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consumer-faq-no-fault.md

Auto Insurance in New York: Frequently Asked Questions

As of: June 2026. Plain-language guide for consumers; your policy and the law control if anything here differs.

Q. What insurance am I required to carry on my car in New York?

Every registered vehicle must carry three coverages, all from a company authorized in New York:

1. Liability coverage of at least $25,000 per person / $50,000 per accident for bodily injury, $50,000 / $100,000 for death, and $10,000 for property damage.
2. No-fault (Personal Injury Protection) of at least $50,000 per person.
3. Uninsured motorists coverage of at least $25,000 / $50,000 ($50,000 / $100,000 for death) for crashes caused by uninsured or hit-and-run drivers in New York State.

You must keep this coverage in force for as long as the vehicle is registered — even if it sits in the driveway all winter.

Q. What does "no-fault" actually mean?

It means your own auto insurer pays your medical bills and lost wages after a car accident, promptly and regardless of who caused the crash. You do not have to sue anyone, or wait for an investigation into fault, to get these "first party benefits." In exchange, the law limits when you can sue the other driver for pain and suffering (see below).

Q. What does no-fault pay for?

Up to $50,000 per person in combined benefits:

• All reasonable and necessary medical and rehabilitation costs related to the accident (paid at fee-schedule rates directly to providers in most cases).
• 80% of your lost earnings, up to $2,000 per month, for up to three years.
• Up to $25 a day for other reasonable necessary expenses — for example, transportation to medical appointments or household help — for up to one year.
• A $2,000 death benefit to the estate, on top of the $50,000.

Q. Who is covered by my no-fault?

You and any passengers injured in your car, and any pedestrian or bicyclist your car injures. If you are hurt as a passenger in someone else's car, you claim no-fault from that car's insurer. If you are hit by a car while walking, you claim from the insurer of the car that hit you.

Q. Are motorcycles covered by no-fault?

No. Motorcyclists and their passengers do not receive no-fault benefits for their own injuries. (A pedestrian hit by a motorcycle does receive benefits through the motorcycle's policy.) Motorcyclists who are injured can sue the at-fault driver without having to meet the "serious injury" test.

Q. What deadlines do I have to worry about after an accident?

Three big ones:

• Send written notice of claim to the no-fault insurer within 30 days of the accident. Use form NF-2 if you have it, but any written notice with the basic details starts the clock. Late notice can be excused only with a reasonable justification.
• Medical providers must bill the insurer within 45 days of treatment.
• Proof of lost earnings must go in within 90 days of the loss.

Miss the 30-day notice and you may lose benefits entirely, so do this first.

Q. Can I sue the driver who hit me?

For your economic losses above $50,000 — yes, always. For pain and suffering — only if you sustained a "serious injury" as the law defines it: death, dismemberment, significant disfigurement, a fracture, loss of a fetus, permanent loss of use of a body organ or member, permanent consequential limitation, significant limitation of a body function or system, or an injury that prevented you from performing substantially all of your usual daily activities for at least 90 of the 180 days right after the accident. A sore neck that resolves in a few weeks will not qualify; a broken wrist automatically does.

Q. The other driver had no insurance. Am I stuck?

No. Your own policy's mandatory uninsured motorists coverage pays what the at-fault driver's liability insurance would have paid for your bodily injury, up to at least 25/50. If you bought SUM (supplementary uninsured/underinsured motorists) coverage at higher limits, those higher limits apply, and SUM also covers you when the other driver carried some insurance but less than yours, and in out-of-state crashes. Since June 2018, new and renewed policies automatically include SUM equal to your own liability limits unless you sign a form choosing less.

Q. My claim was denied. What can I do?

For no-fault denials, you may demand arbitration (administered through the American Arbitration Association under state-approved procedures) or sue the insurer in court — your choice, not the insurer's. If a payment is late, the insurer owes interest at 2% per month plus your attorney's fee for collecting it. You can also file a complaint with the New York State Department of Financial Services (DFS), which regulates insurers, online or by mail.

Q. Nobody will sell me a policy. Now what?

If you are turned down in the regular ("voluntary") market, you can get coverage through the New York Automobile Insurance Plan (NYAIP), the state's assigned-risk plan. Any licensed broker or agent can submit an NYAIP application. Premiums run higher than the voluntary market, so re-shop every renewal.

Q. Does my premium go up if the accident wasn't my fault?

Insurers may not surcharge you for an accident in which you were not principally at fault. Rating rules are filed with and policed by DFS; if you believe a surcharge is wrong, ask the insurer for its written basis and complain to DFS if unsatisfied.

minimum-limits-and-sum-coverage.md

Minimum Liability Limits and UM/SUM Coverage in New York

As of: June 2026.

This note pulls together the mandatory liability minimums and the uninsured/underinsured side of the New York personal auto policy, because the two interlock: the UM floor mirrors the liability floor, and SUM limits since 2018 default to the insured's own liability limits.

The statutory minimums

VTL § 311(4) sets the floor for every owner's policy:

Coverage	Per person	Per accident
Bodily injury	$25,000	$50,000
Death	$50,000	$100,000
Property damage	$10,000 (single limit)	—

The shorthand "25/50/10" understates New York's scheme slightly, since the death limits are double the bodily-injury limits. A wrongful-death claim against a minimum-limits policy therefore has $50,000 available for one decedent, not $25,000.

These are floors, not recommendations. A single overnight hospital admission can exhaust $25,000; carriers and producers should document any insured's decision to stay at minimums.

