No-Fault insurance is available to New York residents involved in an automobile accident. No-Fault benefits are part of the insurance policy of New York vehicles you occupy (as either a driver or passenger) at the time of a car accident. If you are a pedestrian struck by a vehicle you may also be eligible for No-Fault benefits under the insurance policy of the vehicle that struck you. These benefits are governed by the New York No-Fault insurance laws and pay a percentage of your lost wages, as well as your medical bills and expenses. You could be entitled to No-Fault benefits even if your vehicle was the cause of the accident.
You do not qualify for No-Fault benefits if you are involved in an accident in your own (or your spouse’s) uninsured vehicle. You will also not qualify for No-Fault benefits if you were riding a motorcycle at the time of the accident. In New York, every insured automobile carries at least $50,000 in No-Fault coverage for each occupant of the vehicle. You must file a claim for No-Fault benefits within 30 days of the accident to ensure that you receive maximum benefits. Generally, you can receive payments for lost wages at a rate of 80% of your gross wages, up to $2,000 a month. You can also receive payment for medical treatment received. Your treating physicians must submit medical bills to your No-Fault carrier within 45 days of the treatment or risk not being reimbursed for their services.
If the doctors do not comply with the 45 day rule, you may become personally liable for the bills that accrue. In addition, your No-Fault insurance could send you to an “independent” medical examination or IME. These IME doctors are hired by your No-Fault carrier to confirm your injuries.
These doctors are not treating physicians – their examination is solely for the insurance company’s benefit.
If the IME doctor examines you and says you do not need the treatment you are receiving, you could be denied future benefits. If the IME doctor determines that no further treatment is necessary the No-Fault provider will issue a denial terminating your No-Fault benefits. You are required to appear for these IMEs. If you fail to appear for a No-Fault IME, you will be denied further No-Fault benefits.
While these examinations are called “independent,” the truth is these doctors work for the insurance company. That means they are under pressure from their employers (the insurance companies) to deny No-Fault benefits. Thus, it is important to immediately consult with No-Fault attorneys who will assist you with your claim, and assure all of your treating physicians have the correct No-Fault information. As experienced New York City automobile accident attorneys, The Platta Law Firm will handle your No-Fault claim as well as your personal injury claim. We can advise you on how to conduct yourself during an IME to protect your rights, and if necessary we will attend the examination with you.