(718) 249-7447
Call Us Now
New York is a no-fault insurance state, which means your own auto insurance pays for your medical bills and lost wages after a car accident, regardless of who caused it. This coverage, called Personal Injury Protection (PIP), provides up to $50,000 per person and applies to most drivers, passengers, and pedestrians involved in a crash.
Understanding how this law works matters because it directly affects what you can recover and whether you can sue the at-fault driver for additional compensation. New York’s no-fault rules come with strict deadlines, coverage limits, and legal thresholds that can make or break your claim.
This article explains exactly how the law works, what it covers, and what steps protect your right to full compensation.
Who Is Covered Under New York No-Fault?
PIP covers most people involved in a car accident in New York, not just the driver. If you were hurt in or near a vehicle with a valid New York auto insurance policy, you are likely covered.
- Drivers and passengers: Anyone inside an insured New York vehicle at the time of the crash.
- Pedestrians and cyclists: Anyone struck by a covered vehicle, even if they have no auto insurance of their own.
- Household relatives: Family members living with the policyholder who are injured as pedestrians.
A few groups are excluded from no-fault benefits entirely, including motorcyclists,people driving under the influence, and occupants of uninsured vehicles.
What Does No-Fault Insurance Pay For?
Your basic PIP coverage helps pay for accident-related expenses across several categories. Here is what each one covers.
Medical bills and rehab: No-fault pays for all reasonable and necessary medical treatment related to the accident. This includes emergency care, surgery, physical therapy, prescription drugs, dental work, and psychiatric treatment. Bills are typically paid directly to your providers.
Lost wages: If your injuries prevent you from working, no-fault reimburses 80% of your lost earnings, up to $2,000 per month, for up to three years. This amount may be reduced if you are also receiving Social Security Disability or workers’ compensation benefits.
Other necessary expenses: You can receive up to $25 per day for one year to cover costs such as transportation to medical appointments or hiring help around the house.
Death benefit: If someone dies from injuries sustained in the crash, their estate receives a $2,000 death benefit from the no-fault policy.
What Does No-Fault Not Cover?
No-fault insurance only covers economic losses—your bills and income. It does not pay for pain and suffering, emotional distress, or damage to your vehicle.
| Covered by No-Fault (PIP) | Not Covered by No-Fault |
| Medical bills up to $50,000 | Pain and suffering |
| 80% of lost wages (capped at $2,000/month) | Vehicle repair or property damage |
| Transportation and household help costs | Losses above $50,000 |
| $2,000 death benefit | Motorcyclist injuries |
For losses that fall outside PIP, you may need to file a separate personal injury claim against the at-fault driver.
What Deadlines Apply to No-Fault Claims?
No-fault claims have strict deadlines. Missing even one of them can result in your entire claim being denied, even if your injuries are serious and your case is otherwise valid. Think of it as the 30-45-90 rule.
- 30 days: You must file your Application for No-Fault Benefits (Form NF-2) with the correct insurer within 30 days of the accident.
- 45 days: Your medical providers must submit bills to the no-fault insurer within 45 days of each treatment date.
- 90 days: You must submit proof of lost wages within 90 days of the first missed workday.
If you miss the 30-day NF-2 deadline, your claim will be denied unless you can provide a written, legally valid reason for the delay, a very difficult standard to meet.
How Do You File a No-Fault Claim?
To start a claim, you file Form NF-2 with the auto insurance company that covers the vehicle you were in. If you were a pedestrian, you file with the insurer of the vehicle that struck you.
If the driver was uninsured or fled the scene, you may still have options: you can file under a household relative’s auto policy or with MVAIC, the Motor Vehicle Accident Indemnification Corporation. MVAIC is a state-run fund that steps in when no other insurance is available.
Once your claim is open, make sure every medical provider knows it is a motor vehicle accident claim. Give them your claim number so they can bill the no-fault insurer directly, not your health insurance.
When Can You Sue for Pain and Suffering?
Here is where things get important. No-fault insurance was designed to limit lawsuits over minor injuries. To sue the at-fault driver for pain and suffering, your injuries must meet what the law calls the “serious injury threshold.”
Under New York Insurance Law § 5102(d), a serious injury is one that results in:
- Death or dismemberment.
- A significant and permanent disfigurement.
- A fracture.
- The loss of a fetus.
- Permanent loss of use of a body organ or function.
- A significant limitation of use of a body function or system.
