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What Do No-Fault Benefits Cover After a Car Accident?


Even if the injuries are minor, car accident victims can incur bills in the thousands for necessary medical expenses. You might be wondering how these medical bills will get paid. You may also be concerned about how you will make ends meet if you are unable to work due to your injuries. In New York State, every vehicle owner must carry no-fault insurance — these benefits ensure an accident victim’s medical treatment and lost wages are covered up to a certain amount. 

How Does No-Fault Insurance Work?

Regardless of who was at fault for the car accident, each injured party can apply for no-fault benefits. Although many people mistakenly think the no-fault application is filed with the adverse vehicle’s insurance company, it’s actually submitted to the insurer of the vehicle you were in at the time of the crash. In other words, drivers will turn to their own insurance companies for no-fault benefits — even if they weren’t responsible for the collision.

It’s crucial that you file the no-fault application within 30 days of the accident, or your insurance company could deny your benefits. The paperwork asks a series of questions about the accident, your injuries, medical treatment, and employment. Generally, it’s best to have the guidance of an experienced car accident attorney when filling out the application.  

Significantly, no-fault benefits can kick in very soon after an accident, providing economic relief for your medical costs from the outset of your case. 

What Expenses Are Covered By No-Fault Insurance?

New York no-fault benefits may cover up to $50,000 of reasonable and necessary medical expenses for treatment related to the accident, as well as 80% of lost wages up to $2,000 a month. Drivers, passengers, pedestrians, and bicyclists who qualify for no-fault benefits may be entitled to coverage for the following accident-related expenses:

  • Office visits
  • Emergency room treatment
  • Medication for injuries related to the accident
  • Durable medical equipment
  • MRIs, X-rays, and EMG-NCVs
  • Psychiatric treatment in connection with the accident
  • Surgery
  • Reasonable transportation costs to and from medical appointments
  • Physical therapy
  • Ambulance services

Families who have lost loved ones in a New York car accident may also be entitled to receive no-fault death benefits.

Notably, there are a few exceptions to the no-fault law. Drivers who were under the influence, committing a felony, or driving a vehicle they knew to be stolen at the time of the accident are not eligible to receive no-fault benefits. In addition, no-fault benefits do not apply to motorcyclists or their passengers.   

What Happens When No-Fault Benefits Run Out?

Since they generally cap at $50,000, no-fault benefits can quickly be exceeded in cases involving extensive auto accident injuries. However, no-fault benefits are not the only avenue of recovery for many car crash victims.

In New York, if you suffered physical harm in an auto accident, you may be entitled to file a personal injury action if you’ve sustained what NY Insurance Law 5102(d) defines as a “serious injury.” By bringing a lawsuit, a prevailing plaintiff may be able to recover the medical expenses and lost wages that weren’t covered by no-fault insurance — as well as for their non-economic damages such as pain and suffering and loss of enjoyment of life. Unlike in the no-fault system, an injured plaintiff may hold the responsible party accountable for their negligence in a personal injury action.

Contact an Experienced New York Car Accident Attorney

After a car accident, you’re likely feeling stressed, confused, and overwhelmed. There are many important deadlines that must be met after a car crash occurs to make sure you get the benefits and maximum compensation to which you’re entitled — this is why it’s essential to contact an auto accident attorney as soon as possible who can protect your rights. The car accident attorneys at The Dearie Law Firm, P.C. can help ensure you secure the best possible outcome in your auto accident lawsuit.  

The Dearie Law Firm, P.C. has convenient office locations in Manhattan, Brooklyn, and the Bronx, as well as mobile locations serving Brooklyn, Queens, Manhattan, the Bronx, Staten Island, Westchester, Rockland County, and on Long Island in Nassau County, and Suffolk County. Contact us for a consultation.