The New York "No-Fault" Law

Some thoughts on injuries in car accidents. Insurancedismemberment (loss of) a body part;
companies try to sell the idea that if there is not a3. Significant disfigurement (a scar; there's no hard
lot of damage to your car, you can't be seriouslyand fast formula for scar size - depends on the
hurt. This has been disproved by numerous studies,visibility of the scar; usually scars above scalp line
but let me tell you about a demonstration that somedon't clear the threshold);
attorneys have used at trial to demonstrate injury to4. A fracture (broken bone);
the jury. A low speed car accident can push your5. Loss of a fetus (traumatic abortion);
body and brain back and forth, even without a lot of6. Permanent loss of use of a body organ, member,
property damage.function or system (the first of the "tricky"
A good lawyer trick: A trial attorney may hold up andcategories);
drop a carton of eggs to the ground. The eggs7. Permanent consequential limitation of use of a
break, yet the carton remains visibly undamaged. Likebody organ or member (pain alone won't do;
the eggs, the human body can be hurt, yet a car, likeheadaches alone won't do; a herniated/bulging disc
the egg carton, can show very little outside damage.alone won't do; sprains/strains won't do);
Insurance companies seem to have the attitude that8. Significant limitation of use of a body function or
everyone exaggerates or fakes pain. In thousands ofsystem; or,
negotiations with insurance companies, I've heard9. A medically determined injury or impairment of a
them "poo-poo" clients' complaints of pain. Pain alonenon-permanent nature which prevents the injured
won't carry the day, either for settlement, or inperson from performing substantially all of the
court.material acts which constitute such person's usual and
Learn why by reading on.customary daily activities for not less than ninety
What do we mean by "No-Fault"?days during the one hundred eighty days immediately
Put simply, No-Fault refers to having yourfollowing the occurrence of the injury or impairment
accident-related medical bills paid, up to $50,000,(known as the 90 out of 180 days rule).
regardless of whose fault the accident is.The first five are the easy categories, they are fairly
Two different things happen after a car accident.straightforward.
First: No-Fault insurance pays your medical bills andThe two less tricky categories:
lost wages, except in certain instances involvingNumber "6": If you can no longer use a part of your
buses, motorcycles and heavy trucks. No-Fault alsobody, you can qualify.
protects pedestrians and bicycle riders. Second: ThisNumber "9": Usual and customary daily activities
should not be confused with issues of liability in angenerally means that you miss three months of work
accident, which are very much about who is at fault,in the first six months after the accident, but there
and the focus of the second thing that may happen:are two wrinkles. First: Your failure to work has to be
a lawsuit. Let's learn about No-Fault insurance andmedically determined. In other words, your doctor
what it means for your he satisfies the requirementsmust say that you can't work. Second: You need to
of the No-Fault law. The No-Fault law precludesshow that you couldn't do any of your other
recovery for pain and suffering, between "coveredcustomary daily activities. This may be housework,
persons," unless the accident victim proves a "seriousdriving the children to school, or other things.
injury." This is one of the most litigated sections ofThe two trickier categories:
New York law, with many, many reported caseNumbers "7" and "8" have no fixed definition or
decisions. And at this point, we are not even talkingexplanation. Some cases make it; some don't. Your
about liability (fault for the accident), which is alawyer needs a thorough understanding of the
completely separate issue. We are only talking aboutcurrent case law to know how the courts are
the degree of injury.applying these two threshold categories. Frequently, it
The nine No-Fault serious injuries in New York State'scomes down to documenting a reduced range of
Insurance Law are:motion in the injured part of your body - for example
1. Death (brought about by the accident);the doctor determines that you can't fully bend or
2. Dismemberment - mangling, mutilation ortwist or turnyour back or neck.