Dealing with Insurance Companies After a New York Accident

Understanding New York’s No-Fault Insurance System
New York operates under a no-fault insurance system (Article 51 of the New York Insurance Law). This means your own insurance provider covers medical expenses and lost wages up to policy limits, regardless of who caused the crash. Mandatory Personal Injury Protection (PIP) covers:

• Medical bills (up to $50,000 per person)
• 80% of lost wages (capped at $2,000/month for up to three years)
• $25/day for other reasonable expenses (e.g., transportation to medical appointments)

You must file a PIP claim within 30 days of the accident using Form NF-2. Delays can jeopardize coverage.

Immediate Steps at the Accident Scene

1. Call 911 if there are injuries, fatalities, or property damage exceeding $1,000 (required by NY Vehicle & Traffic Law § 605).
2. Exchange information with the other driver: name, insurance details, license plate, and vehicle registration.
3. Document the scene: Take photos of vehicle damage, injuries, road conditions, traffic signs, and weather.
4. Get witness contacts: Collect names and phone numbers of bystanders.
5. Limit statements: Avoid admitting fault or speculating about injuries.

Reporting the Accident and Filing a Claim

• Notify your insurer within 24 hours, even if the accident seems minor. Delayed reporting can give insurers grounds to deny coverage.
• File a Motor Vehicle Accident Report (MV-104) with the NY DMV within 10 days if injuries or property damage exceeds $1,000.
• Submit a PIP application to your insurer alongside medical records and bills.

Dealing with Your Own Insurance Company

• Keep meticulous records: Log all calls, emails, and correspondence. Save claim numbers and adjuster contacts.
• Review your policy: Understand PIP limits and optional add-ons like Supplementary Uninsured/Underinsured Motorist (SUM) coverage.
• Track medical treatment: Insurers may deny claims if treatment gaps exceed 45 days or if care isn’t from a licensed professional.

Handling the Other Driver’s Insurance Company

• Avoid recorded statements: Adjusters may twist your words to minimize payout.
• Don’t accept early settlements: Insurers often offer lowball amounts before you grasp the full extent of injuries.
• Beware of “release” forms: Signing these can terminate your right to pursue future claims.

Medical Documentation is Critical
New York’s no-fault system requires tying expenses directly to the accident.

• Secure a doctor’s report within 45 days showing injuries are accident-related.
• Attend all follow-ups: Insurers can deny claims if they argue gaps in treatment suggest recovery.
• Itemize expenses: Save bills for prescriptions, medical devices, and rehabilitative care.

Serious Injury Threshold: Suing for Additional Damages
If injuries meet New York’s “serious injury” threshold (Insurance Law § 5102[d]), you can step outside no-fault and sue for non-economic damages (e.g., pain and suffering). Qualifying injuries include:

• Fractures
• Significant disfigurement
• Permanent disability
• Loss of a fetus
• Death

An attorney can help gather evidence (e.g., MRI results, expert testimonies) to prove your case meets this standard.

Negotiating a Settlement

• Calculate fair compensation: Factor in future medical costs, lost earning capacity, and emotional distress.
• Demand letter: Have an attorney draft a detailed breakdown of damages, supported by evidence.
• Reject pressure tactics: Insurers may rush you with deadlines—respond strategically, not reactively.

Common Mistakes to Avoid

1. Delaying medical care: Postponing treatment lets insurers argue injuries weren’t accident-related.
2. Posting on social media: Insurers scour platforms for photos/updates contradicting injury claims.
3. Skipping legal counsel: Insurers spend billions annually to reduce payouts; experienced attorneys level the playing field.

When to Hire an Attorney
Involve a New York-licensed personal injury lawyer if:

• The insurer denies your PIP claim.
• Injuries are severe or long-term.
• The other driver is uninsured/underinsured.
• The insurer acts in bad faith (e.g., unreasonable delays, lowball offers).

Special Considerations for Rideshare/Bicycle Accidents

• Rideshare drivers: Uber/Lyft provide $1 million in liability coverage only when the app is active.
• Bicyclists: You’re covered under the driver’s PIP if hit by a vehicle. For bike-on-bike crashes, file through your auto insurance (if applicable) or sue.

Policyholders’ Rights Under New York Law

• Timely responses: Insurers must acknowledge claims within 15 days and approve/deny PIP payments within 30 days.
• Appeals: Challenge denied claims via the insurer’s internal process or NY Department of Financial Services.
• Bad faith lawsuits: Sue insurers who unreasonably withhold benefits.