Free Consultation (212) 970-6500

Free Consultation
(212) 970-6500

Close this search box.

Understanding New York State’s “Serious Injury” Threshold

Serious Injury

If you were hurt in a car accident in New York State, you may be entitled to no-fault benefits. These benefits can help you make ends meet if you’re out of work due to your injury and medical bills are piling up. But if you’ve suffered what is defined as a “serious injury,” no-fault insurance may not be sufficient to cover the full extent of your losses. In such cases, you may be eligible to file a personal injury lawsuit if you can satisfy the “serious injury” requirement of Section 5102(d) of New York Insurance Law.

What Is the “Serious Injury” Threshold?

After a car accident, no-fault insurance will compensate a victim up to $50,000 for their medical bills and a portion of their lost wages. However, these benefits are often inadequate to cover the costs of physical rehabilitation, multiple surgeries, out-of-pocket costs, and the extensive medical treatment often required. They also do not compensate for the victim’s physical pain and emotional anguish. 

Under New York Insurance Law, if you’ve suffered what is defined as a “serious injury” in a car crash, or you have incurred economic loss in an amount greater than $50,000 due to your injuries, you may file a personal injury lawsuit to recover your losses. By satisfying these criteria, you may be eligible not only to recover your economic losses — but also to receive compensation for your pain and suffering.                           

What Injuries Qualify under the “Serious Injury” Threshold?

The “serious injury” threshold of New York’s Insurance Law limits the types of injuries that qualify to pursue a car accident lawsuit. In addition to the $50,000 economic loss category, eight categories of injuries can form the basis of a personal injury action following a motor vehicle accident. Specifically, these categories include the following:

  • Death
  • Dismemberment
  • Fracture
  • Loss of a fetus
  • Permanent loss of use of a body organ, member, function, or system
  • Permanent consequential limitation of a body organ or member
  • Significant limitation of use of a body function or system
  • An impairment that results in a victim being unable to perform their usual and customary daily activities for 90 days in the 180 days immediately following the accident

While the first four categories under the serious injury threshold are straightforward, the last four typically require substantial medical evidence and proof. For instance, a significant limitation might involve a soft tissue injury or a herniated disc, which by itself does not fit into any of the “serious injury” categories. However, these types of injuries can substantially impact the quality of a victim’s life and their ability to work. By providing the proper medical documentation and other evidence that show the effects these injuries had on your life, you may be able to establish that you meet the necessary criteria under Section 5102(d) to recover your damages. 

Critically, it’s important to continue treatment until your doctor has determined that you have reached maximum medical improvement. If there are any gaps in your medical treatment in the weeks or months after your injury, you must obtain a report from your doctor explaining why your treatment was discontinued.

Contact an Experienced New York Personal Injury Attorney

If you’ve suffered a serious injury in a car accident, it’s crucial to have a skillful personal injury attorney by your side who will fight to obtain the monetary recovery you deserve. The Dearie Law Firm, P.C. has represented clients in car accident cases for over three decades and works diligently to achieve the best possible outcome in each unique case. Contact us today for a consultation.