The bills start arriving before the bruises fade. An ambulance ride, an emergency room visit, an MRI, and you’re staring at five figures while someone else’s insurance company investigates who caused the crash.
Here’s what New York decided about that problem decades ago: you shouldn’t have to wait. Your medical bills and lost paychecks get paid first, by an insurance policy that’s already in place, and the argument about fault happens later. That’s the whole idea behind no-fault insurance. We handle these claims every week, and the system genuinely works, but only for people who follow its rules. The most important rule gives you 30 days.
What No-Fault Insurance Is
No-fault, also called Personal Injury Protection or PIP, is one of the three coverages every registered New York vehicle must carry. It pays for your economic losses after a car accident, meaning medical costs, lost earnings, and certain out-of-pocket expenses, up to $50,000 per person, without anyone proving negligence first. The insurer of the car you were in pays even if its own driver caused the crash. That’s the “no-fault” part.
The system is a trade. New York pays economic losses quickly, and in exchange it closes the courthouse door on smaller injury lawsuits. Under Insurance Law Section 5104, you can’t sue another driver for pain and suffering unless your injury crosses a defined threshold. We’ll come back to that, because it’s where injured people most often misunderstand their rights.
Two more features matter on day one. No-fault is primary to health insurance, meaning it pays first when a car accident causes the injury, so your medical providers need to know from the first visit that a motor vehicle crash is involved. And it travels with you: your policy protects you and household relatives in accidents anywhere in the United States and Canada.
What No-Fault Pays For
Basic no-fault coverage includes four benefits:
- Medical care. All necessary accident-related medical, hospital, surgical, nursing, dental, prescription, and rehabilitation costs, paid under state fee schedules that providers must accept as full payment.
- Lost earnings. 80 percent of lost earnings from work, up to $2,000 per month, for up to three years from the accident date, reduced by offsets for state disability, workers’ compensation, and Social Security disability benefits.
- Other expenses. Up to $25 per day for up to a year for reasonable costs the injury creates, like household help and transportation to medical appointments.
- A death benefit. $2,000 paid to the estate, on top of the $50,000 limit, when a covered person is killed.
All of it counts against the single $50,000 per-person cap that Insurance Law Section 5102(a) calls “basic economic loss.” A serious injury exhausts that cap faster than most people expect, which is why the upgrades at the end of this guide exist.
Who’s Covered, and Who Isn’t
Coverage follows the vehicle, then catches nearly everyone the vehicle touches:
- The driver and every passenger in the insured car
- You and relatives in your household, in accidents nationwide
- Pedestrians struck by the car in New York, every one of them, even if they carry no insurance of their own
- Cyclists hit by motor vehicles, who are treated like pedestrians for no-fault purposes, a rule with its own wrinkles we cover in our guide to NYC bicycle no-fault rules
The exclusions are just as specific. No-fault does not pay:
- Motorcyclists. Riders and their passengers are excluded, one of the harshest rules in New York insurance. A pedestrian struck by a motorcycle is still covered.
- Impaired drivers, when intoxication or drugs contributed to the crash, apart from emergency care, which the insurer can claw back after a conviction.
- Anyone injured while committing a felony, riding in a known stolen vehicle, or who intentionally caused their own injury.
- The owner of an uninsured vehicle. Letting your own coverage lapse forfeits your no-fault protection in your own car.
What No-Fault Never Covers
Three gaps define the boundary of the system, and each one has its own solution:
- Pain and suffering. No-fault pays economic losses only. Compensation for what the injury did to your life comes from a liability claim against the at-fault driver, and only a serious injury unlocks it.
- Your car. No-fault is personal injury coverage. Vehicle damage runs through the at-fault driver’s property damage liability or your own collision coverage.
- Anything past $50,000. Once basic no-fault exhausts, continuing medical costs and lost earnings become part of your claim against the driver who caused the crash.
How to File a No-Fault Claim, Step by Step
The process rewards speed and precision. Here’s the sequence we run:
- Report the crash. Notify the police, and report the accident to the insurance company promptly. If anyone was injured or the damage passes $1,000, New York also requires a Form MV-104 accident report to the DMV.
- Identify the right insurer. File with the insurer of the vehicle you occupied, no matter who caused the crash. Struck as a pedestrian or cyclist? File with the insurer of the vehicle that hit you. Injured on a bus? File with your own auto policy or a household relative’s, and only if neither exists does the bus company’s insurer pay. Hit by an uninsured or unidentified driver with no household policy to turn to? Your claim goes to MVAIC, and the accident must reach police within 24 hours.
- Send written notice within 30 days. The claim opens with a written notice identifying who was hurt and the time, place, and circumstances of the accident. It must reach the insurer within 30 calendar days of the crash.
- Complete the application. Within five business days of your notice, the insurer must send you the claim package, including the Application for Motor Vehicle No-Fault Benefits, Form NF-2. Fill it out completely and return it fast. Incomplete answers become delay.
