While most people have heard of "No-Fault", many have no idea under what circumstances it applies and generally use the term incorrectly. Enacted in 1973 the Comprehensive Automobile Insurance Reparations Act or the No-Fault Insurance Law (probably referred to in your policy as Personal Injury Protection) was designed to limit the number of law suits arising from automobile accidents, while at the same time compensating those injured in such accidents by providing medical and lost wage benefits. Prior to 1973 individuals injured by or in automobiles could bring a claim regardless of the nature or extent of the injury. There was, however, no requirement that the injured party's insurer pay the costs of medical treatment, wages for time out of work or other necessary expenses. As a trade off the New York State legislature enacted the No-Fault Law which requires New York insurance carriers to provide these benefits regardless of who caused the accident (hence the name "no-fault") however, limits the ability to bring a lawsuit arising from the automobile accident unless the injured claimant has sustained a statutorily defined "serious injury".*

     Under the current statutory scheme any insurance company that underwrites automobile policies in New York State must provide minimum No-Fault coverage of $50,000.00 per person for the following combined items: (1) all necessary expenses incurred for medical, hospital, surgical, nursing, dental, ambulance, x-ray, prescription drugs and prosthetic services, psychiatric, physical and occupational therapy and rehabilitation; (2) loss of earnings up to $2,000.00 per month for not more than three (3) years from the date of accident; and (3) all other reasonable and necessary expenses incurred up to $25.00 a day for not more than one (1) year from the date of accident. Once the $50,000.00 basic limit is reached in any one of the above categories (or their combination) the benefits cease. Most insurance carriers offer increased Personal Injury Protection in $50,000.00 or $100,000.00 units for an additional premium.

     It is important to note that getting hurt in an automobile accident does not guarantee benefits to the full amount purchased. Insurance companies will often attempt to minimize the extent and duration of the benefits you receive. They do this via strict notice requirements or by sending the injured person to an "independent" doctor to review the claim. If you are involved in an automobile accident it is important to contact an attorney who is experienced in dealing with no-fault matters so that you can receive the full benefits to which you are entitled.

* PLEASE WATCH FOR FUTURE ARTICLES DISCUSSING "SERIOUS INJURY" AND ITS SIGNIFICANCE.