New York No-Fault Instructions

In New York State, every vehicle is required to have a minimal amount of personal injury protection coverage so that most individuals injured in a motor vehicle accident can get benefits regardless of fault. This 'No-Fault' insurance provides reimbursement of a portion of the injured individual's economic damages, which includes medical expenses, loss of earnings and other reasonable expenses (such as prescriptions, travel expenses and household help).

ITEMS TO CONSIDER

• File for Disability Benefits
  You must file a New York Sate Disability form with your employer's disability carrier thirty (30) days from the date of your accident or the date you become disabled as a result of this accident. IF YOU DO NOT DO THIS YOU MAY LOSE A PORTION OR ALL OF YOUR DISABILITY BENEFITS.
  
• File for Workers Compensation:
  If you were in the course of your employment when this accident happened, you must file for Workers' Compensation benefits through your employer. The Workers' Compensation carrier will pay you a portion of your earnings and the No-Fault carrier will pay you a portion totaling eighty (80%) percent of your gross earnings, or up to $2,000.00 per month. When you receive papers from Workers' Compensation, you must give a copy to this office.

DENIAL OF NO-FAULT BENEFITS

• The No-Fault carrier is entitled to have you examined by a doctor they choose. This is called an 'independent medical exam'.
• Often the No-Fault carrier's independent medical exam results in the No-Fault carrier denying a payment to you or a denial of all future benefits.
• Despite the denial of benefits it is expected that you continue your medical care and treatment if you have not recovered and your doctor believes you need the treatment. The failure to continue treatment will falsely lead the defendant's insurance company to conclude that you've fully recovered and are no longer injured.

WHAT YOU HAVE TO DO AFTER THE DENIAL

• If you have private health insurance, arrange for them to pay your medical bills. Even though your own insurance is paying, YOU MUST TELL THE DOCTORS, HOSPITALS AND THERAPISTS TO CONTINUE TO SUBMIT THE BILLS TO THE NO FAULT CARRIER ALSO OR YOU CAN SUBMIT THEM YOURSELVES. THE ARBITRATOR CAN ONLY DECIDE ABOUT BILLS THAT HAVE BEEN SUBMITTED TO NO-FAULT AND DENIED. YOU MUST CONTINUE TO GET DISABILITY NOTES FROM YOUR DOCTOR AND SUBMIT THEM TO PROTECT YOUR LOST WAGE CLAIM.
• IF YOU ARE PAYING THE DOCTORS YOURSELF, the above instructions also apply. THE BILLS SHOULD BE SENT TO NO-FAULT, EVEN THOUGH THEY ARE GOING TO DENY THEM.
• IF YOU HAVE NO INSURANCE and cannot afford to continue treating, speak to your doctor concerning your continued treatment on a lien basis. These additional medical lien expenses would become part of the damages being claimed in your underlying case against the defendant.
• The No-Fault carrier will tell you how to fight or arbitrate the denial. You MUST NOT ARBITRATE THE NO-FAULT DENIAL UNTIL AFTER YOUR LAWSUIT IS RESOLVED. Your failure to follow this advice can destroy your lawsuit.

YOU MUST

• Never discuss your case or injury with anyone. You should always refer any questions regarding your case or injury to your attorney's office.
• Always keep copies of the bills, lost wage forms, mileage statements, etc. that you mail to the No-Fault insurance company.
• Immediately advise your attorney of any new doctor or hospital visits. Send your attorney the doctor's card with your name written on the back.
• Immediately advise your attorney if you stop treating.
• Never sign anything for anyone without first showing your attorney.
• Do not leave the New York State Disability form with your doctor or your employer as you only have thirty (30) days from the date of the accident or the date you become unable to work to send this form into your employer's insurance company.

If you or a loved one have been injured in a car accident and you are researching legal options, please call us at 1.800.966.4999 or fill out the form to the right of the page for a free case evaluation.