In New York, mandatory no-fault insurance can provide a person who gets hurt in a car accident with guaranteed reimbursement of medical expenses and partial reimbursement of lost wages. However, under New York’s no-fault insurance system, an injured car accident victim may only have the right to file a lawsuit for non-economic losses if they meet the “serious injury” threshold under the no-fault law. As a result, people who suffer injuries in car crashes in Queens need to understand how the serious injury threshold works and how it may affect the compensation they can recover.
How No-Fault (PIP) Coverage Works
In New York, the no-fault insurance system requires drivers to carry insurance with personal injury protection (PIP) coverage. When an insured party suffers injuries in a car accident in Queens, their PIP coverage can help pay for certain expenses or financial losses from their injuries, including:
- Reasonable and necessary medical treatment and rehabilitation
- 80 percent of lost wages, up to $2,000 per month
- $25 per day for household assistance or transportation to medical appointments
A person may file a claim under their PIP coverage with their insurance company, regardless of who caused the car accident, making it a form of “no-fault” coverage. However, the no-fault insurance system does not provide compensation for non-economic losses, such as pain and suffering. A person may not sue an at-fault driver for pain and suffering or other non-economic losses unless their injuries meet the “serious injury” threshold.
The Reasons for the “Serious Injury” Threshold
The no-fault system imposes a “serious injury” threshold to reduce the number of lawsuits arising from car accidents. People who suffer minor injuries in car crashes can obtain guaranteed compensation for their financial losses from their insurer rather than pursuing a claim against the at-fault driver. However, a person who suffers serious injuries that may result in losses exceeding their PIP coverage can pursue a lawsuit for all their losses, including pain and suffering.
The Categories of Serious Injury
Under New York law, a car accident injury can meet the “serious injury” threshold if it meets one or more criteria, including:
- Results in death
- Involves dismemberment
- Causes significant disfigurement
- Involves a fracture
- Causes the loss of a fetus
- Causes permanent loss of use of an organ, member, bodily function, or system
- Causes permanent consequential limitation of an organ or member
- Causes significant limitation of use of a function or system
Common Threshold Disputes
At-fault drivers and insurance companies may dispute whether an accident victim’s injuries meet the “serious injury” threshold by raising arguments, such as:
- Soft-tissue injuries: Insurers and defense counsel may dispute whether an accident victim’s soft-tissue injury, especially injuries like whiplash or spinal disc herniations, meet the loss or limitation categories under the threshold.
- Inadequate medical documentation: Lack of medical records documenting injuries or gaps in treatment may lead opposing parties to question the severity of an injury.
- Evidence of limitation: Opposing parties may dispute whether an injury meets the threshold when the record lacks evidence of a crash victim’s limitations.
Contact Our Firm Today After Suffering Injuries in a Motor Vehicle Crash in Queens
Have you suffered injuries in a car crash in Queens? If so, you need to understand how New York’s no-fault insurance governs the financial recovery you might receive. Contact McCann Legal, PC today for a free, no-obligation consultation with a Queens personal injury attorney to learn about New York’s no-fault insurance system and discuss how the law’s “serious injury” rule can affect your right to file a lawsuit against an at-fault driver to recover compensation for both your financial and personal losses.