The "New York Comprehensive Auto Insurance Act," which most people refer to as a "no-fault statute," was enacted in 1973 and went into effect the following year. The purpose of the bill was to limit the amount of personal injury claims caused by road accidents, as many politicians had this agenda on their platforms.
The error-free statute was revolutionary by providing immediate payment for medical care, lost earnings and other reasonable pocket expenses incurred as a result of motor vehicle accident injuries. The law provides that these costs must be paid up to $ 50,000 per person. These payments are what are known as "first party benefits" or "basic economic loss." The reason it is called error free is because these payments are made regardless of the error. If you lose control of your car and get stuck in a tree, you still get these payments.
If your medical bills, lost earnings, and / or expenses out of your pocket are more than $ 50,000, you can still sue the party who caused you injuries for these extra amounts (as well as for your pain and suffering.) If your injuries are " seriously "and caused by the negligence of another, you can still file a lawsuit. It does not cover property damage without error, so you still need to sue for damage to your car unless you carry "collision" or "full coverage" for your vehicle.
WHO IS NOTIFIED?
"Unauthorized benefits are insured for economic loss arising from the use or operation of a motor vehicle (Insurance Act Section 5103). Section 5102 defines a motor vehicle as" all vehicles on the highway accept motorcycles. "motorcycles were deliberately excluded due to the frequency of accidents, which would make motorcycle insurance much more expensive.
You are insured against faultless insurance and therefore the statute calls "covered person" if you are an insured person, driver or passenger in a vehicle or a pedestrian injured by vehicle operation. If you are not an insured and your car insurance is not in force, you would be covered for the “first side” of the no-fault fee under any car insurance policy in your household. For example, if your adult child in your home were a car, it would cover you. If there is no "home car", there is a government fund called the Motor Vehicle Accident Compensation Corporation (MVAIC) that would provide error-free benefits.
There are some exceptions that you should be aware of. First, there must be an accident. Failure to provide benefits will not pay off if the injury was caused by a deliberate act. Most insurance policies disclaim intentional acts, non-infringements, and other types of claims. For example, you would not expect your homeowners to have to pay for the damage you caused because you no longer loved your carpet, so you inked it. Similarly, if someone intentionally jumps into your car, insurance will not cover the loss. Fortunately, things like this don't happen very often!
You are also not covered if you are "in employment". This applies, for example, if you drive a taxi, work as an ambulance assistant, or are on a sales call. In most cases, workers' compensation pays somewhat similar benefits, which will be covered in another article.
If you are a driver and you are driving under the influence, you will not be compensated for the benefits, but will be paid to the passengers or pedestrians you have injured. Not surprisingly, if you were injured while committing a crime or when seeking to evade law enforcement, no compensation will be paid. Cover will also not be afforded if you operate a vehicle that is known to have been stolen.
So the downside is that you are automatically entitled to medical expenses and many other things if you are involved in a car accident, except for the exclusions mentioned above. The downside is that in order to have a claim for "wrongdoing" for negligence against an operator who caused you injuries, you must have what the law defines as "serious injury". I will explain this in more detail in this article.
WHAT DO YOU GET IF YOU DO IT?
Section 5102 of the Insurance Act defines it as $ 50,000 per person for:
All necessary expenses incurred for medical and related services, therapy, certain non-medical treatments adopted by the religious method and other professional health services until their occurrence is established within one year of the injury;
The loss of earnings and the reasonable and necessary expenses incurred in acquiring services in lieu of such such persons would result in income, up to $ 2000 per month, within three years;
All other reasonable and necessary expenses incurred up to $ 25 per day for not more than one year after the accident.
The first paragraph describes the types of medical treatment that are covered. Non-medical treatments may include acupuncture and some other holistic therapies, but I would not risk advocating for "religious" treatments that are not widely known. Fee payments are on a “fee schedule” and treatment by medical professionals cannot charge a higher fee, which makes it challenging to find physicians who are willing to accept nonpayment. Most chiropractors and physical therapists are happy to accept this, but answers like orthopedic doctors, neurologists and plastic surgeons are hard to come by.
