No-Fault Benefits: NY OBEL Coverage & APIP

No-Fault Benefits: NY OBEL Coverage & APIP

Motor vehicle insurance coverage law can vary dramatically from state to state. If you purchase an auto insurance policy in New York, it must provide a mandatory minimum of $50,000 in personal injury protection coverage (PIP) according to New York State law.

Most people know about basic motor vehicle coverage to take care of their car and liability in the case of an accident. But you might not be aware that you have the opportunity to purchase additional coverage through either APIP (Additional Personal Injury Protection,) or OBEL (Optional Basic Economic Loss) coverage. Insurance policies such as these provide more protection beyond the mandatory minimum of $50,000. These policies can be obtained through your insurance agent for usually a small additional premium.

PIP

A PIP, or “personal injury protection” policy provides additional protection to an insured individual in the case of an accident or injury and covers basic economic losses. This additional coverage can be used for medical expenses, lost wages, and other necessary expenses such as in-home help and transportation to and from medical treatment. PIP also includes a death benefit that covers the family and survivors of the insured.

APIP

Insurance companies will offer Additional Personal Injury Protection (APIP) in increments of $50,000. So with the basic personal injury protection (PIP) of $50,000, that’s part of your standard auto insurance coverage, the most basic APIP add-on would increase your coverage by $50,000 to a total of $100,000. This additional coverage may be a huge help if you are injured in an auto accident.

In the case of lost wages, the benefits under the minimum no-fault coverage will only provide 80% of your wages up to $2,000 a month. If you would like more protection, the basic PIP coverage may not suffice. By purchasing an additional APIP policy, you will not only get paid for more of your lost wages but also medical and other expenses in the event of a serious injury.

For the above reason, you may wish to consider purchasing an additional insurance policy that will provide coverage for the entire amount of your salary. If your monthly salary is, for example, $3,500 a month, and that’s what you need to pay your bills, the basic no-fault coverage will come up short of taking care of you during your recovery. So in this case, the basic no-fault policy will cover the first $2,000 a month. Then, an APIP would be needed to cover the $1,500 a month difference.

Do I Have To Pay Any Money Back?

It’s worth noting that your APIP insurance carrier has the right to ask you to pay back money that was paid on your behalf if you recover a court-ordered judgment against the other driver.

If APIP paid for additional lost earnings and medical expenses, and you won a personal injury claim against the at-fault party, your insurer will typically go after the other driver. But if you settle with the other driver’s insurer, you could be asked to repay the money that was given to you out of your settlement proceeds.

OBEL

OBEL coverage (Optional Basic Economic Loss) provides a person with an additional $25,000 of coverage beyond the no-fault PIP $50,000 limit. OBEL coverage works very similarly to an APIP policy, with one major difference.

In the case of optional basic economic loss, OBEL coverage gives you the ability to decide which expenses and what party gets the payout. In some cases, regular no-fault insurance won’t provide coverage if you require psychiatric, physical, or occupational treatments following your accident. While you can use your OBEL coverage for basic economic loss in the form of lost earnings and medical bills, you could also use it to cover the expenses of in-home help or physical therapy.

Economic Losses

If you’re involved in a car accident in New York, your world can turn upside down overnight. It’s not just being injured in a car crash that can take its toll. Lost income and medical expenses can easily cost more than the minimum $50,000 basic economic loss coverage that’s offered by most basic PIP policies. By speaking to our knowledgeable personal injury lawyers at Rosenberg & Gluck, we can compile your damages, and see to it that you get the compensation you deserve.

To be clear, basic economic loss includes the financial losses that you experience as a direct result of your auto accident. These can include:

  • Medical costs for those who’ve suffered injuries
  • Lost income due to missing work
  • Mileage to and from doctors appointments

What About Non-Economic Losses?

Non-economic losses can include, but are not limited to:

  • Loss of enjoyment in life
  • Loss of consortium with your spouse
  • Physical pain and suffering resulting from your injuries sustained in the accident
  • Mental turmoil

Non-economic losses are sometimes difficult to put a price on. They can be related to economic losses covered by your PIP, APIP or OBEL policies.

A Word Of Caution:

It’s once again important to note; however, that if you end up with a settlement from the person who caused your motor vehicle accident, your insurer may attempt to recover part of your compensation if APIP benefits are paid.

Have you been injured in a motor vehicle accident? Get help from the experienced car accident lawyers at Rosenburg & Gluck.

Is Anyone Not Eligible For No-Fault Benefits?

New York no-fault laws cover pedestrians injured in a motor vehicle accident, drivers of cars, bicyclists, and passengers in a car or truck that’s involved in an accident. Motorcyclists and scooter riders; however, are not considered eligible to receive no-fault benefits.

Qualifying for No-Fault Benefits

If you are involved in a car accident in New York, here is what you need to prove in order to qualify for no-fault benefits:

  • The automobile in the collision must be a truck, taxi, or another automobile that is registered and covered by the no-fault law. Motorcycles, unfortunately, are never automatically included in the coverage, although coverage can be purchased.
  • The car or truck must be insured by a New York policy.
  • The injured party in the accident must be either a passenger, the driver, a pedestrian or a cyclist.

Lost Wages

You may be eligible to file for lost wages due to the accident. You must have your employer verify your lost earnings and fill out a No-Fault Wage Verification Report. You may be entitled to receive up to 80% of your lost income, up to $2,000 per month.

In addition to your employer verification, you must have a doctor’s note that verifies your injury and the disability you received due to the accident.

Steps to File for No-Fault Benefits

The sole aim of an insurance company is to make money. So filing a no-fault claim in New York must be done with great care. The insurance companies will carefully screen your application for errors. If they find any, they may deny your claim for benefits.

Here Are The Necessary Steps:

  • If you were behind the wheel at the time of the accident, the insurance company will give you a no-fault application called an NF-2 Form. This must be filled out completely and accurately. If you were a pedestrian or bicyclist injured in the accident, you must request the form from your own insurer.
  • After the date or your accident, you will have 30 days to file the no-fault application. You will not be given an extension of time if you forget to file.
  • Send the completed form to the insurance company of the vehicle you were in at the time of collision or to the company for the person who struck you if a pedestrian or cyclist.

What Happens After a Claim Is Filed?

You will receive a no-fault claim number once you have filed your paperwork. This number and the contact information of the insurance company must be given to your doctor throughout treatment until completed. The rest will be handled through the insurance company and your doctors in determining the no-fault benefits you may be entitled to receive.

Should I File My Claim Myself?

Personal injury cases are complex. And understanding the legal nuances involved in getting the compensation that you and your family deserve can only be helped by enlisting the services of a skilled personal injury attorney. The lawyers at Rosenberg & Gluck will gather evidence of the other driver’s fault, compile a list of your damages, and negotiate with both parties’ insurers, as well as the other driver’s lawyers.

Turning to a New York State Personal Injury Lawyer

If you live in New York State and were injured in a motor vehicle accident, you may find it helpful to get the advice of an experienced personal injury attorney for help in understanding the various benefits of APIP or OBEL coverage. A good attorney can help you with some of these policies and their benefits or drawbacks — to say nothing of helping to ensure that you get the maximum compensation for your injuries and medical bills.

Check out the Whole Series:

Filed Under: Car Accidents

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