The law regarding recovery for medical bills and lost earnings resulting from an auto accident (known as no-fault benefits) differs from state to state. All information provided on this website refers to New York State’s no-fault auto accident law only.

All persons injured as a result of the use or operation of a motor vehicle (even pedestrians and bicyclists) are entitled to receive no-fault benefits for accident-related losses, regardless of fault. Motorcycles, mopeds, and ATV’s are excluded.

New York State’s no-fault auto accident benefits include payments for:

• Medical bills
• Lost earnings
• Travel expenses
• Household care
• Death benefits
• Prescriptions

These benefits are provided by the insurance company insuring the vehicle you were in (or in the case of a pedestrian or bicycle knockdown, the vehicle that struck you).

Read answers to frequently asked questions below, or if you would like more information about no-fault benefits, please call your local auto accident attorneys at Fine, Olin & Anderman, LLP at (855) 451-5621. If you believe you have a case, submit your free “Do I Have a Case?” evaluation. 

Who Is Covered Under New York State’s No-Fault Auto Accident Law?
What If the Vehicle I’m in at the Time of the Auto Accident is not insured?
What If I’m the Passenger and Neither I Nor the Driver Are Insured at the Time of the Auto Accident?
Do I Have to Send in the Medical Bills and Records Myself If I’m Injured in an Auto Accident?
How Do I Get Reimbursed for Prescriptions and Medications If I’m Injured in an Auto Accident?
How Do I Get Reimbursed for Time Lost at My Job Due to an Auto Accident Injury?
Is There a Limit to What I Can Receive for Lost Wages Due to an Auto Accident Injury?
Can I Collect No-Fault Auto Accident Benefits and Either Workers’ Compensation or Disability Insurance?
How Do I Make a Claim for Travel or Home Care Expenses?
What if the Insurance Company Wants Their Doctor to Examine Me? Can I Refuse?
What About Pain and Suffering Damages?

 

Who Is Covered Under New York State’s No-Fault Auto Accident Law?

Anyone in an automobile accident is covered, including pedestrians, but there are three exceptions: victims of motorcycle accidents, owners of uninsured vehicles if the accident is in their car, and drivers under the influence of drugs or alcohol are not covered.

What If the Vehicle I’m in at the Time of the Auto Accident is not insured?

If the owner of the vehicle you’re in isn’t insured, and you are, then your insurance company pays for the benefits. If you are the uninsured driver, you are not entitled to no-fault benefits.

What If I’m the Passenger and Neither I Nor the Driver Are Insured at the Time of the Auto Accident?

Your auto accident no-fault benefits claim can then be submitted to the insurance company of any relative who is part of your household. If that does not apply, you can make a claim to the Motor Vehicle Accident Indemnification Corporation (“MVAIC”), a state agency, and they will handle the claim as long as two requirements are met: you must not be the operator of an uninsured vehicle and the auto accident must have occurred in New York State and involved New York State residents.

Do I Have to Send in the Medical Bills and Records Myself If I’m Injured in an Auto Accident?

You might have to, but usually the doctor and/or hospital will bill the insurance companies directly for any medical bills related to your auto accident injury. If you are covered in a managed care plan, the plan will handle the payment directly.

How Do I Get Reimbursed for Prescriptions and Medications If I’m Injured in an Auto Accident?

You should keep all of your bills and receipts for medications and prescriptions related to your auto accident injury. Make sure your doctor’s name and date are on all of your documents. Make copies of these bills and receipts and send the originals to the insurance company that is responsible for paying the claim. The insurance company should reimburse you for these expenses.

How Do I Get Reimbursed for Time Lost at My Job Due to an Auto Accident Injury?

You need to fill out a form called an Employee’s Wage Verification Report, which you can get from your employer. You also need a doctor’s note stating that you had to stop working for a certain period of time due to motor vehicle accident injuries. These papers should then be sent to the insurance company. If you are self-employed, you need to fill out a different form known as the Verification of Self-Employed Income Form and submit that with your Federal Tax Returns for the past two years.

Is There a Limit to What I Can Receive for Lost Wages Due to an Auto Accident Injury?

Yes. There is a $50,000 cap on the total no-fault auto accident claim benefits you are entitled to. Within that limit, you may receive 80% of your wages, or up to $2,000/month, for a maximum of three years from the date of the auto accident. The only exception to this is if you have paid a bigger premium for supplemental no-fault coverage.

Can I Collect No-Fault Auto Accident Benefits and Either Workers’ Compensation or Disability Insurance?

No, you can’t collect twice. If you are already collecting Workers’ Compensation or Disability Insurance benefits, those benefits will be deducted from your no-fault auto accident benefits. Together, any or all of these benefits may cover up to 80% of your lost wages for three years from the date of the auto accident. When you submit your request for no-fault benefits, you must include documentation of workers’ compensation or disability insurance benefits that you have received.

How Do I Make a Claim for Travel or Home Care Expenses?

You must document all of your expenses. Provide a doctor’s note explaining that household help was needed and for how long after the event of an auto accident. Get receipts for travel to doctors or therapists. Make copies of these papers and send the originals to the insurance carrier. For driving, No-Fault will pay 55 cents/mile as of January, 2009. There is a limit of $25/day for up to one year from the date of the auto accident for travel and household help combined. This amount could be higher if you have opted for expanded coverage.

What if the Insurance Company Wants Their Doctor to Examine Me? Can I Refuse?

If you refuse, the insurance company may be entitled to deny your auto accident benefits claim and cut off your benefits. If you do see the doctor they have chosen to examine you, that doctor may claim that you are no longer entitled to no-fault benefits. To appeal, you can have your doctor send a letter of rebuttal to the insurance carrier, outlining your condition, treatment, and future treatments as related to the auto accident injury. If necessary, you can file for arbitration where a qualified third party will review all of the records and make a decision as to your eligibility to receive no-fault benefits.

What About Pain and Suffering Damages?

In order to bring a claim for pain and suffering, you must have a certain level of injury caused by an auto accident. Examples of these types of serious auto-related injuries include fractured bones, loss of fetus, death, dismemberment, disfigurement, permanent scarring or any medically certified injuries which prevent you from performing normal activities for a given period of time. If you want to know more about your rights in this regard, you should contact our experienced motor vehicle attorneys at 800-522-9001.