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When Is a Person Not Eligible for No-Fault Insurance Benefits?

As New York is a state with comprehensive no-fault insurance coverage, you need not worry about covering your accident-related expenses provided you have the right insurance policy. While no-fault insurance is indeed comprehensive, it is not all-encompassing, and there are situations where you may not be eligible for no-fault insurance benefits. In this blog, the Gabriel Law team will act as an injury lawyer in Brooklyn and examine New York’s no-fault insurance, its limits, and your legal options if you’re ineligible.

What is no-fault insurance in New York?

In New York, drivers are required to have a combination of personal injury protection insurance, liability insurance, and uninsured motorist insurance to satisfy the minimum insurance requirements mandated by the state. The term ‘no-fault insurance’ is another term used to describe personal injury protection insurance. 

If you’ve been injured in a car accident in New York, you can claim the following benefits under your PIP coverage. 

  • Any reasonable and necessary medical and rehabilitative expenses connected to the accident;
  • Up to $25 per day up to one year from the accident to reimburse other expenses connected to the accident such as transport and housekeeping;
  • Up to 80% of lost earnings with a maximum payment of $2000 up to three years from the accident; and 
  • An $2000 death benefit (in addition to the $50,000 limit) payable to the estate of the individual who died in the accident.

What are the limitations of no-fault insurance? 

While no-fault insurance offers a quick and hassle-free way to obtain compensation for your injuries, there are limits to how much you can claim and on what grounds you may claim no-fault insurance benefits. 

First, New York has set a limit of $50,000 for no-fault insurance coverage. This means that New York insurance companies are only required to cover the accumulative cost up to $50,000, and you must look for an alternative to cover any excess costs. 

Second, insurance claims only account for economic damages, which are tangible and quantifiable. However, a car accident can also result in non-economic damages such as pain and suffering, mental distress, the loss of consortium, and the loss of enjoyment of life. 

Insurance companies are vehemently against including coverage for such damages because they do not have a set financial value and thus are determined on a case-by-case basis. As such, the company could be paying out more than expected and thus be bad for business. If you want to claim compensation for non-economic damages, you will need to file a personal injury lawsuit in New York and prove your case in court.

When is a person not eligible for no-fault benefits?

As we mentioned above, while no-fault insurance is comprehensive, it is not all-inclusive, and there are instances where you may be injured in an accident but not entitled to no-fault insurance benefits. They are:

  • When you have been injured as an operator or passenger in a motorcycle or All-Terrain Vehicle (ATV).
  • When the accident occurred while the injured person was engaged in a felony or was fleeing from law enforcement. 
  • When the person was driving under the influence
  • When the driver is uninsured.

Conclusion 

If you’re looking to claim compensation for your New York car accident injuries, then your first and quickest option is to file a claim under your no-fault insurance. While it can cover your losses up to a certain extent, it has its limits, and there is the possibility that your accident may not be covered under no-fault insurance. 

Therefore, understanding New York’s insurance landscape is vital to ensuring you receive fair and reasonable compensation, and if you are looking for an experienced accident injury lawyer in Brooklyn, then look no further than Gabriel Law. Ensuring the protection of your rights is our top priority, and we will be there to guide you every step of the way. Contact us today to schedule your free consultation.

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