Editor's note: updated July 2026 for New York's 2026 tort-reform changes.
After a car accident in New York, two separate legal frameworks apply at the same time. The no-fault system pays immediate economic benefits through your own insurance. The personal injury claim seeks full damages from the at-fault driver. No-fault benefits are available to everyone. The personal injury claim is available only to people whose injuries meet the serious injury threshold. The first system is the floor. The second is the ceiling. The threshold is the gate between them.
Many people injured in car accidents assume that because someone else was at fault, they have a lawsuit. Many others assume that because they recovered, they do not. Both assumptions are often wrong.
Whether you have a case depends on three specific questions. Those questions have nothing to do with who was at fault or how much the accident hurt. Understanding them helps clarify what pursuing a claim actually involves and what it may be worth.
No-fault benefits: the floor
PIP provides up to $50,000 per person for medical treatment and lost earnings, regardless of who caused the accident. These benefits are available immediately after you file the NF-2 application within 30 days. You do not need to prove fault. You do not need to meet the serious injury threshold. PIP covers economic losses only. That means medical bills, 80% of lost wages up to $2,000 per month, and transportation costs at $25 per day for travel to medical appointments. It does not cover pain and suffering, loss of enjoyment of life, or future damages beyond the $50,000 cap.
The $50,000 limit is not per year or per treatment category. It is the total available under the basic PIP policy. A single emergency room visit with a CT scan and overnight hospitalization can consume $15,000 or more. Ongoing physical therapy, specialist consultations, diagnostic imaging, and injection procedures can exhaust the remaining balance within a few months. Once PIP is exhausted, your health insurance becomes the primary payer for continued treatment. The remaining medical costs then become part of the damages claimed in the personal injury lawsuit.
The personal injury claim: the ceiling
A personal injury claim against the at-fault driver can recover full compensatory damages. That includes past and future medical expenses beyond what PIP covers. It includes full lost wages and loss of earning capacity, without the $2,000 monthly cap. It includes pain and suffering and loss of enjoyment of life. In some cases, a spouse can also bring a loss of consortium claim.
A wrongful death case recovers pecuniary losses to the surviving family members. It also recovers the decedent's conscious pain and suffering between the accident and death.
The personal injury claim carries no statutory cap other than the available insurance coverage.
The personal injury claim is brought against the at-fault driver. It also reaches the vehicle owner under Vehicle and Traffic Law Section 388. If the driver was working at the time, the employer may be liable under respondeat superior. Any other responsible party can be named as well. The claim is paid by those defendants' insurance carriers. If the damages exceed the carriers' limits, the uncovered amount may be pursued against the defendant personally. In practice, that rarely succeeds. Most defendants do not have personal assets worth pursuing. This is why available insurance coverage sets the practical ceiling on recovery.
The three questions that determine whether you have a case
First, was someone else at fault?
New York's comparative fault rule means you do not need to prove the other driver was entirely at fault. But in a motor vehicle case, fault percentages matter more than many people expect.
A claimant is barred from recovering non-economic damages when their share of fault exceeds the combined fault of all defendants. That threshold is the number the adjuster is working toward. If the evidence puts your share above that line, you lose non-economic damages entirely, not just proportionally.
Below that line, your recovery is reduced in proportion to your share of fault. A claimant found 30% at fault recovers 70% of their damages. The question is not simply whether fault exists on the other side. It is whether the evidence supports a defendant's fault, and where the percentages land.
Second, do your injuries meet the serious injury threshold under Insurance Law Section 5102(d)? A fracture meets it automatically. A disc herniation with documented range of motion deficits and radiculopathy typically meets it. Soft tissue complaints without objective medical findings frequently do not. The medical evidence determines the answer, not the level of pain you experienced. Your treating physician's documentation at every visit matters most. Objective measurements, imaging correlations, and causation opinions are what establish or fail to establish the threshold.
Third, is there insurance coverage available to pay a recovery? Clear liability and devastating injuries mean nothing if the at-fault driver carries a $25,000 minimum policy and you have no SUM coverage. Coverage determines the ceiling. Every applicable policy must be identified. That means the at-fault driver's policy, the vehicle owner's policy, your own UM and SUM coverage, household policies, and any employer policies. That search determines whether the ceiling is $25,000 or $500,000 or more. Strong liability and strong damages with limited coverage produce a very different case than the same facts backed by comprehensive coverage.
Cases that are stronger than they appear
Minor vehicle damage does not rule out a serious injury. Disc herniations happen in low-speed collisions. The link between vehicle damage and injury severity is weaker than the defense typically argues.
Pre-existing conditions do not automatically sink a case. Under the eggshell plaintiff doctrine, the defendant takes the plaintiff as they find them. That includes vulnerabilities the accident made worse.
An uninsured driver does not mean there is no recovery. The injured person's own UM coverage can step in. Sometimes those limits are higher than the at-fault driver's policy would have provided.
If one lawyer says you do not have a case, do not stop there. Law is complex and specialized. A lawyer who handles routine auto cases may pass on something a serious-injury attorney would take. Get a second opinion from someone who regularly handles cases like yours.
Cases that face obstacles
A dramatic accident with heavy vehicle damage but injuries that clear up within weeks may not meet the serious injury threshold. Damage to the car is not a stand-in for injury to the person. The inquiry focuses on medical evidence, not photographs of the wreckage.
Clear liability alone does not carry a case past a threshold motion. Subjective pain complaints without measurable limitations often fall short of significant limitation or permanent consequential limitation.
An accident with severe injuries but substantial comparative negligence may have limited net value after the fault reduction. A case with $500,000 in damages and 60% comparative fault results in a net recovery of $200,000. That is still significant, but dramatically less than the gross figure. These are not reasons to abandon a claim. They are factors that affect its value and must be evaluated honestly by the attorney and by the client.
Damages you can recover in a New York personal injury case
Compensable damages in a New York car accident claim include past medical expenses beyond what PIP covered. Future medical expenses reasonably certain to be incurred are also recoverable. Past and future lost wages and loss of earning capacity count too. So do past and future pain and suffering, loss of enjoyment of life, and, for a married plaintiff, loss of consortium for the spouse.
In a wrongful death case, damages include the pecuniary losses to surviving family members. Funeral expenses are recoverable. So is the decedent's conscious pain and suffering between the accident and death.
Each category of damages needs its own supporting evidence. Medical expenses are documented through bills and explanation-of-benefits statements. Future medical expenses require a life-care plan or a physician opinion supporting the projected costs. Lost wages are supported by employment records, pay stubs, and tax returns. Loss of earning capacity often requires an economist or vocational expert to put a number on it. Pain and suffering is supported by medical records, a symptom journal, and testimony from the plaintiff and family members. That testimony shows how the injury has affected daily life. The case value is the sum of these elements. Each one must be proven.
How Schwartzapfel Holbrook evaluates whether you have a case
We evaluate every potential car accident case by examining the liability evidence, the medical evidence supporting the serious injury threshold, and the available insurance coverage. We give honest assessments. If the case is strong, we explain why and how we would pursue it. If the case has weaknesses, we identify them and explain what they mean.
We are selective about the cases we accept. When we take a case, we prepare it expecting it may need to be proven at trial. If we do not accept a case, we encourage people to seek another opinion. The answer one lawyer gives is not always the final answer. The initial evaluation is free, and there is no obligation to proceed.
Schwartzapfel Holbrook / Fighting For You
