How No-Fault Insurance Works After a New York Car Accident

In New York, PIP insurance is no-fault coverage that pays your medical bills, part of your lost earnings and some expenses, whoever caused the crash. Insurance Law 5102(a) caps those benefits at fifty thousand dollars per person in basic economic loss, shared across all three. No-fault stops at four lines: that shared ceiling, two short deadlines, insurer exams, and pain and suffering, which needs a separate serious injury claim.

Yes, New York is a no-fault state, and PIP pays regardless of who caused the crash

No-fault is New York’s name for PIP: first-party benefits paid through an insurance policy, not by the other driver. The name describes how benefits are paid, not who is responsible.

Fault returns in the separate injury claim. For actions commenced on or after May 26, 2026, CPLR 1411(b) bars recovery in a motor vehicle injury action if the injured person’s fault exceeds that of the person sued, or of everyone sued combined. Vehicle damage sits outside no-fault and is claimed against the at-fault driver’s property damage liability coverage, which New York requires at a minimum of ten thousand dollars per accident. Write down the other driver’s insurer and policy number.

One fifty thousand dollar ceiling has to cover your medical care, wages and expenses together

Insurance Law 5102(a) pays “up to fifty thousand dollars per person of the following combined items”: necessary medical and rehabilitation care, lost earnings and other reasonable expenses. Insurance Law 5102(a)(2) pays eighty percent of lost earnings, capped at two thousand dollars a month for not more than three years. Insurance Law 5102(a)(3) pays other reasonable expenses up to twenty-five dollars a day for one year. All three benefits draw on the same fifty thousand dollars.

Suppose you earned six thousand dollars a month before the crash. Eighty percent of that is four thousand eight hundred dollars. The cap holds the monthly payment at two thousand dollars. Twelve capped months use twenty-four thousand dollars of the shared ceiling before a single medical bill is paid. This illustrates the statutory caps, not any person’s benefits.

Higher earners lose the most to the wage cap. Find your last three pay stubs now.

Two deadlines in the first forty-five days decide whether no-fault pays at all

No-fault runs on two early deadlines under DFS Regulation 68: written notice of claim within thirty days and health care bills within forty-five days. Lost earnings proof follows a third, ninety-day clock.

Suppose a car hits you on March 1. You go to urgent care that afternoon. Physical therapy starts on March 10.

Written notice is due by the end of March. The March 10 therapy bill has to reach the insurer by late April. The ninety-day earnings proof lands at the end of May. You can send the notice yourself, without a lawyer. People lose the forty-five-day bill clock most often, because providers usually submit the bill and patients rarely check.

Write the dates on a calendar, and ask each provider whether the bill went in.

An insurer exam can end your benefits, but a denial does not mean you were not hurt

The insurer may send you to a doctor it chooses, who reports to the insurer, not to your own physician. If the report says you need no more treatment, the insurer can stop paying for it. Attend every scheduled exam. If you cannot make it, call beforehand and get the new date in writing.

A denial means no-fault stops paying for that treatment, not that your injury is not real. A routine claim rarely needs a lawyer, and a cut-off often does. Our guide on why car insurance claims get denied covers what can follow. Keep the letter and note the date it arrived.

Pain and suffering sits outside no-fault, behind the serious injury threshold

No-fault never pays pain and suffering. It belongs to a separate claim against the at-fault driver, which Insurance Law 5102(d) opens only for a serious injury. Part EE of Chapter 58 of the Laws of 2026 rewrote the definition for actions commenced on or after May 26, 2026. The current text lists eight categories:

• death
• dismemberment
• significant disfigurement
• a fracture
• loss of a fetus
• permanent loss of use of a body organ, member, function or system
• permanent consequential limitation of use of a body organ or member
• significant limitation of use of a body function or system

Many guides still list a category the 2026 amendment deleted. The shorter list is harder to cross.

