Friday, March 12, 2010

Protect yourself through "No-Fault" of your own.

Many states including New York are known as "No-Fault" states when it comes to coverage under your Personal Auto (PA) policy. This "No-Fault" status was brought on in the 1970's to help ensure that persons injured in auto accidents would have prompt and adequate resources to cover their injuries and subsequent income loss. In New York it came into effect on Feb. 1, 1974 as a result of the New York Comprehensive Motor Vehicle Insurance Reparations Act.

The intent of the law here in NY was to relieve the injured parties of the burden of the time consuming and often fruitless litigation needed to secure the money to pay for their injuries. At the time this law went into effect only 14% of liability premiums were reimbursing victims for their economic loss, and then only after 16 months from the time of the accident.

The law provides for a bundle of benefits to vehicle occupants that are injured as a result of a covered accident. These benefits are known as Personal Injury Protection (PIP) and they came from the promise of Basic Economic Loss stipulated in the legislation. In exchange for these guaranteed and promptly paid benefits, the covered individual gives up some legal rights to sue for what is known as non-economic damages, such as pain and suffering and offset by possible collection under other social programs (i.e. workers' compensation and social security). These benefit are payable regardless of who is at fault, hence the term "No-Fault". There is still the ability to litigate against the negligent party if the injury is one on the "verbal threshold". This is a list of nine injury types, and if the injury meets this definition they injured party may pursue litigation. The threshold list is:

  1. Death;

  2. Dismemberment;

  3. Significant disfigurement;

  4. A fracture;

  5. Loss of a fetus;

  6. Permanent loss of use of a body organ, member, function or system;

  7. Permanent consequential limitation of us of a body organ or member;

  8. Significant limitation of use of a body function or system;

  9. A medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person's usual and customary daily activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment.

The PIP benefits, the product of the promise of Basic Economic Loss, are a up to $50,000 per person for the following in combination:

  • All eligible medical expenses resulting from the accident, without limit for time;

  • Income lost up to $2,000 per month and no more than 3 years;

  • Other reasonable and necessary expenses (i.e. transportation, cleaning) up to $25 per day and only for 1 year;


  • Death Benefits of $2,000 payable to the estate of the covered person.

It must be remembered that these benefits are guaranteed, however they may also come from other sources such as workers' compensation, Social Security or state disability benefits. They can contribute with your auto insurance to meet your Basic Economic Loss.

Under the law you also have the option to purchase and additional $25,000 of Optional Basic Economic Loss (OBEL) which can be used to cover the same benefits as the base $50,000. However, you or your legal representative are allowed to determine what it is spent on as opposed to the party who 1st demands it (e.g. your physician).

A NY automobile insurance policy holder also has access to purchase what is called Additional Personal Injury Protection. This as an additional amount of PIP of up to $100,000 which not only covers the 3 Basic Economic Loss benefits defined in the law; but also broadens the definition of an eligible injured person to include a NON-Residents of New York if they are a passenger in your vehicle while you are outside of NY state.

No Fault coverage is a complex yet critical component of your automobile insurance policy. It is very important you discuss this coverage thoroughly with you Independent Insurance Agent so that you fully understand how it impacts you and your family; and to determine the proper limits and structure of coverage.

At my agency we strongly encourage all of our clients to carry the maximum PIP benefits available to them. After all, the purpose of the benefits are to be sure you have the means necessary to get the medical care you need if you are injured in an automobile accident and $50,000 in today's health care climate does not go very far. As the additional cost to increase from the basic amount is nominal why not be sure you have the protection you and your family deserve.

Why expose yourself and your family to a serious financial situation from an automobile accident through "No-Fault" of your own?

1 comment:

  1. Really very nice article because the experienced lawyer would help us to organize the evidence to show the chain of circumstances that lead to vehicle damage also. Personal Injury Attorney Columbus