- A medically confirmed injury that prevents you from doing your normal daily activities for at least 90 out of the 180 days following the accident (known as the 90/180 rule).
Insurance companies fight these claims hard and often send you to their own doctor—called anIndependent Medical Exam (IME), to argue your injuries are not serious. This is exactly why having the right kind of attorney in your corner matters.
How Does No-Fault Affect the Value of Your Personal Injury Claim?
No-fault gets your bills paid quickly, but it caps your recovery at $50,000 and blocks you from suing for pain and suffering unless you clear the serious injury threshold that can affect the average personal injury settlement in New York. Your claim’s full value depends on whether you qualify to step outside this system.
Think of it as two separate paths. The no-fault path pays your immediate economic losses fast. The personal injury lawsuit path allows you to recover pain and suffering, future medical costs, and any economic losses above $50,000, but only if your injury qualifies under the law.
Special Rules for Motorcycles, Rideshare, and Work Vehicles
Not everyone on the road is covered the same way. Three common situations have different rules.
- Motorcyclists: Riders are completely excluded from New York’s no-fault system. They must use their own health insurance for medical bills and can sue the at-fault driver for all losses—economic and non-economic—from the very first dollar.
- Rideshare passengers (Uber/Lyft): If you are a paying passenger in a rideshare vehicle, you are covered by the rideshare company’s commercial insurance policy for no-fault benefits.
- Work vehicle drivers: If you are injured while driving a commercial vehicle as part of your job, your claim typically goes through your employer’s workers’ compensation insurance, not no-fault.
Common Mistakes That Trigger No-Fault Denials
Valid claims get denied every day because of procedural errors. Insurance companies look for any reason to reject a claim, and the rules are easy to get wrong while you are also trying to recover from an injury.
- Missing the 30-day NF-2 deadline: This is the most common and damaging mistake. There is almost no way to fix it after the fact.
- Gaps in medical treatment: If you stop seeing your doctor for a stretch of time, the insurer will argue your injuries have healed and cut off your benefits.
- Skipping an IME: The insurer has the right to send you to their own doctor. If you miss that appointment, your benefits will be denied immediately.
- Wrong billing: If your doctor’s office accidentally sends bills to your health insurance instead of the no-fault insurer, it can create delays that lead to a denial.
Hurt in a Crash? Here Is How Grigor Law Can Help
Handling a no-fault claim while recovering from an injury is a lot to manage on your own. At Grigor Law Injury & Car Accident Lawyers, we handle the insurance companies, deadlines, and paperwork so you can focus on getting better.
Founded by Chrissy Grigoropoulos, Esq.—recognized as a Top 40 Under 40 Rising Star and one of the American Institute of Personal Injury Attorneys’ 10 Best Female Attorneys for Client Satisfaction—our firm fights hard for injured New Yorkers across all five boroughs, Nassau, Suffolk, and Westchester counties.
We are available 24/7, offer free consultations, and charge nothing unless we win your case. Our team speaks Spanish, Greek, French-Creole, and Korean because we believe a language barrier should never stand between you and justice.
Call us or submit a free consultation form today. You deserve an advocate who is as fierce about your rights as they are compassionate about your recovery.
FAQs About New York No-Fault Insurance Claims
Can I Choose My Own Doctor for a No-Fault Claim?
Yes, you can choose your own licensed doctors and therapists, but they must agree to accept payment under New York’s no-fault fee schedule and submit bills within the 45-day window.
What Happens if My No-Fault Benefits Run Out Before I Recover?
After your $50,000 in basic PIP is exhausted, your health insurance becomes the primary payer for ongoing medical bills. If you purchased Optional Basic Economic Loss (OBEL) or Additional Personal Injury Protection (APIP), those extra limits will apply first.
How Do I File a No-Fault Claim After a Hit-and-Run Accident in New York?
Report the accident to the police promptly and file a Notice of Intention to Make Claim with MVAIC within 90 days; missing this deadline can permanently bar your recovery.
What Should I Do if the Insurance Company Denies My No-Fault Benefits After an IME?
Contact a personal injury attorney right away. An attorney can challenge the denial through arbitration or litigation and present medical evidence to get your benefits reinstated.
Does No-Fault Insurance Cover Me if I Was Partly at Fault for the Accident?
Yes. Because no-fault is a first-party benefit paid by your own insurer, your share of fault in the accident has no effect on your right to receive PIP benefits.
