The first is a No-Fault claim, which must be filed within thirty (30) days from the date of occurrence with the insurance carrier for the vehicle you occupied (if a pedestrian – the vehicle that struck you). If there is any question of coverage for the vehicle you occupied (or in the case of a pedestrian – struck by), then a No-Fault claim should be filed with any vehicle in your household (A household vehicle is defined as any vehicle registered to you or someone you reside with related by blood or marriage). If the vehicle you occupied (or in the case of pedestrian – struck by) is uninsured, and you have no household vehicles, then coverage for the No-Fault claim should be covered by the Motor Vehicle Accident Indemnification Corporation (A company that provides coverage to victims of uninsured accidents – where there is no household vehicle).
The No-Fault claim provides coverage for all necessary medical treatment and a portion of lost wages. The minimum coverage for No-Fault benefits in a New York State Policy is $50,000. Generally, the medical provider will require an assignment of the No-Fault claim, which allows them to bill the No-Fault carrier directly. In consideration of the assignment, as long as the claim is not denied for failure to cooperate (see below – duties to cooperate in the No-Fault claim), the medical provider is limited to what the carrier pays for treatment, either by way of voluntary payment or arbitration. In other words, the patient is generally not responsible for the portion or charges for treatment that the medical provider charges when the No-fault claim is assigned to the medical provider.
As for lost wages, No-Fault provides coverage for 80% of your income or $2,000 per month, which ever is less. After the application for No-Fault benefits is filed, the carrier should send a wage verification form to your employer. The employer completes the form and sends it directly back to the carrier. When the carrier has the completed wage verification form together with some medical documentation justifying the inability to work, then payment should be made.
In sum, the No-Fault claim provides basic coverage in automobile related accidents for medical and a portion of lost wages. The law was passed to make sure that all persons injured in an automobile related accident receives basic coverage for medical and lost wages. However, the law limits the right to maintain a liability case in court for compensation for non-economic losses (pain and suffering). The limitation is imposed by the Serious Injury Requirement.