The second paragraph allows for the payment of provable lost earnings due to an accident. If you are self-employed, you can file tax returns to show a loss of income. You usually need to submit three years of tax return – the two previous years showing what you usually earn and the year in which the accident occurred show that you made less. If you need to hire someone to replace you temporarily, such as someone who will drive your taxi when you own the locket, the amount you pay to the replacement driver may be reimbursed. Obviously, if you work "off the books," you cannot claim compensation for lost earnings.
The third paragraph offers a small amount of money that is commonly used to reimburse taxis for medical treatment and similar expenses. You can also get a household assistance fee if you are unable to care for your children or take care of your home (but only $ 25 per day). There is an option to buy an additional $ 25,000 after you have exhausted $ 50,000, but very few people choose to buy this extra coverage. Your unauthorized insurance coverage will, under some circumstances, cover you even for accidents that occur in other states.
The request for non-compliance must be submitted to the insurance company within thirty days of the accident. All requests must be submitted within 180 days of delivery. Most insurance companies will pay the fee immediately. Issues may arise regarding the adequacy of the evidence submitted, which may delay payment. Insurance companies will sometimes claim that treatment is not medically necessary and withhold payment, in which case the doctor may arbitrate that denial or sue the insurance company for payment of the bill. It is worth discussing with medical professionals who are willing to do these arbitrations rather than end up being liable for payment or a lien on your case should the insurance company refuse to pay. The insurance company also has the right to see you by the doctors they hire to determine if your treatment is needed. Eventually, as your injuries improve, an hired doctor at an insurance company will "deny" your medical treatment as it is no longer needed, which can be arbitrated or judged by a medical professional who treats you.
HOW DOES NEW YORK LAW RESOLVE "SERIOUS INJURY?"
The "serious injury" threshold is defined in §5102 (d). Damage to pain and suffering can only be compensated if the claimant retains injuries resulting in:
Significant disparagement; or
Fetal loss; or
Permanent loss of use of a body, member, function or system; or
Permanent consequential restriction on the use of bodily function or system; or
Significant limitation on the use of bodily function or system; or
Medically established injury or damage of an unstable nature, which prevents the injured party from performing substantially all of the material, acts that constitute the usual or ordinary activities of such person for at least 90 days during the 180 days immediately following the occurrence or injury.
The first two categories are obvious. Fractures are displayed on the x-ray and will always meet the threshold of serious injury, no matter how minor. A hair fracture on the left pink toe will be sufficient even if no treatment is required and there is no disability. Significant denigrations are less clear. It is usually the cuts and scratches on the face or other visible parts of the body that result in "scars" and whether or not the remaining traces are actually an eclipse. Case law explains that a scar must be so unattractive that the person is the target of "pity and disparagement." A label that must be "highlighted" will not meet the threshold.
With the loss of the fetus, it must be proven that the miscarriage was actually caused by an accident. It would not be likely to claim that the miscarriage was caused by a minor impact, especially if the woman did not immediately seek treatment for any injuries and lost her baby after a month.
The sections of "permanent loss" and "significant restriction" were supposed to cover paralysis or other serious losses of use, but they developed into much less serious damage such as tears of the ligaments and hernias on the neck and back. There must always be objective evidence, such as an MRI and reports from physicians to substantiate these claims, subjective claims of pain are never sufficient to meet the threshold of serious injury.
The threshold is met when an injured person loses more than 90 days of work due to injuries. Work times need not be instantaneous and need not be consecutive. For example, a person might be out of work for a month after an accident, try to go back to work, be out again, go back, do surgery and be out again to recover. As long as the first 180 days total more than 90 days, it meets the threshold of serious injury until the doctor confirms that you really couldn't work. It's not impossible, but it's much harder to qualify for this program without a full-time job, but there are some circumstances in which this might apply. For example, a home-grown manufacturer with young children may not be able to provide care and needs child care, losing 90 of the 180 usual activities.