is medically necessary as a result of your accident injuries. This examination is done by a doctor or medical professional hired by the insurance company, rather than your personal physician.

If you have been requested for an IME, you will likely receive a notice in the mail with a specific date and time for the exam. While it may be frustrating, you should not miss the examination as it can result in your claim being denied or your benefits being terminated.

Serious Injuries

In New York, to recover for pain and suffering after an accident, you may need to show that you have sustained a “serious injury.” A serious injury is legally defined as an injury that results in:

  • Death;
  • Significant disfigurement;
  • Dismemberment;
  • Fracture;
  • Loss of a fetus;
  • Permanent loss of use of a body organ, member, function, or system;
  • Permanent consequential limitation of use of a body organ or member;
  • Significant limitation of use of a body function or system; or
  • A non-permanent injury preventing you from performing your daily activities for not less than 90 days within the 180 days immediately following your accident.

To learn more about how to file a claim for pain and suffering, contact the legal team at William Mattar today.

Contact the Team at William Mattar

At William Mattar, we can explain and help you navigate the no-fault insurance requirements. We offer a free case evaluation if you or someone you know was injured in a car accident. To schedule yours today, call (844) 444-4444 or complete our online contact form.

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