Under N.Y. CLS Ins. Law Sections 5101-5109 automobile insurers are required to provide " first party benefits " or " No Fault Benefits" up to $50,000.00 per insured for necessary expenses incurred for healthcare goods and services, as well as compensation for time missed from work( up to $2,000 a month). The No Fault laws were enacted with the intent to draw a line between motor vehicle accidents and other types of torts. Motorcycle riders involved in accidents cannot recover no fault benefits, but do not have to prove a serious injury under the law to recover monetary damages.
The No Fault law provides first party compensation for basic economic loss resulting from injuries that occur while using or operating an insured motor vehicle regardless of fault. Michigan Millers Mut. Insurance Co. v. Cullington, 59 A.D. 2d 784, 398 N.YS. 2d 740.(2d Dept. 1977). However , the No Fault Law bars recovery in automobile accident cases unless the plaintiff ( the injured party suing ), has a " serious injury as defined by NY Insurance Law Section 5102(d) . ( See my blog on Serious Injury Law ).
An insurance company must pay bills within 30 days after receipt of a proof of claim, unless additional verification is requested, in which case the thirty day window for paying the claim is put on hold until such information is received.
If you are injured on a bus for example you can file a No Fault Application with the bus company on the bus where you were a passenger involved in an accident.
It is important after an accident that you consult an attorney or file a No Fault Claim form with your automobile insurance carrier , or if you are a passenger in a car or bus or a pedestrian then the driver's insurance carrier.
The police report will often have codes that will post a number reflecting the name of the insurance carrier , and one can look that up to determine the name and address of the insurance carrier with whom to file the No Fault Application.
Routinely after 3 months of treatment the insurance carrier will request a no fault exam by a doctor hired by the insurance company , who may deny payment of all or part of your future bills for treatment based on findings in their report.
If you need any further information on No Fault Law or any other topic , please call me Ed Lemmo Esq of Lemmo Law @ 646-522-9082. I am here to help .
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