What is no-fault insurance in New York?
New York is a no-fault insurance state, which means that after most car accidents your own auto insurer pays your medical bills and a portion of your lost earnings — up to your policy's limit — regardless of who caused the crash. These benefits come from New York's no-fault law, Insurance Law §5102 and §5104. Because the system pays quickly and without proving fault, there is a trade-off: you can only sue the other driver for pain and suffering if your injury meets a legal threshold.
No-fault is one of the most misunderstood parts of New York injury law. People assume that because someone else caused the crash, that driver's insurance pays their bills. In New York, for the basic costs, it is usually your own policy. Here is how the system works.
What does no-fault insurance cover?
New York no-fault benefits — formally called Personal Injury Protection (PIP) and defined as "basic economic loss" in Insurance Law §5102(a) — cover the essential costs of a car accident, generally up to a $50,000 basic limit per person. That coverage includes:
- Medical expenses — reasonable and necessary treatment for accident injuries.
- Lost earnings — a percentage of lost wages, subject to a monthly maximum set by statute, for a limited period.
- Other reasonable and necessary expenses — a per-day amount for things like household help or transportation to medical appointments.
These benefits are available to the driver, passengers, and pedestrians injured by the vehicle, subject to the policy and the statute.
Who pays — my insurance or the other driver's?
In most cases, your own auto insurer pays your no-fault benefits, no matter who was at fault. That is the core of the "no-fault" idea: you do not have to prove the other driver caused the crash to get your medical bills and lost wages paid. If you were a pedestrian or passenger, the no-fault coverage of the vehicle involved generally applies.
What is the 30-day rule for no-fault claims?
This is the deadline that catches the most people. To preserve a no-fault claim, the injured person generally must file a written notice of claim with the no-fault insurer within 30 days of the accident. The governing no-fault regulations set this short window, and missing it can give the insurer a basis to deny benefits unless there is a reasonable justification for the delay.
There are related deadlines on the back end as well: claimants and medical providers must submit proof of claim (bills and documentation) within a set number of days of treatment. The practical lesson is simple — report the accident to your own insurer immediately and start the no-fault claim right away.
If no-fault pays my bills, can I still sue the other driver?
Sometimes. No-fault pays your economic losses, but it does not pay for pain and suffering. To sue the at-fault driver for those non-economic damages, New York requires that your injury cross the "serious injury" threshold in Insurance Law §5102(d).
Under §5102(d), a "serious injury" includes categories such as:
- Death
- Dismemberment
- Significant disfigurement
- A fracture
- Loss of a fetus
- Permanent loss of use of a body organ, member, function, or system
- Permanent consequential limitation of use of a body organ or member
- Significant limitation of use of a body function or system
- A medically determined injury that prevents you from performing substantially all of your usual daily activities for at least 90 of the 180 days following the accident
If your injury fits one of these categories, Insurance Law §5104 allows you to step outside the no-fault system and bring a personal-injury lawsuit for pain and suffering against the at-fault party. If it does not, your recovery is generally limited to no-fault benefits. Whether a particular injury meets the §5102(d) threshold is frequently contested and fact-specific.
What should I do after a car accident in New York?
- 1Get medical care promptly and tell the providers the injury is from a car accident — gaps in treatment can undercut both your recovery and a later threshold claim.
- 2Report the accident to your own auto insurer immediately to start the no-fault claim within the 30-day window.
- 3Keep records — the police report, medical bills, proof of lost wages, and all insurer correspondence.
- 4Speak with a personal-injury attorney if you have significant injuries, to assess whether your case may meet the §5102(d) threshold.
Questions to consider
Does no-fault pay for pain and suffering?
No. No-fault covers economic losses like medical bills and lost earnings. Pain and suffering is only recoverable through a lawsuit, which requires meeting the §5102(d) serious-injury threshold.
How long do I have to file a no-fault claim?
Generally 30 days from the date of the accident to give written notice to the no-fault insurer. Acting immediately is the safest course.
Whose insurance covers me as a passenger or pedestrian?
Generally the no-fault coverage of the vehicle involved in the accident, regardless of fault.
Talk to a personal-injury attorney
No-fault is designed to get your basic costs covered quickly, but its deadlines are short and its threshold for suing is strict. If you were injured in a car accident in the five boroughs, a prompt case review can make sure your no-fault claim is protected and your injury is evaluated against the §5102(d) threshold while the evidence is fresh.
This article is general information about New York's no-fault insurance law, not legal advice for your situation, and reading it does not create an attorney-client relationship. Coverage, deadlines, and whether an injury meets the Insurance Law §5102(d) threshold depend on the specific facts. Speak with an attorney about your circumstances. This is attorney advertising. Prior results do not guarantee a similar outcome.
