Personal Injury Law: No Fault Insurance Claims Explained

As of now, Queens, NY follows the “no fault” car insurance system. No fault insurance means that if you get into an accident, the car insurer will pay some or all of the medical bills and lost earnings, regardless who was at fault in the situation. This type of claim is usually made through the “personal injury protection” provisions of the insurance policy, which is mandatory in no fault states. Here, we’ll go over the finer details to clear up some of the confusion involved with this law and types of claims.

One of the major features of the no fault plan is that you are not allowed to make a pain and suffering claim against the at fault driver unless your injury is seen as sufficiently serious and/or your medical bills reach above a certain level. Only then can you step outside of the no fault rules and pursue a personal claim against the person at fault. Some of the situations that qualify as sufficiently serious are bone fracture, significant disfigurement, permanent limitation of body or organ and full disability for 90 days or more.

All normal rules for dealing with a vehicle insurer should be completely disregarded when dealing with a no fault situation. The law commonly requires you to give over all recorded information and may even require you to have medical examination performed by a doctor selected by the insurance company. If you fail to cooperate or are unable to go through with this process, depending on your contract with the insurance company, they may have the right to deny your claim.

Another exception to the rule comes in the form of what is known as a “mini tort” statute. A mini tort is a statutorily defined claim that, instead of using your insurance company to straighten out the situation, is paid by the other drivers no fault insurance carrier. The amount of this type of claim payable by law is usually somewhere between 500 and 1,000 dollars. Your insurance will usually require you to file this type of claim as a matter of course, even is the amount exceeds the mini tort amount. Then, the proceeds are deducted from the payout that your insurance company makes.

The no fault laws are put in place to reduce the number of auto negligence cases filed in court. By mandating payouts and restricting conditions on the ability to sue the “at fault” party, courts are not overwhelmed with auto negligence claims. One of the main reasons that auto insurance companies support this legislation is that non economic damages are not allowed in no fault claims. All in all, only the most serious and life altering situations call for a victim to bring suit against a person who was at fault. This should have cleared up a lot of the questions that you may have had about no fault states and the laws that govern how no fault claims operate in these states.

Contributed by: Ribowsky Law 109-12 Jamaica Ave, Richmond Hill, NY 11418 (718) 659-5333

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