What does it mean to be a No-Fault state?

The term “no-fault” can be confusing because people often believe it refers to the status of who is at fault when they have an accident in regards to the legal liability. The term no-fault applies only to states where insurance companies pay first-party benefits and where there are restrictions on the right to sue, it does not apply to your regular fender bender or sideswipe accident. If you have ever said or heard “it was a no-fault accident why is it showing up” or “New York is a no-fault state so why is that accident showing as my fault” then, unfortunately you have been mislead as to what no-fault insurance really is.

No-Fault insurance basically means is that if you are involved in an accident, whether you are at fault or not, the insurance for the vehicle you are in will pay for your medical bills, lost wages from work, housekeeping fees, prescription drugs, and/or transportation to and from medical providers, as long as those costs are a result of that accident. There are also protections for pedestrians and bicyclists who are injured in accidents with vehicles, that vehicles insurance will pay for all of the no-fault benefits.

These benefits are not automatic though, there is a thirty day window allotted, from the date of the accident, in order to file for no-fault benefits. The process can be confusing to start, however most insurance companies will provide you with the full application and we here at the Cote Agency can help you complete that paperwork.

If you are involved in an accident and are not at fault and you are looking to sue or make a claim against the vehicle that is at fault, unfortunately you will have to meet New York States “serious injury threshold.” New York is serious injury threshold no-fault state which means instead of meeting a monetary threshold, your injuries need to be deemed “serious enough” under New York's laws to warrant a personal injury lawsuit. A brief list of acceptable “serious injuries” are as follows:

• Death

• Dismemberment

• Significant disfigurement

• A fracture

• Loss of a fetus

• Permanent loss of use of a body organ, member, function, or system

• Permanent consequential limitation of use of a body organ or member

• Significant limitation of use of a body function or system

• A “medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less than 90 days during the 180 days immediately following the occurrence of the injury or impairment.”

There are other coverages that can be added to your policy to make sure you are covered in these circumstances as well. The other driver may not have enough coverage on their policy to make you whole again, but your insurance might be able to help. Make sure you ask your local Cote Agency to review your policy so we can help you determine if you are properly covered for these situations.