No-Fault Benefits: Part 1 – Overview

Did you know that if you are in a motor vehicle accident, the insurance company of the motor vehicle you were in must cover up to $50,000 of your medical bills and lost wages? 


This coverage is called “No-Fault”.  No-fault is required by New York State law.  Every auto insurance policy issued in New York must provide a mandatory minimum of $50,000 in “personal injury protection” or “PIP.” 


No-fault provides benefits for medical treatment, lost wages and other expenses needed by a “covered person” as a result of a “covered accident.” 


So ask yourself – are you a “covered person”?  You are if you own, operate or are a passenger in a vehicle.  You are also “covered” if you are a pedestrian hit by a vehicle.  But, if you operate a motorcycle, or are a passenger on a motorcycle, you are NOT a “covered person.”


What is a “covered accident”?  An accident is “covered” if it occurs while using or operating a vehicle.  Some examples: multi-car accident on the Long Island Expressway; pedestrian struck by van while crossing a road; one car accident involving a telephone pole. 


In order to qualify for no-fault benefits, you must immediately notify the insurance carrier that an accident occurred and that you were injured.  After you notify the carrier that you were involved in an accident, the carrier will send you a No-Fault application to be completed.  You must return the application within 30 days of the accident in order to receive no-fault benefits.  It is recommended that you have an attorney assist you in the completion of this application.  Why?  Because from this point forward, every document that you complete and/or sign is a statement that may be used against you or used to contradict later statements. 


Remember: sometimes you will notify a carrier other than your own.  In other words, if you are a passenger in your friend’s car when you get into an accident, you tell your friend’s insurance company that you are hurt.  If you are a pedestrian hit by a van, you tell the van’s insurance company that you are hurt.  If you are driving your own car, you tell your insurance company that you are hurt.


Another question often asked: What if you are “on the job” when you get into an accident?  Who covers your injuries or lost wages?  If you get into an accident during the course of your employment, your Workers’ Compensation Carrier will cover your injuries.  It is imperative that you notify your employer that you were injured in an accident while on the job. 


Check out the whole Series:

No-Fault Benefits (Part 1 – Overview)  — Current

No-Fault Benefits (Part 2 – Medical Treatment)

No-Fault Benefits (Part 3 – Lost Wages)

No-Fault Benefits (Part 4 – APIP and OBEL)

No-Fault Benefits (Part 5 – Denial of Benefits)