The injury claim has its own clocks. CPLR 214 generally allows three years to start the lawsuit. If a City vehicle was involved, General Municipal Law 50-e requires a notice of claim within ninety days after the claim arises. General Municipal Law 50-i then requires the action within one year and ninety days. Check the police report for the other vehicle’s owner.

Hit-and-run and uninsured drivers go through MVAIC, and motorcycles fall outside no-fault

When a driver flees or carries no insurance, the injury claim runs through the Motor Vehicle Accident Indemnification Corporation (MVAIC).

Under Insurance Law 5208, the crash must be reported within twenty-four hours to a police, peace or judicial officer, unless a report in that time was not reasonably possible. An affidavit must reach MVAIC within ninety days when the driver is unidentified, or within one hundred eighty days when the uninsured vehicle is identified. Insurance Law 5210 caps a judgment paid by MVAIC at twenty-five thousand dollars for injury to one person. Insurance Law 3420(f)(1) requires every New York liability policy to include uninsured motorist protection, including against an unidentified vehicle that leaves the scene. The twenty-four-hour report is the least forgiving clock, so make it first.

Motorcycles fall outside the motor vehicle definition in Insurance Law 5102(f) and (m). A rider should ask an attorney which coverage applies.

The first month after a crash comes down to seven tasks

Each task below ties to a specific clock.

First, get medical care and a police report. If the driver fled, make that report within twenty-four hours. Second, send written notice to the insurer within thirty days. Third, ask each provider to confirm its bills reached the insurer within forty-five days. Fourth, collect pay records for the ninety-day earnings proof. Fifth, check whether a City vehicle was involved, because that starts the ninety-day notice of claim. Sixth, keep every letter, email and form the insurer sends, and sign nothing you do not understand. Finally, attend any scheduled insurer exam.

Rate increases can wait, and missing documents can often be obtained later. Start with your own insurance policy.

Straight answers on no-fault deadlines, wages, medical bills and pedestrians

What happens if I miss the thirty-day no-fault deadline?

The insurer can deny the claim for late notice. DFS Regulation 68 sets thirty days for written notice. Send the notice anyway, today, and raise the delay with an attorney.

Does no-fault cover lost wages in New York?

Yes, up to the two thousand dollar monthly cap. Insurance Law 5102(b) produces the eighty percent figure through a twenty percent deduction from lost earnings, and also offsets workers’ compensation, Social Security disability, New York disability and Medicare. Proof is due within ninety days, so bring pay records.

Who pays medical bills after a car accident in New York?

No-fault pays first, regardless of fault, until the shared ceiling is used. After that, it pays nothing unless the policy carries optional basic economic loss, which adds twenty-five thousand dollars under Insurance Law 5102(a)(5). Additional PIP is a separate add-on. The TLC requires livery and black car vehicles seating one to seven passengers to carry one hundred thousand dollars in personal injury protection. Read your declarations page.

Does no-fault cover pedestrians and cyclists in New York?

Pedestrians and cyclists struck by a motor vehicle generally fall within no-fault, but which policy pays depends on the vehicles and policies involved. NYC DOT’s Bicycle Crash Data 2025 report counts nine thousand eighty-seven pedestrians and four thousand four hundred three traditional bicycle riders injured in 2025, with data as of April 15, 2026. If the driver fled, the MVAIC rules apply. File promptly.

When no-fault stops paying and your injury has not stopped

Call a lawyer when no-fault benefits stop or your injury outgrows them. The no-fault claim and the injury claim start on the same day. Consultations at Caesar & Napoli are free and carry no obligation. Most personal injury cases are handled on a no-win, no-fee basis, so attorney’s fees are owed only if there is a recovery. The main office is in the Woolworth Building at 233 Broadway, with offices in Queens and Brooklyn. Contacting the firm does not by itself create an attorney-client relationship.

Call (888) 235-6766 and have every insurer letter in front of you.

Related practice areas

• Auto Insurance Litigation
• Pedestrian Injuries
• Uninsured/Underinsured Motorists

Prior results do not guarantee a similar outcome. Every case is decided on its own facts. This article is general information and is not legal advice about any individual claim.

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