No-Fault Laws and Impacts

New York State No‑Fault Laws: Structure & Impacts

Mandatory No-Fault (PIP) Coverage

Eligibility & Exclusions

Serious Injury Threshold

Statutory Offsets & Compliance Rules

1. Mandatory No‑Fault (PIP) Coverage

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

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

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

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

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

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

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

Under New York’s no-fault laws, your Personal Injury Protection (PIP) coverage is designed to cover specific “basic economic losses.” This coverage has a minimum limit of $50,000 per person and applies to a range of expenses, including:

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