New York No-Fault Insurance: A Complete Guide for Accident Victims

What No-Fault Pays

New York is a no-fault insurance state. Under Insurance Law §5102, your own auto policy's personal injury protection (PIP) pays your initial medical bills and a portion of lost wages regardless of who caused the crash, up to a $50,000 basic limit. To sue the at-fault driver for pain and suffering, your injury must meet the statutory 'serious injury' threshold — such as a fracture, significant disfigurement, permanent limitation of a body organ or member, or a medically determined injury that prevents you from performing your usual activities for at least 90 of the 180 days following the accident.

Critical Deadlines

You must submit a no-fault application (NF-2) to the insurer within 30 days of the accident, and medical providers must bill within 45 days. Missing these deadlines can jeopardize your benefits, which is why prompt action matters.

The Serious-Injury Threshold

Stepping outside no-fault to sue for pain and suffering requires meeting the §5102(d) serious-injury threshold. Categories include death, dismemberment, significant disfigurement, fracture, permanent loss or limitation of a body organ or member, and the 90/180-day category.

Disputes and Denials

Insurers frequently deny or cut off no-fault benefits by scheduling independent medical examinations designed to find you've recovered. If your benefits are denied, you have rights — including arbitration — and an attorney can help you assert them.