If you’ve been injured in a car accident in Suffolk County, you might be surprised to learn that your path to compensation works differently than in most states. New York operates under a “no-fault” insurance system, which fundamentally changes how accident victims recover damages for their injuries. Understanding this system is essential for protecting your rights and maximizing your recovery.
New York is one of approximately a dozen states that have adopted no-fault auto insurance laws. Under this system, when you’re injured in a car accident, you first turn to your own insurance company for compensation—regardless of who caused the crash. This coverage is called Personal Injury Protection (PIP), and every vehicle owner in New York is required to carry a minimum of $50,000 in PIP coverage.
The purpose behind no-fault insurance is straightforward: to ensure accident victims receive prompt payment for their medical bills and lost wages without the delays that come from determining fault or engaging in lengthy litigation. Rather than waiting months or years to receive compensation while lawyers argue over who caused the accident, injured parties can access funds quickly to cover their immediate needs.
Your PIP coverage in New York pays for what the law calls “basic economic losses.” These include:
It’s important to understand that no-fault insurance is primary coverage—meaning it pays before your health insurance for accident-related injuries. Your medical providers should bill your auto insurance carrier directly, not your health plan.
While PIP coverage provides valuable benefits, it has significant limitations. No-fault insurance does not cover property damage to your vehicle—that’s handled separately through collision or property damage liability coverage. More importantly, PIP does not compensate you for non-economic damages like pain and suffering, emotional distress, or loss of enjoyment of life.
This is where New York’s “serious injury threshold” becomes critically important for Suffolk County accident victims.
Under normal circumstances, New York’s no-fault system prevents you from suing the other driver, even if they clearly caused your accident. However, the law creates an important exception: if your injuries meet the “serious injury threshold” defined in New York Insurance Law Section 5102(d), you can step outside the no-fault system and file a lawsuit against the at-fault driver.
Meeting this threshold allows you to pursue compensation for damages that no-fault insurance doesn’t cover, including pain and suffering, future medical expenses beyond your PIP limit, and loss of earning capacity.
New York law specifically defines nine categories of injuries that qualify as “serious”:
A medically determined injury that prevents you from performing substantially all of your usual daily activities for at least 90 days during the 180 days immediately following your accident (known as the “90/180 day rule”).
The final category—often called the 90/180 day rule—deserves special attention because it can apply to many Suffolk County accident victims whose injuries might not otherwise qualify. This provision allows you to sue if you suffered any medically determined injury that prevented you from performing substantially all of your normal daily activities for at least 90 days during the first six months after your accident.
However, meeting this standard requires more than simply claiming you were in pain or couldn’t work. You must have objective medical evidence—such as MRI results, CT scans, or assessments from medical specialists—documenting your condition and limitations. Courts require contemporaneous medical records from shortly after the accident showing how your injuries prevented you from performing your usual activities.
New York’s no-fault system imposes strict deadlines that can affect your ability to recover compensation:
While no-fault insurance is designed to provide prompt payment, insurers don’t always make the process easy. Common obstacles include claim delays, denials of coverage for certain medical treatments, and requests for Independent Medical Examinations (IMEs).
IMEs are conducted by doctors selected by the insurance company—not your own physicians. Refusing to attend an IME can result in denial of benefits.
Certain individuals are excluded from no-fault coverage under New York law, including those injured while driving under the influence, operating an uninsured vehicle, committing a felony, participating in vehicle theft, or engaging in illegal street racing.
Motorcycle riders and passengers are not covered by no-fault insurance. However, they are not subject to the serious injury threshold and may pursue pain and suffering claims directly. Pedestrians and bicyclists struck by motor vehicles are covered under the vehicle’s no-fault policy.
Navigating New York’s no-fault system while recovering from serious injuries can be overwhelming. An experienced Suffolk County car accident attorney can help ensure deadlines are met, documentation is properly gathered, and insurers are held accountable.
If you’ve been injured in a motor vehicle accident in Suffolk County, Palermo Law can evaluate your claim and guide you through the process. Strict deadlines apply, so do not delay seeking legal help.