What is No-Fault Insurance?

No-Fault insurance is a term that is commonly used to refer to “first party” benefits that are available to pay for medical bills, lost earnings and some out-pocket-expenses for traffic accidents in New York.  New York is a mandatory “no-fault” state so there is always some type of coverage if you are in a traffic accident, (unless you were working for an employer, then Worker’s Compensation will pay similar benefits.)  In most cases, an application for no-fault insurance coverage must be filed within thirty days of the accident, but there are some exceptions.  You cannot choose to use your health insurance instead, and you must treat with medical providers that accept no-fault rates.  There are no co-payments, so that’s a plus over using health insurance that people like.  You will need to attend Independent Medical Examinations (IME’s) with the insurance company and eventually the benefits will be cut off.  Many doctors are willing to hire lawyers to arbitrate these cut-offs so that you can treat longer if necessary.

If you are a driver or passenger in a vehicle, the no-fault insurance for the car you are in will be primary for no-fault benefits.  If there is no insurance on the car, the passenger can apply through their own car or a car “in their household,” or with MVAIC, but the driver is “out of luck” when driving a car with no insurance.  For pedestrians and bicyclists  the car that hit you is primary, then your own insurance or household insurance, then MVAIC.  There is no no-fault insurance coverage for motorcycle riders.

For more information see our article, “Everything You’ve Ever Wanted to Know about No-Fault”