No-Fault Benefits-Personal Injury Protection (PIP)
No-Fault insurance, also called Personal Injury Protection (PIP), is designed to pay promptly, regardless of who is at fault or whether there was any negligence, for economic losses (meaning medical/health expenses, lost earnings, and certain other reasonable and necessary expenses related to injuries sustained), up to $50,000 per person (“basic No-Fault coverage”), to the driver and all passengers injured in your car as well as any pedestrians injured by your car, because of its use or operation in New York State.
The purpose of No-Fault insurance is to restore individuals hurt in auto accidents to health and productivity as swiftly as possible. Because of New York’s No-Fault law, lawsuits due to auto accidents can be brought only for economic losses that exceed No-Fault insurance benefits and for non-economic damages (such as pain and suffering) only if a “serious injury” (as defined in the Insurance Law) is sustained.
Basic No-Fault auto insurance coverage includes:
- reasonable and necessary accident related medical and rehabilitation expenses (in accordance with established fee schedules);
- 80% of lost earnings from work, up to a maximum payment of $2,000 per month for up to three years from the date of the accident; subject to statutory offsets for New York State disability, Worker’s Compensation, and Federal Social Security disability benefits.
- up to $25 a day, for up to a year from the date of the accident, to reimburse other reasonable and necessary expenses, (e.g., household help, and transportation expenses to/from medical treatment) resulting from the auto accident; and
- a $2,000 death benefit (in addition to the $50,000 basic No-Fault limit), payable to the estate of a person eligible for No-Fault insurance benefits who is killed in a motor vehicle accident.
Liability Insurance-Bodily Injury & Property Damage
This liability coverage protects you (and anyone driving your car with your permission) if a claim is made against you by another person (“third-party”), alleging that you were negligent or otherwise at fault. Thus this coverage will make payments on your behalf to that injured third-party, in the event your car is involved in an accident that results in serious injury or death to others or damage to their property.
In addition, your insurance company must provide you with a legal defense against such claims, without reducing your policy’s liability limits.
The minimum limits of third-party bodily injury liability coverage mandated by New York’s Vehicle and Traffic Law are:
- $25,000 for bodily injury (not resulting in death), or $50,000 for any injury resulting in death, sustained by any one person in any one accident;
- $50,000 for bodily injury (not resulting in death) sustained by two or more persons in any one accident, or $100,000 for any injuries resulting in death sustained by two or more persons in any one accident (subject to the above per person limits).
Since the minimum limit of coverage required by law for property damage liability protection, for damage to another party’s car or property, is $10,000 per accident, these minimum liability limits in New York are sometimes together referred to as “$25,000/$50,000/$10,000” or “25/50/10”.
Consumer Frequently Asked Questions
What is No-Fault coverage and what am I entitled to under it?
Answer: See our Consumers Guide on Automobile Insurance – No-Fault Benefits.
When and where should I file my No-Fault claim?
Answer: As soon as reasonably practicable, but in no event more than 30 days after the date of the accident, unless the eligible injured person submits written proof providing clear and reasonable justification for the failure to comply with such time limitation.”
You should file your claim with the insurance company which covers the car in which you were an occupant (either as passenger or driver) or, if you were a pedestrian, with the car that struck you. If you do not know the vehicle that struck you or if the vehicle was uninsured, you may file a claim with the insurer of a household family relative who had an auto policy at the time of the accident. If there was no auto policy in the household, you should file a claim with the Motor Vehicle Accident Indemnification Corporation (MVAIC). Additional information on MVAIC can be obtained on their web site www.mvaic.com or you can contact them by telephone at (646) 205-7800.
What do I do if my expenses exceed the $50,000 available under No-Fault?
Answer: When the basic No-Fault benefits are consumed, you may apply for Additional No-Fault (Additional PIP) benefits either from the vehicle you occupied or any auto policy of a related member of your household. Additional PIP is an optional coverage which is usually not expensive. If no Additional PIP benefits are available, you may make a claim to your standard health insurance to pay for your medical expenses. You may also be eligible for Federal Social Security Disability benefits. In addition to the above, you can also sue the party responsible for the accident, in order to recover the costs that you paid which exceed your policy limit.
What if the vehicle involved was a motorcycle?
Answer: If you are the operator or passenger of a motorcycle involved in an accident, you are excluded from No-Fault benefits (you may sue from first dollar loss). If you were a pedestrian struck by a motorcycle, you should file a claim with the insurer of the motorcycle. If it is not insured, then you may file the claim with the insurer of a household family relative who had an auto policy at the time of the accident. If there was no auto policy in the household, you should file a claim with the Motor Vehicle Accident Indemnification Corporation (MVAIC).
Can I sue for “serious injury” against another driver’s liability coverage?
Answer: You may sue another driver if he or she caused the accident that injured you and you sustain a “serious injury”. Section 5102(d) of the New York Insurance Law describes various conditions that meet the definition of “serious injury”.
Additional helpful links concerning Insurance Regulation 68, including the text of the old (pre-April 5, 2002) Regulation 68 as well as the version of Regulation 68 currently in effect along with all amendments promulgated to date, can be located here.
We Accept prescriptions from the following No-Fault Insurance companies:
21st Century Security Insurance Co.|A-Central Insurance Co.|Adriondack Insurance Exchange|Allmerica Financial Alliance Insurance Co.|Allstate Fire and Casualty Insurance Co.|Allstate Insurance Co.|Amica Mutual Insurance Co.|Amica Property and Casualty|Chubb National Insurance Co.|Citizens Insurance Co. of America|Country-Wide Insurance Co.|Erie Insurance Co.|Esurance Insurance Co.|Esurance Property and Casualty Insurance Co.|Garrison Property and Casualty Insurance Co.|GEICO General Insurance Co.|GEICO Indemnity Co.|Government Employees Insurance Co.|Hartford Accident and Indemnity Co.|Hartford Casualty Insurance Co.|Hartford Fire Insurance Co.|Hartford Insurance Co. of the Midwest|Hartford Underwriters Insurance Co.|Kemper Independence Insurance Co.|LM General Insurance Co.|LM Insurance Corporation|MAPFRE Insurance Co. of New York|Massachusetts Bay Insurance Co.|Mercury Casualty Co.|Metropolitan Casualty Ins Co|Metropolitan Group Property and Casualty Ins Co|Metropolitan Property and Casualty Ins Co|Mid-Century Insurance Co.|National General Assurance Co.|National General Insurance Online Inc|Nationwide Affinity Insurance Co. of America|Nationwide Mutual Insurance Co.|Natiowide Affinity Ins Co.|New South Insurance Co.|New York Central Mutual Fire Ins Co|Preferred Mutual Insurance Co.|Progressive Advanced Ins. Co.|Progressive Casualty Ins. Co|Progressive Max Ins. Co.|Progressive Specialty Ins. Co|Progressive Specialty Ins. Co.|Property and Casualty Insurance Co. of Hartford|Republic Franklin Insurance Co.|Sentinel Insurance Co., Ltd|State Farm Fire and Casualty Co.|State Farm Mutual Automobile Insurance Co.|The Hanover Insurance Co.|Travelers Personal Insurance Co.|Travelers Personal Security Insurance Co.|Trumbull Insurance Co.|Twin City Fire Insurance Co.|United Services Automobile Association|USAA Casualty Insurance Co.|USAA General Indemnity Co.|Utica Mutual Insurance Co.|Utica National Insurance Co. of Texas