If you are injured in an automobile accident, you have two different sets of rights: (1) you have the right to receive no-fault payments; and (2) a separate right to sue for pain and suffering if you have a serious or permanent injury. This article will deal with your no-fault rights.
By law, every insurance policy in New York must provide for no-fault benefits of at least $50,000. The reason it is called “no-fault” is because it does not matter even if you are 100% at fault when you are hurt in a car accident; it does not matter if you are the driver or passenger in an automobile, or if you are a pedestrian. So long as you are injured by a motor vehicle in New York and so long as it is not a motorcycle and you are not drunk or on illegal drugs, you are entitled to receive no-fault benefits.
However, there are strict requirements that you need to be aware of to obtain the no-fault benefits. Within thirty days of being injured, you must request and submit a no-fault application to the insurance company, or if the motor vehicle is uninsured from MVAIC. If you do not submit a no-fault application within thirty days, the insurance company can disclaim and refuse to pay any benefits.
Once you submit your no-fault application to the insurance company you are entitled to have them pay your medical bills which are incurred by the accident. Doctors and hospitals who treat accident victims must, by law, accept no-fault payments. Most doctors and hospitals will take an assignment so that you do not have to pay them, they will simply bill no-fault directly. You are also entitled to have your medications paid for, as well as household help, and car services if you are unable to travel by public transportation.
Also you should be aware that even if you have your own medical insurance coverage that insurance company will not pay for any treatment that you need because of a car accident.
You must keep receipts and send them to the insurance company within thirty days. The submission of fraudulent receipts or inflated receipts is a crime.
Once you apply for no-fault benefits, the insurance company has a right to send you to a doctor who is selected by the insurance company and who may find that you do not need any further medical care or therapy; if so, the insurance company will then stop paying for your medical care unless you appeal that decision.
If you miss your appointment with a doctor selected by the insurance company that will give the insurance company an easy excuse not to pay your benefits. It is therefore very important to keep appointments with any doctors designated by the insurance company.
In addition, you are entitled to get paid up to $1,000 a month for lost wages. Your employer will have to submit a form showing how much you earned and you are entitled to 80% of that amount, up to $1,000 a month, unless the car has additional no-fault, which is a topic for a different day.
You may apply for no-fault so long as you are injured in a car accident, even if you are not legally in the United States, and you are also entitled to bring a claim for pain and suffering which is a separate claim.
If you are a passenger on a bus and there is an accident within the State of New York you are likewise entitled to receive no-fault benefits. If you do not own a car, the no-fault benefits will be paid by the bus company’s insurance company. If you own a car, or someone you live with owns a car, you may have to submit a claim for no-fault benefits to your own insurance company. In order to protect your rights, you should request a no-fault application from both the bus company’s insurance company and your own insurance company and let the insurance companies decide who will pay.
If you are entitled to no-fault benefits and do not make a claim, your medical insurance carrier will refuse to pay on the grounds that you should have obtained no-fault benefits.
If you are involved in a car accident while at work, you may have to apply for workers compensation benefits first, instead of no-fault.
If you have any question as to how to proceed, you should contact a knowledgeable personal injury lawyer.
If you or a loved one were injured as a result of an automobile accident and are in need of legal assistance, call Jaroslawicz & Jaros at 212-227-2780, or toll free in New York 1-800-269-2780, or submit an online questionnaire. The initial consultation is free of charge, and if we agree to handle your case, we will work on a contingency fee basis, which means we get paid for our services only if there is a monetary recovery of funds. In many cases, a lawsuit must be filed before an applicable expiration date, known as a statute of limitations. Please call to ensure that you do not waive your right to compensation. Or you can email us at [email protected].
By Abraham Jaros
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