- Route the bills. Tell every provider this is a no-fault case. Providers can bill the insurer directly, or you can pay and submit receipts. For lost earnings, the insurer will need wage verification from your employer, or proof of income if you’re self-employed.
- Hold the insurer to its own clock. Once it has your proof, the insurer must pay each claim within 30 days. Overdue benefits accrue interest at 2 percent per month, plus your reasonable attorney’s fees for collecting them.
- Fight denials. If benefits are denied or cut off, you can demand no-fault arbitration, sue in court, or file a complaint with the Department of Financial Services. Denials of continuing treatment, usually after an insurance company medical exam, are where these claims turn adversarial.
The Serious-Injury Threshold: When You Can Sue
No-fault pays the bills. It never compensates the injury itself. That claim belongs in a lawsuit against the at-fault driver, and Insurance Law Section 5102(d) guards the door with the serious injury definition. An injury qualifies if it results in:
- 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
Some categories are clean. A fracture qualifies, full stop. The limitation categories are fought case by case on medical proof, and building that record starts with the treatment decisions made in the first weeks. Our colleague Jeffrey Antin examined how courts apply the threshold, and why insurers fight it so hard, in his analysis of when New York’s no-fault wall breaks.
The threshold just got narrower
If that list looks shorter than what you’ve read elsewhere, it is. For decades the definition included a ninth category, known as the 90/180 rule, for a non-permanent injury that prevented substantially all of your usual daily activities for at least 90 of the 180 days after the accident. New York eliminated it in a package of auto insurance reforms under Bill A10008, effective May 26, 2026, applicable to lawsuits filed on or after that date. Cases filed before then proceed under the old definition.
Meeting the threshold changes what your case is worth, because a lawsuit reaches everything no-fault excluded: pain and suffering plus every economic loss beyond the $50,000 cap. And if the driver who caused that serious injury carried little or no insurance, your own policy may hold the answer. We walk through that in our companion guide to uninsured motorist coverage in New York.
Two Upgrades Worth Knowing About
Basic no-fault is a floor, and New York lets you raise it for an additional premium:
- Optional Basic Economic Loss (OBEL) adds $25,000 that you can direct toward lost earnings or rehabilitation after the first $50,000 runs out.
- Additional PIP raises the overall no-fault limit to $100,000 or more and extends coverage to out-of-state guest passengers in your car.
If your household depends on your paycheck, the $2,000-per-month wage cap in basic no-fault is the number to stress-test. It replaces less than half of many New York salaries, and these riders are the only way to raise it before you need it.
Where This Leaves You
For a minor crash with a sprain and a week off work, no-fault usually does its job: file on time, route the bills, and the system pays. The calculation changes when the injury is serious. Then the no-fault file, the serious-injury proof, and the liability claim against the at-fault driver all have to move together, against insurers whose interests run the other way, and decisions made in the first 30 days echo through all of it.
That first month is exactly when we want to hear from injured people. A consultation costs nothing, and it’s a lot easier to keep a claim on track than to rescue one.
Frequently Asked Questions
What is no-fault insurance in New York?
No-fault, also called Personal Injury Protection or PIP, is mandatory coverage on every New York auto policy. It pays your medical bills, lost earnings, and certain other expenses after a crash, up to $50,000 per person, without anyone proving fault first. The trade: you can only sue for pain and suffering if your injury meets the serious injury definition in Insurance Law 5102(d).
What does no-fault insurance cover?
Necessary accident-related medical and rehabilitation costs under state fee schedules, 80 percent of lost earnings up to $2,000 per month for up to three years, up to $25 per day for up to a year of other reasonable expenses, and a $2,000 death benefit on top of the $50,000 limit.
What does no-fault NOT cover?
Pain and suffering, and damage to any vehicle or property. It also excludes motorcyclists, impaired drivers who contributed to the crash, anyone hurt while committing a felony or in a known stolen car, and owners of uninsured vehicles.
How long do I have to file a no-fault claim?
Thirty calendar days from the accident, in writing, to the responsible insurer. Late filings need written proof of a clear and reasonable justification.
Can I sue the other driver after a car accident in New York?
Only if your injury qualifies as a serious injury under Insurance Law 5102(d), or for economic losses that exceed the $50,000 no-fault limit. Qualifying injuries are death, dismemberment, significant disfigurement, fracture, loss of a fetus, and the permanent and significant limitation categories. The former 90/180-day category for non-permanent injuries no longer applies to lawsuits filed on or after May 26, 2026.
Who pays if the driver who hit me was uninsured?
If no auto policy exists for you or a household relative, your no-fault claim goes to MVAIC, the state’s indemnification fund, and the accident must be reported to police within 24 hours. Your injury compensation may then come through uninsured motorist coverage or MVAIC’s bodily injury protection.