No-Fault Benefits

No-Fault, also called Personal Injury Protection (PIP), is designed to pay promptly regardless of who might have been at fault or whether there was any negligence, for economic losses (meaning medical/health expenses, lost earnings, and certain other reasonable and necessary expenses related to injuries sustained), up to $50,000 per person ("basic No-Fault coverage"), to the driver and all passengers injured in your car as well as any pedestrians injured by your car, because of its use or operation in New York State.

The purpose of No-Fault insurance is to restore individuals hurt in auto accidents to health and productivity as swiftly as possible. Because of New York's No-Fault law, lawsuits due to auto accidents can be brought only for economic losses that exceed No-Fault benefits and for non-economic damages (such as pain and suffering) only if a "serious injury" (as defined in the Insurance Law) is sustained.

No-Fault is a personal injury coverage and does not pay for auto body repair of your car or damage to any other party’s motor vehicle or real or personal property. No-Fault is also primary to health insurance, which means it pays first in the event injury is due to an auto accident.

Under this coverage, your insurer provides you and all relatives who reside in your household with protection against economic losses arising from injuries sustained in motor vehicle accidents anywhere within the United States, its territories and possessions, or Canada. It also provides coverage for any passengers injured in accidents in New York State while in your vehicle, as well as any guest passengers who are New York State residents injured in your vehicle anywhere in the United States, its territories and possessions, or Canada, if they are not covered under another auto insurance policy in New York State.

All pedestrians injured by motor vehicles in New York State are also protected by No-Fault.

Basic No-Fault auto insurance coverage includes:

• reasonable and necessary accident related medical and rehabilitation expenses (in accordance with established fee schedules);
• 80% of lost earnings from work, up to a maximum payment of $2,000 per month for up to three years from the date of the accident; subject to statutory offsets for New York State disability, Worker’s Compensation and Federal Social Security disability benefits.
  
• up to $25 a day, for up to a year from the date of the accident, to reimburse other reasonable and necessary expenses, (e.g., household help, and transportation expenses to/from medical treatment) resulting from the auto accident; and
• a $2,000 death benefit (in addition to the $50,000 basic No-Fault limit), payable to the estate of a person eligible for No-Fault benefits who is killed in a motor vehicle accident.

However, under most insurance policies, a person will be ineligible for No-Fault benefits, if:

• driving while intoxicated or impaired by use of a drug that contributes to the accident;
• intentionally causing his or her own injuries;
• riding an all terrain vehicle (ATV) or a motorcycle as operator or passenger (a pedestrian struck by a motorcycle or ATV is covered);
• injured while committing a felony;
• injured while in a vehicle known to be stolen; or
• an owner of an uninsured vehicle.

Content provided from the New York State Insurance Department