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Suing Beyond New York’s No-Fault Thresholds

personal injury

After you or a loved one have been injured in a car accident in New York, the state’s no-fault insurance laws determine how your medical bills and lost wages are handled. New York’s no-fault system is designed to simplify the process of recovering these damages, allowing you to receive benefits regardless of who caused the traffic accident. However, no-fault insurance has its limitations, particularly when it comes to recovering compensation for pain and suffering or other non-economic damages. To pursue these types of damages, your case must meet New York’s no-fault thresholds. 

As your attorney, I understand that crossing the no-fault threshold can seem complicated, but it is essential to obtaining full compensation for your accident-related injuries. The key is understanding what qualifies as a “serious injury” under New York law and how to prove your claim. New York’s no-fault laws are governed by Insurance Law § 5102(d), which outlines the specific criteria that determine whether you can file a lawsuit for damages beyond what no-fault insurance provides.

What Are New York’s No-Fault Thresholds?

Under New York’s no-fault insurance laws, you are required to carry Personal Injury Protection (PIP) coverage as part of your auto insurance policy. PIP covers medical expenses, lost wages, and other related costs of up to $50,000 per person. However, you cannot seek compensation for non-economic damages, such as pain and suffering, unless your injuries meet certain criteria.

The threshold for filing a lawsuit is defined by Insurance Law § 5102(d), which specifies what constitutes a “serious injury.” Serious injuries include:

  • Death
  • Dismemberment
  • Significant disfigurement
  • A fracture
  • Permanent loss of use of a body organ, member, function, or system
  • Significant limitation of use of a body function or system
  • Permanent consequential limitation of a body organ or member
  • Loss of an unborn child
  • A medically determined injury or impairment that prevents you from performing substantially all of your usual daily activities for at least 90 days within the 180 days immediately following the accident

Proving Serious Injury

To sue beyond the no-fault threshold, it’s crucial to provide clear evidence that your injuries meet the legal definition of a serious injury. This often requires detailed medical records, expert opinions, and testimony that illustrate the extent of your injuries and how they impact your life. 

For example:

  • If you suffered a fracture, X-rays or other diagnostic imaging is necessary to substantiate your claim.
  • For permanent impairments, you’ll need a medical professional to confirm the long-term effects of your injury.
  • In cases involving significant limitations or inability to perform daily activities, documentation of your functional limitations is critical.

Legal Ramifications Of Crossing The Threshold

Meeting the no-fault threshold allows you to pursue a broader range of damages, including:

  • Pain And Suffering – Compensation for the physical and emotional distress caused by your injuries.
  • Loss Of Enjoyment Of Life – Damages for the impact your injuries have on your ability to engage in activities you once enjoyed.
  • Future Medical Expenses – Costs associated with long-term medical treatment or rehabilitation.
  • Lost Earning Capacity – Compensation for the impact your injuries may have on your ability to work in the future.

Filing a lawsuit for these damages involves navigating New York’s personal injury laws, which impose a strict statute of limitations. Under CPLR § 214, you generally have three years from the date of the accident to file your claim. Acting promptly ensures that critical evidence is preserved and that your case proceeds without unnecessary delays.

New York Serious Injury Threshold Frequently Asked Questions

What Qualifies As A Serious Injury Under New York Law?

A serious injury is defined by Insurance Law § 5102(d) and includes conditions like fractures, significant disfigurement, permanent loss or limitation of a body organ or system, and injuries that prevent you from performing daily activities for at least 90 out of 180 days after the accident. The injury must have a substantial and documented impact on your life.

Can I Sue For Pain And Suffering If I Don’t Meet The Serious Injury Threshold?

No, pain and suffering damages are not recoverable under New York’s no-fault system unless your injuries meet the serious injury threshold outlined in Insurance Law § 5102(d). If your injuries do not qualify, you are limited to recovering economic damages through your PIP coverage.

How Do I Prove My Injuries Meet The Serious Injury Threshold?

Proving a serious injury requires detailed medical evidence, including diagnostic tests, doctor’s notes, and expert opinions. Documentation showing how your injuries have limited your ability to work or perform daily activities is also essential. An experienced personal injury attorney can help gather and present this evidence effectively.

What Is The Deadline For Filing A Lawsuit After A Car Accident In New York?

The statute of limitations for personal injury claims in New York is generally three years from the date of the accident, as outlined in CPLR § 214. If you miss this deadline, you may lose your right to pursue compensation. It’s important to consult an attorney as soon as possible to ensure your case is filed on time.

What Damages Can I Recover If I Meet The Serious Injury Threshold?

If your injuries meet the threshold, you can recover non-economic damages such as pain and suffering, as well as economic damages not covered by your PIP insurance. This includes lost earning capacity, future medical expenses, and loss of enjoyment of life.

We Push For Every Penny You’ve Got Coming

At Jonna Spilbor Law, we understand how important it is to recover full compensation for your injuries after a serious car accident. Meeting New York’s no-fault threshold can be challenging, but we are here to help you every step of the way. From gathering evidence to filing your claim, we will work tirelessly to protect your rights and ensure you receive the compensation you deserve.

To receive a free consultation, contact our Poughkeepsie personal injury lawyers today when you call our Poughkeepsie office at (845) 485-2529, our New York City office at (646) 922-9789, or our Cold Spring office at (646) 922-9789. We represent clients throughout the Hudson Valley, Dutchess County, Putnam County, and New York City. Let us help you take the next step toward justice and financial recovery.

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