If you're a New York resident, you likely are aware that it is a "no-fault" insurance state, which means policyholders can expect compensation for their losses regardless of who was at fault in an accident. No fault benefits generally include coverage of medical costs and lost wages. But, does it cover pain and suffering?
The answer is yes, but under specific circumstances. Auto accident lawsuits in New York are limited by the state's no-fault statute to recovering compensation for actual monetary losses in excess of no-fault benefits and, in the case of a "serious injury" (as defined by insurance laws), compensation for non-economic damages like pain and suffering. Keep reading to learn more about this rule.
If you've been injured in a car accident in New York, consult with an experienced car accident lawyer, such as the legal team at Brandon J. Broderick, Attorney at Law. We will provide you with the legal expertise you need to win a successful case.
How No Fault Insurance Works
New York's no fault system, also known as Personal Injury Protection (PIP), is a form of insurance that provides speedy compensation for economic losses incurred as a result of injuries sustained in a car accident. This coverage is not contingent upon determining fault or negligence, and it extends to the driver, passengers, and pedestrians injured by the insured vehicle. The coverage includes medical costs, lost wages, and other necessary expenses related to your injury. There is a maximum limit of $50,000 per individual, which is the "basic no fault coverage."
The state of New York also requires all registered vehicles to carry the following minimum amount of liability insurance:
- $25,000/$50,000 for bodily injury per person
- $50,000/$100,000 for death
- $10,000 for property damage per accident
The primary reason for no fault insurance is to provide a quick resolution to victims who have sustained injuries in automobile accidents to a state of physical well-being and functional capacity. No fault laws in New York restrict the option of filing a lawsuit related to motor vehicle accidents to cases where economic losses surpass the advantages provided by the no fault system. As previously mentioned, claims for non-economic damages, such as pain and suffering, are only permissible if the injured party sustains a "serious injury" as defined by the Insurance Law.
No fault benefit is for personal injury coverage, but does not cover repair costs to your own vehicle or for damages incurred to another party's vehicle or personal property. No fault benefits first before any health insurance coverage a victim may have.
These benefits also provide coverage for any passengers who sustain injuries in accidents within New York State, including guest passengers who are residents of New York State and sustain injuries in an accident in your vehicle within the United States.
No fault protection extends to all pedestrians who sustain injuries as a result of motor vehicle accidents in the state of New York.
"Serious Injury" In New York Defined
In the state of New York, courts have consistently maintained that a subjective claim of pain does not meet the threshold for being classified as a "serious" injury. In situations involving serious injury, it is typically necessary to utilize diagnostic testing as a means of objectively substantiating the claim. Certain injuries can be straightforward and easily identified as "serious injuries", but others exhibit a greater degree of intricacy. Many types of injuries, such as whiplash, possess the potential to be deemed serious but lack the capacity to endanger an individual's life.
Given the potential long-term impact of whiplash, including irreversible impairments and the restriction of an individual's capacity to generate income, it may be categorized as a "serious injury" in specific cases. Gaining a comprehensive understanding of the legal definition of a serious injury under state law is important. Injuries that impact an individual's ability to work or carry out routine daily tasks may be classified as "serious" injuries.
The following are injury categories that can be deemed "serious":
- Death
- Loss of a fetus
- Dismemberment
- Fracture
- Disfigurement
- Permanent loss of use of an organ or member
- Significant limitation of use of a body function or system
- Non permanent impairment for 90 days during the first 180 days succeeding the accident
90/180 Day Rule in New York
If you are injured in a motor vehicle accident, New York no fault insurance may not be enough to cover your losses. If you suffer a "serious injury," you may be able to sue the negligent driver. The 90/180-day rule is one way to meet the requirements for a "serious injury" under the law.
A person is considered handicapped if they are unable to perform all of their usual daily activities for at least 90 of the first 180 days following the accident. However, proving this may be challenging. Your 90/180 claim will be successful if you can prove to a judge or jury that your condition has prevented you from performing "substantially all" of your usual activities. This shows that your injury has significantly altered and interrupted your life.
"Serious injury" is most likely warranted by your condition if a doctor advises that you stay out of work for several months. However, if you just require help with a few chores during the day, this is unlikely to meet the "substantially all" requirements.
How To Prove "Serious Injury"
There are no specific steps you have to follow to prove a serious injury in a New York car accident case. The injuries must meet the criteria for a "serious injury" as defined by Section 5102(d) of the New York Insurance Law. In addition to looking at the injuries, doctors must also offer proof to back up their claims.
Even though the process of proving a case for a serious injury can be time-consuming, gathering all medical records that support the claim is one of the most important steps. Be aware that defense lawyers will work to refute your claims. Therefore, it's important to gather as many medical records as you can that detail the accident-related treatment and recuperation.
Call Brandon J. Broderick, Attorney at Law Today
Hiring a lawyer to defend you after a car accident in New York is vital to the success of your case. Our skilled NY car accident lawyers are educated about the statutes involving car accident injuries, what constitutes a "serious" injury and can help you get justice.
Contact our offices today for help. We have locations in the Tri-State.