There are a dozen states across the country, including New York, that require all auto insurance policies to include no-fault coverage. All auto insurance policies in these states are
No-fault, sometimes referred to as PIP (personal injury protection) is a mandatory provision of every auto insurance policy in New York that pays for medical treatment and lost wages of a covered person as a result of a covered accident. In general, one files the claim with the policy for the vehicle which that person occupied regardless of who is at fault. In addition to no-fault an auto policy may have two optional provisions that provide similar benefits: OBEL (Optional Basic Economic Loss) and APIP (Additional personal injury protection).
No-Fault Coverage In New York
By law, no-fault benefits will cover a minimum of $50,000 in medical and lost wages per person. Lost wages are maxed out at $2,000/month and are subject to a 20% offset potentially making the total payout to the claimant less than $50,000.
For policies issued to TLC vehicles (taxi, car service, ride-sharing such as Uber, Lyft, etc.) in New York City the minimum no-fault benefits are $200,000.
When Is No-Fault Coverage Available?
No-fault benefits only apply when injuries arose out of the “use or operation” of the vehicle. That includes the typical auto accident situations. It doesn’t matter if the vehicle was moving or not at the time of impact. It doesn’t matter if the impact is with another vehicle or a stationary object such as a tree. It also may include instances where a person is just getting into the car whether or not the car is running.
Typically drivers and passengers involved in a covered accident are covered by no-fault. Coverage also applies to pedestrians or bicyclists injured by a vehicle. It doesn’t matter if the person is in the country legally, or has a social security number.
Excluded from coverage are the following:
- Occupants of a motorcycle
- Some, but not all, e-bicycles qualify as a motorcycle depending on technical specs of a particular model
- A person who intentionally causes own injury
- Intoxicated drivers
- A person who is committing a felony at the time of injury or is occupying a vehicle known to be stolen
- An owner of an uninsured vehicle involved in an accident, or a spouse of an owner of an uninsured vehicle and a passenger in that uninsured vehicle
Qualifying For No-Fault Benefits
A no-fault claim must be filed with the insurance carrier within 30 days of the accident. There is a special form, called NF-2, that is used in New York for that purpose. Sometimes it may not be obvious which insurance company the claim should be filed with. Drivers and passengers of a vehicle should file with the insurance company of that vehicle. Passengers or bicyclists injured by a vehicle should file with the vehicle’s insurance company.
Accidents Involving Hit-And-Run or Uninsured Vehicles
Sometimes there are complicated situations such as when a pedestrian is injured In a hit-and-run, or where the vehicle is uninsured. If the injured person or a relative in that person’s household has an auto insurance policy (for a vehicle not involved in the accident) the claim should be filed with that insurance company. Otherwise, the claim would be filed with MVAIC (Motor Vehicle Accident Indemnification Corporation) which also requires that a police report be filed within 24 hours of the accident.
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