Every New York driver must carry Personal Injury Protection (PIP), or no‑fault insurance, which covers economic losses regardless of fault
Coverage Includes:
Up to $50,000 per person in basic economic loss, covering medical and rehabilitation expenses
80% of lost wages, capped at $2,000/month for up to 3 years
Up to $25/day for up to 1 year for reasonable and necessary expenses like household help or transportation
A $2,000 death benefit payable to the insured’s estate if death results from the accident, in addition to the $50,000 limit
Impact
Faster payouts: medical bills and economic losses processed quickly by your own insurer
Limits litigation: reduces pressure on courts and streamlines recovery, especially for minor injuries
2. Eligibility & Exclusions
Who is covered: Named insured, household residents, vehicle passengers, pedestrians and cyclists injured by the insured vehicle in New York State
Excluded: individuals who were drunk or impaired, riding motorcycles, intentionally self‑injured, involved in felonies (e.g. stolen vehicle), or not carrying a valid NY insurance policy
Impact
Protects a broad range of victims, but disqualifies individuals engaged in wrongdoing during the accident, potentially denying them basic benefits.
3. Going Outside the No‑Fault System: Serious Injury Threshold
You can only sue the at‑fault party for non‑economic damages like pain and suffering if:
Your basic economic losses exceed $50,000, or
You suffer a legally defined “serious injury”, including:
death, fractures, disfigurement, permanent organ or body part loss, significant loss or limitation of bodily function, or inability to perform customary daily activities for 90 out of the 180 days post‑accident
Impact
The threshold restricts lawsuits to serious cases, limiting exposure for insurers but also potentially denying fair compensation for moderate injury
Requires strong medical documentation and legal support
4. Statutory Offsets & Compliance Rules
PIP lost wage payments are subject to a 20% offset and must deduct other disability benefits such as workers’ comp or SSDI—ordering of offsets depends on taxability of those benefits
Medical bills must be submitted within 45 days, lost wages within 90 days, and initial no‑fault claim filed within 30 days after accident
Accident must be reported within 10 days to DMV if injury, death, or significant property damage occurred
Impact
Strict deadlines and offsets can reduce your actual payout unless you act promptly and track other benefits
Summary Table: No-Fault Laws & Impacts
Law / Rule
What’s Covered
Trigger/Threshold
Impact
PIP coverage (mandatory)
$50K economic loss, 80% lost wages, daily needs, death benefit
Automatically with valid NY auto policy
Quick payouts; limited litigation
Exclusions
Drunk driving, motorcycle, felonies, out-of-state or invalid policy
Applies at the moment of accident
Certain claims denied entirely
Serious‑injury threshold & excess (> $50K)
Lawsuits for non-economic damages
Injury must meet statutory criteria or losses exceed $50K
Only serious cases can sue; others limited to PIP
Filing deadlines & offsets
Medical expense submissions, wage claims, form filing
Claims within days/weeks post-accident, benefits offset rules
Miss deadlines → partial or lost benefits
Why This Matters to You
Benefit of speed and certainty: PIP grants near‑immediate access to economic recovery without fault-finding
Limitation on compensation: No emotional, pain & suffering, or property damage under PIP
Legal threshold matters: If you suffer a serious injury or incur over $50K in economic loss, you may pursue further compensation—but only if you meet New York’s strict criteria
Attention to detail: Filing on time and tracking benefit offsets is essential
Contact Us to Get Started
Ready to resolve your denied no-fault insurance claim? Contact our team today. You can reach our Cheektowaga office at (716) 882-2727 or submit a message through our contact form.
