No-Faut insurance is also known as Personal Injury Protection (PIP) coverage. This type of automobile insurance is mandatory in New York State and helps pay for medical expenses, lost earnings from work, and other necessary expenses caused by a motor vehicle accident.
- The minimum policy amount for No-Fault coverage that must be purchased in New York is $25,000 per person and $50,000 per accident.
- PIP coverage pays for medical bills instead of your health insurance.
- PIP coverage provides benefits to drivers and passengers of a car, it also includes the pedestrian if they were injured by an automobile.
What Does Basic PIP Coverage Cover?
- Reasonable and necessary accident-related medical and rehabilitation expenses.
- Up to 80% of lost wages from work, up to a maximum payment of $2,000 per month for up to 3-years from the date of the accident.
- Up to $25 per day, for up to a year from the date of the accident for reimbursement of necessary expenses such as household help and transportation expenses to/from the medical facility.
- 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 been killed in a motor vehicle accident.
New Yorkers are able to purchase option, additional PIP benefits and Optional Basic Economic Loss (EBEL):
- Additional PIP Coverage may be purchased to raise the overall limit of PIP benefits available up to $100,000 or higher. This also increases the maximum amounts for lost earnings and other benefits including death benefit.
- Unlike basic No-Fault coverage, additional PIP coverage etends to all out-of-state guest occupants in your car when driving anywhere in the continenetal United States, US territories and Canada.
- Additional PIP coverage does not lenthen the 3-year limit for wage loss benefits.
- Optional Basic Economic Loss:
- Insurers must offer OBEL coverage. If purchased, this coverage increases the basic economic loss coergage by an additional $25,000. This benefit can be desginated by the injured person to be applied to payments for loss of wages, for rehabilitation or to all elements of basic economic loss.
- OBEL coverage also does not increase the 3-year limit for wage loss beenfits payable.
What is not covered by No-Fault Benefits?
The following is a brief overview of what is not covered by No-Fault benefits in New York State.
- Driving while intoxicated or impaired by the use of a drug that contributes to the accident, except for emergency health-related services performed in a general hospital or by an ambulance worker outside of a general hospital.
- Exception 1: No-Fault carrier is prohibited from raising intoxication as a defense to payment of a claim if it fails to preserve this defense in a timely denial.
- Exception 2: In order for an insurance company to deny based on intoxication, the insurer must prove the following:
- The eligible injured person (“EIP”) was operating their vehicle in an intoxicated and/or impaired condition and the EIP was injured due to operating their vehicle in an intoxicated and/or impaired condition.
- Intentionally causing injuries to themselves.
- Riding an ATV (all-terrain vehicle) or a motorcycle as an operator or passenger. A pedestrian struck by a motorcycle or ATV is covered.
- Injuries while committing a felony or seeking to avoid arrest by police.
- Injuries obtained while racing.
- Injuries obtained while driving a stolen vehicle.
- Injuries obtained while repairing or servicing a motor vehicle (i.e. repairing a car in a mechanic shop).
- Uninsured vehicle.
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- Minimum Auto Insurance Requirements Coverage—No-Fault benefits—Personal Injury Protection (PIP), https://www.dfs.ny.gov/consumers/auto_insurance/minimum_auto_insurance_requirements
- Minimum Auto Insurance Requirements Coverage—Basic No-Fault Auto Insurance Coverage Includes, https://www.dfs.ny.gov/consumers/auto_insurance/minimum_auto_insurance_requirements
- Options Auto Insurance, https://www.dfs.ny.gov/consumers/auto_insurance/optional_auto_insurance