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How Does No-Fault Insurance Work After a Car Accident?

Feb 14, 2023 | Accidents, Auto Accidents, Personal Injury

Every driver in New York State is required to have no-fault insurance. In the event of an accident, no-fault insurance will cover certain expenses related to the crash — and as inferred by its name, it doesn’t matter who is to blame for no-fault to kick in. Whether the accident was the result of the other driver’s negligence or your own, each driver’s own policy is meant to cover them.   

What Does No-Fault Insurance Cover?

No-fault insurance — also known as personal injury protection (PIP) — will pay up to $50,000 for reasonable and necessary accident-related medical expenses. This can include doctor’s visits, emergency treatment, hospital stays, and the cost of physical therapy. You might also be entitled to reimbursement for out-of-pocket expenses in connection with your medical visits and treatment.  

Importantly, no-fault will also pay out 80% of your lost earnings up to $2,000 a month. However, this amount is offset by disability benefits and Worker’s Compensation if applicable in your case. No-fault also reimburses accident victims $25 a day for necessary household help. For instance, if you required assistance with laundry, cleaning, or other chores, at least part of the cost would be covered.   

While no-fault insurance is meant to provide accident victims with immediate access to funds they may need for medical expenses and to cover their bills while they are out of work, it doesn’t cover pain and suffering. In other words, no-fault doesn’t compensate you for the physical pain, mental anguish, and inconvenience you may have suffered as a result of your injuries. This is one of the reasons filing a personal injury action can be beneficial — to recover both your economic damages and non-economic damages.

When Will No-Fault Not Cover You?

There are certain situations in which no-fault will not cover the costs of a victim’s medical care or lost wages. Specifically, no-fault won’t pay out if:

  • The injured party missed the 30-day timeline to apply for benefits
  • The injuries were sustained during the commission of a felony
  • The injured party knew the car they were driving was stolen
  • The injuries were self-inflicted intentionally
  • The injured party was driving under the influence of drugs or alcohol

Although no-fault applies to vehicle operators, bicyclists, passengers, and pedestrians, it does not cover motorcyclists. 

Can You File a Personal Injury Claim if You Were Covered by No-Fault?

Regardless of whether you were covered by no-fault, you may still be able to pursue a personal injury claim in court. 

If you’ve suffered a serious injury in a car accident, medical bills can add up fast and the no-fault threshold can quickly be exceeded. In addition, depending on your injuries, you may be required to take extensive time away from work — or you might be unable to work ever again. In these cases, you may be able to recover your losses by filing a personal injury action.

In a personal injury lawsuit, you may be eligible to recover medical expenses that you incurred which were not reimbursed through no-fault or another insurance. You may also be able to recover your unreimbursed lost wages and out-of-pocket damages. Significantly, in a personal injury action, the most substantial part of an accident victim’s monetary recovery is usually the pain and suffering award. 

Contact an Experienced New York City Personal Injury Attorney

If you were hurt in a car accident, it’s crucial to have a personal injury attorney on your side who can protect your rights and ensure you obtain the monetary recovery you deserve for your injuries. As a result of our skill, experience, and commitment to clients, we regularly obtain settlements and verdicts in the millions.

The Edelsteins, Faegenburg & Brown LLP is a personal injury law firm dedicated to fighting for the rights of accident victims to ensure they get the maximum compensation they deserve for their injuries. Located in Manhattan, our firm has been handling personal injury cases throughout New York City since 1937. Call to schedule a free consultation at (212) 425-1999 today.




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