New York’s No-Fault Law: What Is It and What Qualifies as a “Serious Injury?”
by Daniel S.L. Rubin, Esq.
Girvin & Ferlazzo, PC
You may have heard that New York is a “no-fault” insurance state – and you may have also wondered what does that mean? Essentially, no-fault insurance ensures that almost every person involved in a motor vehicle accident – regardless of whether or not they caused the accident – has immediate access to up to $50,000 in insurance funds to cover the cost of medical care and lost wages related to the accident. In contrast, in at-fault states, a person involved in an accident has to establish someone else was the cause of the accident before they can recover these expenses, a process that typically requires bringing a lawsuit and can take years. For most people, especially those without medical insurance, this could be financially ruinous. How long would you be able to cover your rent/mortgage, food for your family, and medical bills if you were physically unable to work? The no-fault safety net comes at a price, however, in exchange for the immediate access to up to $50,000, the no-fault laws prohibit accident victims from filing a lawsuit against the at-fault party to collect additional damages unless they can prove they sustained a “serious injury.” In this article we explain what a serious injury is and how personal injury attorneys help injured parties to recover over and above what is available through no-fault.
What qualifies as a “serious injury?”
A serious injury is:
• Death;
• Dismemberment;
• Significant disfigurement;
• Fracture/broken bone;
• Loss of a fetus;
• Significant limitation of the use of the body;
• Permanent loss of use of the body, and
• A non-permanent injury that limits your ability to perform substantially all of your usual and customary daily activities for not less than ninety (90) days during the one hundred eighty (180) days following the injury.
Some injuries, such as broken bones, loss of limbs or facial lacerations, are readily apparent and/or irrefutably provable with an x-ray. With these injuries, it is not a question of if the injured party is entitled to collect damages from the at-fault party, but how much they are entitled to. Other common injuries, however, such as concussions, back and neck sprains and other types of soft tissue injuries are not always as easy to diagnose. Often, whether or not these injuries will qualify as “serious” can only be determined in court by a “battle of the experts.” In this battle of the experts each side will marshal a team of medical experts, economists and vocational rehab specialists to opine on whether the injury was serious, whether it was permanent, and the true extent of the damages to which the injured party is entitled.
What should you do if you think you sustained a serious injury?
You can count on the at-fault driver’s insurance company to secure one or more “hired guns,” doctors who specialize in reviewing cases for insurance companies, to deny or minimize the existence and/or extent of your injuries. If you feel you have suffered a serious injury you should contact an attorney to help you evaluate your claim and find the right experts to prove your case. Most attorneys offer free consultations for this purpose. You should never discuss your case or injuries with the at-fault attorney’s insurance company until you have first discussed it with your own attorney.
Daniel Rubin can be reached at 518-462-0300.