No-Fault Coverage

Steven Schwartzapfel Feb 10, 2016

What is No-Fault Coverage?

No-Fault or Personal Injury Protection (PIP) is a mandatory coverage that pays for the reasonable and necessary medical expenses and lost wages for covered parties for treatment due to injuries sustained in an automobile accident. This coverage applies regardless of whether or not you are responsible for the accident and includes passengers in your vehicle or even pedestrians injured by your vehicle during an automobile accident.

How Much Coverage is Provided?

PIP coverage provides up to $50,000 for medical bills, increased household expenses such as house keeping or transportation ($25/day for up to one year), 80% of lost earnings up to $2,000 a month for 3 years, and a $2,000 death benefit. Additional Personal Injury Protection (APIP) coverage may also be purchased, which raises the PIP benefit from $50,000 to $100,000.

Be Wary of Time Constraints

As per the New York Insurance Department, you must file a written notice of claim with your no-fault insurer providing sufficient details to identify the injured parties, time, place, and circumstances of the accident as soon as it is reasonably practicable, but not more than 30 calendar days after the date of the accident. You may only file the claim after 30 days if you can provide reasonable and justifiable proof as to why the claim was not filed timely.

You Must Notify Your Health Care Provider

It is important to notify your health care provider that you are being treated for injuries resulting from a motor vehicle accident and to provide them with your PIP carrier, claim, and representative information. No-Fault billing and payments are subject to and paid in accordance with a prescribed fee schedule, which the health care provider is mandated by law to accept as full payment

Grounds for a Denial of Benefits

Certain circumstances do exist in which a PIP claim will be denied such as driving under the influence of alcohol or drugs, committing a felony at the time of an accident, crashing intentionally, or driving a stolen vehicle when the accident occurred. In addition, PIP coverage does not cover any non-economic losses such as pain and suffering, property damage, or any medical payments, lost income, etc. above $50,000 per person.

Contact Schwartzapfel Lawyers P.C.

If you have been involved in a motor vehicle accident, contact the attorneys at Schwartzapfel Lawyers P.C. for all of your legal needs. With over 150 years of combined experience, we know what it takes to receive the money and benefits you deserve. Contact us today by calling 1-877-737-4806 or by filling out our online contact form.

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