Not all states have No-Fault laws, but New York is one of the states that do.  Inevitably when you are involved in a motor vehicle accident, you will go through the No-fault insurance process to obtain some compensation for the accident and your injuries.  When our experienced attorneys here at Greenberg and Greenberg handle Hudson motor vehicle accidents, we commonly are asked a lot about No-Fault insurance and how it works.  Here are some of the more common questions:

What is no-fault and what does it cover?

No-fault insurance is coverage under the automobile insurance policy of the vehicle registered in New York that you occupy at the time an accident occurs.  No-fault coverage is designed to pay for lost wages, medical bills, and other expenses that are medically necessary.  This insurance is available regardless of who caused the accident.

Deadline Information

Your no-fault carrier needs to be placed on written notice within 30 days of the accident through an Application for No-Fault benefits to be able to make a claim.  There are no exceptions in most cases, but the time frame can be extended in limited instances.

Amount of Coverage

Every insured automobile carries a minimum of $50,000 in no-fault coverage for each occupant in the automobile.  Monthly wage loss is covered at 80% of gross wages (with a maximum of $2,000 per month) unless a special rider was elected on the policy which would extend to a higher monthly lost wage.  Additionally, no-fault payments are not taxable since they are reduced by 20% to simulate taxes.  Other expenses are reimbursed as well, including medical supplies such as wheelchair or crutch rental, mileage to and from your doctors, in addition to payment for any household chores your doctor has said you cannot perform. 

Who is not covered?

There are some groups of people who are not eligible for no-fault coverage in most cases, including:

·         Motorcycle drivers;

·         Motorcycle passengers;

·         There is no coverage for a person in their own uninsured vehicle;

·         There is no coverage for a person who occupies their spouse’s uninsured vehicle; and

·         Residents of states other than New York may not be eligible for coverage. 


Occupying someone else’s uninsured vehicle?

If you are in a vehicle that is not insured, and you do not reside in the same household as that person, you may still be eligible to claim no-fault benefits from your own automobile insurance policy, or the policy of a relative you live with.  However, even if you do not have your own automobile insurance and neither does anyone in your household, you may be eligible to claim no-fault benefits from the Motor Vehicle Accident Indemnification Corporation.  You will need proof that you do not have insurance, and that anyone you live with doesn’t have automobile insurance. 

Do you need a referral to see a doctor?

Under no-fault there is not a requirement to see a specialists.  If you do not have a primary care physician, you will usually still be able to see a specialist without a referral.  However you will need a referral for diagnostic tests such as x-rays, MRI and CAT scans.

Are you covered when driving a rental vehicle?

You should be eligible for no-fault coverage through the rented vehicle, and still be able to use any “extra” coverage you may have on your own automobile insurance policy.  Contact us to determine what coverage applies to your specific situation.

Do you have coverage for accidents outside of New York?

New York residents who own an automobile covered by insurance are most likely covered by no-fault for accidents that occur in the continental U.S. and Canada.  This can change depending on the facts and requires assessment by an experienced car accident attorney.

Types of “extra” no-fault coverage

·         Optional Basic Economic Loss coverage;

·         Additional Personal Injury Protection coverage; and

·         Medical payments coverage.

These additional types of coverage are often available for a small additional cost and extend the basic coverage beyond $50,000. 

Is there a deadline for submitting medical bills for payment?

Medical bills need to be submitted to the no-fault insurance carrier within 45 days of the day of treatment.  It is very important that you give your medical providers your no-fault information as soon as possible, since any treatment submitted beyond the 45 day rule may result in you being personally responsible for paying the bill.  Do not assume that it has already been taken care of; submit all bills, including their duplicates once you receive them.

Is there a time limit for medical treatment?

If medical providers indicate that treatment is required, no-fault insurance will pay for treatment and prescriptions until your coverage used up.  However, the no-fault insurance company may send you to an “independent” doctor to verify your medical status and treatment.  If it is determined that you do not need the type of treatment you are receiving, you may be denied benefits due to lack of medical necessity.  Your medical provider has an obligation to justify the need for the treatment you are receiving and that the treatment is connected to your automobile accident.

What if you are denied no-fault payments?

If you are denied no-fault payments, you can contest or refute the denial.

The Hudson No-Fault insurance attorneys at Greenberg and Greenberg handle cases throughout New York State, including Columbia, Greene, Rensselaer, and Albany County.  Our legal team has earned a reputation for dedicated service to our clients injured in New York personal injury accidents.  Please contact us today to receive a FREE case evaluation by dialing locally to 518-828-3336 or call toll free at 877-469-9300.