Have you ever been involved in a car accident in New York City or Long Island? If so, it’s likely one of the first things you heard about from your insurance provider is whether it was a no-fault accident or whether you were at fault. While this may be an obvious question in some cases, it is not always clear in others.
In this latest article, we take a closer look at what we mean by no-fault and at-fault insurance in New York City. Understanding these terms can help you make better decisions after a collision and avoid costly mistakes.
What is no-fault insurance in New York?
New York is a no-fault insurance state, which means that after a car accident, every injured person must first turn to their own insurance policy for basic benefits, regardless of who caused the accident. This coverage is known as Personal Injury Protection, and the idea is to process payments faster and reduce the number of smaller lawsuits.
That means that instead of having to wait for the fault to be decided, your own insurer will be able to pay certain costs according to your policy limits. In general, no-fault insurance coverage includes:
- Medical expenses related to the injury
- A portion of any wages lost due to not being able to work
- Transportation to medical appointments
- Certain household help expenses if your injury prevents you from carrying out daily tasks.
What no-fault insurance does not cover
While no-fault insurance provides several benefits, it also has limitations and does not cover certain areas. Typically, these types of insurance policies will not cover:
- Pain and suffering
- Emotional distress
- Full lost wages
- Vehicle damage
- Long-term loss of earnings
In these instances, an at-fault system comes into play, but only if your case meets certain legal thresholds.
When does at-fault insurance apply in New York?
Even though New York uses no-fault insurance for basic injury costs, you are still allowed to bring an at-fault claim or lawsuit against the driver who caused the accident, as long as your injuries qualify as “serious” under state law. This includes things such as bone fractures, significant disfigurement, permanent limitation of a body organ or function, significant limitation of use of a body system, injuries that prevent normal daily life following the accident, and permanent disability.
If your injuries meet this threshold, then you may be able to pursue a claim against the at-fault driver for damages that go beyond no-fault benefits. This includes compensation for pain and suffering as well as full economic loss.
Property damage still follows fault
It is important to note that vehicle damage claims are not handled under no-fault rules. Property damage in New York is always handled through the at-fault insurance system. This means that if another driver caused the crash, their liability insurance is generally responsible for your car repairs or its total loss, not your PIP coverage.
However, in real-world accidents in NYC and on Long Island, fault for property damage is often negotiated between insurance companies based on police reports, driver statements, witness accounts, photos and videos, and traffic camera footage.
Why the difference matters after a car accident
Because New York uses a blended insurance system, many accident victims don’t realize they may actually have more than one path to recovery after a crash. In many situations, an injured person can pursue a no-fault claim through their own insurance policy to cover medical expenses and a portion of lost wages, regardless of who caused the collision. At the same time, if the injuries meet New York’s legal serious injury threshold, there may also be a separate at-fault claim available against the driver who caused the accident for broader damages.
Each of these claim types comes with its own rules, documentation standards, and strict filing deadlines. No-fault benefits, for instance, generally require an application to be submitted quickly, typically within 30 days of the accident, while at-fault injury claims follow different legal timelines and require proof that another party’s negligence caused qualifying injuries.
Common mistakes to avoid
It can be easy to feel overwhelmed after an accident and pressured into certain actions without realizing the impact they may have later. One of the most common mistakes individuals make is not seeking medical treatment promptly, believing the injuries are minor; however, waiting too long or gaps in your documentation can affect reimbursement.
Another common issue is providing insurers with detailed statements before they understand their medical condition. Some people mistakenly believe that no-fault rules mean they are never allowed to sue, but this isn’t always the case. Equally, while quick settlements are tempting, you could be accepting an offer significantly under the compensation you deserve.
How fault is still investigated
Even though no-fault insurance provides initial medical and wage benefits regardless of blame, fault is still carefully examined in many New York car accidents, especially when injuries are serious, damages are extensive, or a lawsuit may be filed outside the no-fault system. Insurance carriers will routinely investigate how and why the crash occurred before deciding how to handle larger payouts.
To do this, adjusters and investigators will review whether traffic laws were violated, how each driver was driving, and whether speed was a factor. They closely examine right-of-way conflicts, signs of distracted or impaired driving, and the road and weather conditions at the time of the crash; this analysis is vital if the case meets the serious injury threshold.
Get the right guidance
Understanding how no-fault and at-fault insurance in New York works can be confusing, but it is essential to making an informed decision after a car accident. If you have been involved in a collision and need support to claim the compensation you deserve, our team here at Siler & Ingber Accident & Injury Attorneys is here to help you every step of the way.
Siler & Ingber Accident & Injury Attorneys
The Law Firm You Can Trust When It Matters Most
Offices: 301 Mineola Blvd., Mineola, NY 11501
Phone: (516) 294-2666
Website: https://www.nylawnet.com/
Email: ringber@nylawnet.com
Serving clients across New York City and Long Island. No fee unless we win your case.