No Fault Insurance

No-fault coverage within New York offers protection for pedestrians as well as those within a vehicle at the time of an auto accident. This type of coverage is expressly designed to pay for medically necessary bills as well as lost wages. In order for this to occur, a medical professional must put in writing precisely why you are unable to work or meet financial obligations the pertain to your health. The reasoning behind why it is titled no-fault insurance is due to the fact that coverage is guaranteed regardless to who actually caused the accident.

The carrier of the no-fault policy must be placed in writing within thirty days of the traffic accident. In the vast majority of cases, there are no exceptions to this “rule”. This means that you are obligated to submit what is called an Application for No-Fault benefits no more than 30 days from the time of the accident. This must be done for you to be able to present a claim for future and past lost wages and medically necessary expenses. There are a limited amount of instances in which the 30-day time frame can be extended.

Coverage Each is able to insure drivers for a minimum of $50,000 for no-fault coverage for each of the occupants of the vehicle at the time of a traffic accident. 80% of an insured member’s wages are able to be paid, up to a maximum of $2,000 per month from all sources. This is unless a user selects a special rider for your particular insurance policy in order for the amount to be increased to a higher payout amount. In order to stimulate taxes, wages are decreased to 20%. This translates into taxable no-fault payments. The following expenses, if confirmed in writing by a doctor that can be reimbursed, include payment for household chores, crutch or wheelchair rental, mileage to and from medical appointments, etc. The coverage payments that total $50,000 sources include payments from New York State Disability.

Unfortunately, in the vast majority of cases, the following are not eligible for no-fault coverage:

  • Motorcycle drivers
  • Motorcycle passengers
  • Should you be within your own uninsured vehicle at the time of the traffic accident
  • If you are within the uninsured vehicle of your spouse at the time of the accident
  • Individuals that are not residents of New York

If you are an individual that does not have their own car insurance within your household, there is the possibility that you could be eligible to make a claim for no-fault benefits via the Motor Vehicle Accident Indemnification Corporation. It is required that you present proof of no insurance for yourself as well as proof that you do not reside in a home with an insured person. Similar deadlines will apply to the alternative types of coverage when you are involved in a traffic accident. We will be more than able to assist you in the application process as well as answering any and all questions that may arise along the way.

In most cases pertaining to no-fault coverage, there is no need for a referral for a doctor. A referral is not generally needed should you need to an appointment with a chiropractor, acupuncturist, orthopedist or neurologist. This is expressly helpful should you not have a primary care physician since you will be able to see any specialist needed without any form of referral. It does need to be noted that a referral will be required would you be in need of physical therapy, CAT scans, MRI’s and x-rays.

When renting a vehicle, most of the time, you will be covered via a no-fault insurance policy. The predominant coverage will be via the rental service with additional coverage generated from your personal coverage. We will be able to help you in determining the specific coverage that is able to apply to your specific situation.

When outside of New York, as long as you have been established as a resident, the vehicle that you own will be thoroughly covered. It is more than likely that you will be covered via no-fault for the accident that occurs anywhere within Canada and the continental United States.

There are a variety of no-fault coverage policies that are available. It is highly important that you speak with your local agent so that the options that directly pertain to you are explained in great detail. The option available include the following: medical payments coverage, Additional Personal Injury Protection (APIP) and Optimal Basic Economic Loss (OBEL). More times than not, the costs involved are quite minimal. The coverages extend beyond the basic amount of $50,000.

When submitting medical bills for coverage under the guise of no-fault, it must be done within 45 days of the treatment date. Due to this time constraint, it is very important the all medical professionals involved in your treatment and billing be made aware of your no-fault information promptly. Keep in mind that all of the treatment billing that is received after the 45-day deadline becomes your personal responsibility singularly. It is best that you never assume that all medical bills will be automatically be taken care of. It is your express responsibility to ensure that all deadlines are met and all balances are resolved.

You will need to keep in mind that there no expiration date for any necessary medical treatment. In accordance with the law, your benefits do not expire after a set amount of years/months/weeks/days. Your treatment is able to continue and be paid for so long as it is deemed necessary by a medical professional. The no-fault coverage will continue to pay for prescriptions and treatment until the dollar amount of the coverage has been met. During the course of your treatment, it is plausible for no-fault to require you to be examined by an independent physician in order to verify your treatment and medical status. Should the independent physician deem that your course of treatment is necessary, further benefits will be expressly denied. It is the obligation of your health care providers to justify your need for the treatment course that you have been placed on. It needs to also be proven that any injuries that are being treated are the direct result of you traffic accident.

Should there be any denials in regards to your no-fault coverage, we will be more than able to assist you in that matter. There are a great number of options that are able to work in your favor, and our service will introduce you to them within a very brief amount of time.