No-Fault Benefits: You Must Act Fast

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Steven Schwartzapfel Feb 10, 2016

New York is one of 12 states that operate under a system called No-Fault coverage after a person is the victim of a motor vehicle accident. No-Fault will pay all crash-related medical expenses, lost wages, and other incidental out-of-pocket expenses, regardless of who was at fault for the accident. These benefits are extended to passengers of a motor vehicle involved in an accident, as well as pedestrians struck by a motorist. If you are injured in an accident, No-Fault benefits are paid by the insurance on the vehicle you were driving, the vehicle in which you were a passenger, or the vehicle that hit you while you were a pedestrian. As simple as all this may sound, No-Fault is tightly guarded by the insurance companies, who have a keen eye on cutting off these benefits as quickly as possible.

What Does No-Fault Cover?

No-Fault does ensure that regardless of fault, an insurance company pays benefits to drivers, passengers, and pedestrians for up to $50,000 for their accident-related expenses. These benefits cover all medical expenses, such as ambulance and emergency room fees, doctor’s bills, expenses for any diagnostic testing such as MRIs or X-rays, prescription drugs that are legally prescribed as a result of the injuries sustained, physical therapy, and travel expenses to get to and from any treatment providers. All the expenses must be related back to the injuries sustained in that particular motor vehicle accident. In addition to all of these expenses, No-Fault allows the victim of a motor vehicle accident to recover lost wages for time missed from work as a result of the accident. You are entitled to receive 80% of your lost earnings for time missed for an accident-related injury, although there is a maximum benefit of $2,000 for lost earnings per month, regardless of your salary. You must have your doctor write what’s called a “letter of disability,” which causally relates your injuries to the motor vehicle accident.

No-Fault Is Separate from Personal Injury Claims

It is very important to note the difference between No-Fault benefits and a third party claim for your bodily injury. In addition to No-Fault benefits that are granted to anyone injured in a motor vehicle accident, regardless of fault, you may have a legitimate bodily injury claim. Here at Schwartzapfel Lawyers, we facilitate and assist our clients with No-Fault benefits, but we are retained to specifically handle your bodily injury claim. A bodily injury claim can be made when your injuries are the result of someone else’s negligence. Whether it is another driver on the road or the driver of the vehicle you were riding in, a third party bodily injury claim is separate and apart from your No-Fault benefits, and does require the negligence of another.

No-Fault Benefits Have a Strict Timetable

The most important thing to know about No-Fault, and something that can result in a complete denial of your benefits, is the time constraint. No-Fault must be filed within 30 days of the date of incident. This is not a loose timetable. On day 31, the insurance company will see to it that all benefits are denied. You must file a form called a NF-2 in order to commence your benefits. This form is provided by the insurance of the vehicle that you were driving in, or in the case of a pedestrian or cyclist knockdown, the insurance company of the vehicle that hit you. Schwartzapfel Lawyers will assist you in filing this form and ensuring that you get your No-Fault benefits. But it is very important to adhere to the 30 day deadline, as there is very little recourse besides using your own private insurance if you file late.

Benefits are Limited

Once No-Fault benefits commence, it is very important to keep in mind that they will not last forever. The insurance companies want to stop paying your benefits as soon as possible. Typically, within 60-90 days of your claim, they will have you examined by their doctors. This is required and failure to comply with their request can have devastating consequences, least of which is a termination of your No-Fault benefits. In the worst case scenario, they can disclaim your entire course of treatment, meaning the burden to pay all incurred expenses falls on you personally. So you cannot fail to comply with their request for an IME (Independent Medical Examination). These exams are anything but “independent,” as a doctor being paid by the insurance company will examine you to determine whether you need more treatment or whether you have made a full recovery. These exams do not typically result in an extension of benefits, so it is very important to see a doctor immediately after your accident. Do not skip appointments and go see any specialists that are recommended. As great as No-Fault benefits sound at face value, they can be very limited.

Contact Schwartzapfel Lawyers P.C.

If you have been involved in a motor vehicle accident, contact Schwartzapfel Lawyers P.C. for your legal needs. Whether you are filing for No-Fault benefits or pursuing a third party liability claim, we have the experience and know-how to help you receive the money and benefits you deserve. Contact us today by calling 1-877-737-4806 or by filling out our online contact form.

About The Author

For more than 35 years, Steven Schwartzapfel, the founding member of Schwartzapfel Lawyers P.C., has been one of New York’s most prominent personal injury attorneys. Steve represents clients in all types of personal injury cases. His experience, skill and dedication have enabled Schwartzapfel Lawyers P.C. to recover hundreds of millions of dollars for their clients.

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