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What is No-Fault Insurance?

Updated: Aug 24, 2021




No-fault insurance might sound like a good deal, but it’s not exactly accurate. It is confusing for many people, as there is always blame somewhere. If it were truly no-fault, then insurance companies wouldn’t have to pay.


What no-fault really means is personal injury protection. This protects you and the passengers in the car. It also covers people injured in car accidents for medical expenses, any lost wages due to injury, and out of pocket insurance coverage.


No-fault really means medical insurance coverage for persons injured in a car crash. The biggest takeaway here is that it doesn’t mean that no one is held accountable for an accident.


However, it’s a guarantee that you will get money for injuries even if you caused the accident. If you are in an accident that is not your fault, then it doesn’t make sense that your own insurance company is going to be paying for your medical bills. But that is how this type of insurance works.


Who is at Fault?


The reason this type of insurance was brought to light was to protect those injured by no fault of theirs. That means the person on the bike, the people in your car during the accident, and the people in the other car.


The purpose of no-fault insurance is so that people who are injured get the medical treatment they need. Before, doctors were reluctant to treat people who were injured because they didn’t know how they would get paid. People still need medical treatment, even though their injuries are of no fault of their own.


As all vehicles in the state of New York are required to have no-fault insurance, everyone should be covered, yes? Well, let’s see. It can be a bit tricky working out who is at fault in a -no-fault accident claim.


● If you are the driver or a passenger in an accident, that car’s insurance covers your medical treatment

● If two or more cars are involved in an accident, each car’s insurance is responsible for those payments. The car you are in is responsible for paying your medical bills

● If you are a pedestrian and hit by a car, that car’s insurance is responsible

● If you are on the road on a bicycle and get hit, that car’s insurance pays

● If you are in a taxi, on a bus, or other public transit, things get a little stickier. That car that hit the bus can be responsible unless you don’t have insurance. The bus also has no-fault insurance. If the bus or cab is responsible, they will have to cover your medical expenses



Making Your Claim in New York


There are going to be a lot of confusing parts to making a claim. The most important thing to be aware of is filing and submission deadlines. These are vital and it is important to file right away.


Any claims made past a 30 day period after the accident may leave you without any type of compensation. This is for the no-fault application to the insurance company.


All medical bills, regardless of any that are on-going, must be submitted to the no-fault carrier within 45 days of your treatment. Any other expenses you have to pay for yourself, like transportation, prescriptions, lost wages, or even a healthcare worker must be submitted within 90 days of being incurred.


Other Facts


If you are physically injured in an accident, that claim is separate from the no-fault claim. This is confusing for many people. Most no-fault claims tap out at $50,000. However, you may be able to purchase up to $175,000, if needed,


If you are seriously injured in a crash, as a cyclist, a pedestrian, the driver, or as a passenger, you may have the right to sue for your injuries, pain, and suffering. This is called bodily injury, and if you’re severely injured you may be able to collect under the other drivers bodily injury insurance or your own uninsured/underinsured motorist.


If you are injured, the claim is made to the same insurance company that provides and pays your no-Fault claim and will also be defending and paying a judgment or settlement for your bodily injury claim.


If the accident occurs with a motorcycle, the rules are going to change, as they are exempt from having to have no-fault insurance. If you do ride a motorcycle, make sure you have your own health insurance


If you are on a bike, a pedestrian, a passenger in a car, and you own a car, you should also contact your insurance company, as well.


As it is very confusing, if you find yourself injured in an accident, whether you are driving or not, you may want to consider hiring a lawyer. While these no-fault rules were designed to move claims through very quickly, it seems the exact opposite has happened.

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