Summary of New York No-Fault Law Provisions

What is No-Fault coverage and what am I entitled to under it?

Regulation 68 requires that “in the event of an accident, written notice setting forth details sufficient to identify the eligible injured person, along with reasonably obtainable information regarding the time, place and circumstances of the accident, shall be given by, or on behalf of, each eligible injured person, to the applicable No-Fault insurer, or any of their authorized agents, as soon as reasonably practicable, but in no event more than 30 days after the date of the accident, unless the eligible injured person submits written proof providing clear and reasonable justification for the failure to comply with such time limitation.”

You should file your claim with the insurance company which covers the car in which you were an occupant (either as passenger or driver) or, if you were a pedestrian, with the car that injured you.

What do I do if my expenses exceed the $50,000 available under No-Fault?
Ans: When the basic No-Fault benefits are consumed, you may apply for Additional No-Fault (Additional PIP) benefits either from the vehicle you occupied or any auto policy of a related member of your household. Additional PIP is an optional coverage which is usually not expensive.

What if the vehicle involved was a motorcycle?

Ans: If you are the operator or passenger of a motorcycle involved in an accident, you are excluded from No-Fault benefits (you may sue from first dollar loss). If you were a pedestrian struck by a motorcycle, you should file a claim with the insurer of the motorcycle. If it is not insured, then you may file the claim with the insurer of a household family relative who had an auto policy at the time of the accident. If there was no auto policy in the household, you should file a claim with the Motor Vehicle Accident Indemnification Corporation (MVAIC).

Can I sue for “serious injury” against another driver’s liability coverage?

Ans: You may sue another driver if he or she caused the accident that injured you and you sustain a “serious injury”. Section 5102(d) of the New York Insurance Law describes various conditions that meet the definition of “serious injury”. “Serious injury” includes, among other injuries,: fractures of any type, disfigurement, dismemberment, death of a fetus, or a medically determined injury which prevents the claimant from performing their usual and customary activities for 90 of the 180 days following an accident.

What are some of the more significant regulatory changes in automobile No-Fault insurance that have occurred as a result of the Department’s promulgation of the revised Regulation 68 in September of 2001?

Ans: Insurance Department Regulation 68, as revised effective April 5, 2002, effected numerous changes to the processing of No-Fault claims. The revised Regulation modified the time frames in which to submit written notice of claim from 90 to 30 days and to submit medical bills from 180 to 45 days, respectively, and mandated that lost wage claims must be submitted within 90 days.