Mandatory uninsured motorists (UM) coverage

ISC § 3420(f)(1) requires every New York auto liability policy to include uninsured motorists coverage at the same 25/50 bodily-injury limits (50/100 for death). Core features:

• Covers bodily injury only — no property damage.
• Applies to accidents within New York State.
• Triggered by an uninsured vehicle, a hit-and-run with physical contact, a stolen vehicle, or a vehicle whose insurer disclaims or whose policy turns out void.
• Protects the named insured and resident relatives, occupants of the insured vehicle, and the insured as a pedestrian.

Supplementary UM/UIM (SUM) coverage

SUM coverage under ISC § 3420(f)(2) extends protection in two directions that mandatory UM does not reach:

1. Geography — SUM applies to accidents anywhere in the United States and Canada, not just New York.
2. Underinsurance — SUM pays when the at-fault driver carried liability limits lower than the insured's SUM limits. The trigger compares limits: the tortfeasor's bodily-injury limit must be less than the SUM limit of the insured's own policy.

The SUM recovery is reduced (offset) by what the tortfeasor's liability insurer actually pays. An insured with $100,000 of SUM struck by a 25/50 driver who tenders $25,000 has $75,000 of SUM headroom, not $100,000. Choosing SUM limits equal to liability limits is how an insured guarantees the same protection for their own family that they buy for strangers they might injure.

The 2017 reform. Under the amendment to § 3420(f)(2-a) signed in December 2017 and effective for policies issued or renewed starting in mid-June 2018, insurers must provide SUM coverage at limits equal to the policy's bodily injury liability limits unless the first named insured signs a written waiver selecting lower limits or declining supplementary coverage. Before the reform, SUM was opt-in and chronically under-purchased; now it is opt-out. Insurers must also remind insureds of their SUM options around renewal where coverage was waived or reduced.

Conditions. SUM endorsements (the standard form is prescribed in Regulation 35-D, 11 NYCRR 60-2) impose notice obligations and require the insured to obtain the SUM carrier's consent before settling with the tortfeasor for less than full liability limits, to protect subrogation. Blowing the consent-to-settle condition is the classic way a claimant forfeits an otherwise good SUM claim.

How the pieces fit on a real claim

A claimant hurt by a minimum-limits driver typically runs three tracks at once: PIP from the host/own vehicle's no-fault coverage for medicals and wages; a liability claim against the tortfeasor's 25/50 policy (which requires a serious injury to reach pain and suffering); and a SUM claim under the claimant's own policy for the excess, with the offset rule above. The liability minimums make SUM the only realistic source of full compensation in serious-injury cases against minimum-limits or uninsured drivers.

no-fault-system-overview.md

The New York No-Fault System: A Practitioner's Overview

As of: June 2026. Orientation document for incoming associates and senior paralegals. Statutory citations are to the Insurance Law (ISC) unless noted.

1. Origins and architecture

New York adopted the Comprehensive Automobile Insurance Reparations Act in 1973 (effective February 1, 1974), recodified as Article 51 of the Insurance Law and renamed the Comprehensive Motor Vehicle Insurance Reparations Act. The Legislature's diagnosis was that the pure tort system delivered compensation slowly, expensively, and erratically: small claims were overpaid to make them go away, serious claims were underpaid after years of delay, and a large share of every premium dollar went to friction costs rather than injured people. The legislative bargain: guaranteed, prompt, fault-free payment of out-of-pocket losses up to a defined level, purchased by giving up tort recovery for pain and suffering in non-serious cases.

Three bodies of law implement the bargain and must be read together:

• Vehicle and Traffic Law Article 6 (the Motor Vehicle Financial Security Act, §§ 310–321) makes insurance compulsory and sets the liability minimums — $25,000/$50,000 bodily injury, $50,000/$100,000 death, $10,000 property damage (VTL § 311(4)).
• Insurance Law Article 51 (§§ 5101–5109) creates first-party benefits, defines basic economic loss and serious injury, restricts tort actions, and mandates arbitration options.
• Regulation 68 (11 NYCRR Part 65), promulgated by the Department of Financial Services, supplies the prescribed policy endorsement, the claim-handling timetable, the fee schedules' application, and the arbitration procedures.

Alongside these sit § 3420 (required liability-policy terms, UM/SUM), Article 52 (MVAIC), and Article 53 (the assigned-risk plan).

2. The first-party (PIP) side

2.1 What is covered

Every owner's policy on a New York–registered vehicle must provide first party benefits reimbursing basic economic loss: up to $50,000 per person comprising (i) necessary medical and rehabilitation expense without internal sub-limit, (ii) 80% of lost earnings up to $2,000 per month for up to three years, and (iii) other reasonable and necessary expenses up to $25 per day for up to one year (§§ 5102(a), (b), 5103(a)). A $2,000 death benefit is payable to the estate in addition. Two optional layers extend the basic package: OBEL (an extra $25,000 the claimant can direct to wage loss or specified therapies) and APIP (carrier-filed additional PIP with higher limits and longer periods).

Eligibility follows the vehicle, not fault: occupants of the insured vehicle, and pedestrians or bicyclists it strikes, claim against that vehicle's carrier. Priority disputes between carriers (which of two available policies pays) are resolved under 11 NYCRR 65-3.12 and inter-company arbitration, never at the claimant's expense.

Exclusions are narrow (§ 5103(b)): driving while intoxicated or impaired (with an emergency-care carve-out), intentional self-injury, injury during commission of a felony or flight from arrest, racing, and knowingly occupying a stolen vehicle. Motorcyclists are excluded structurally — a motorcycle is not a "motor vehicle" under § 5102 — though pedestrians struck by motorcycles are covered through the motorcycle policy (§ 5103(f)).

2.2 The Regulation 68 clock

The claimant must give written notice within 30 days of the accident; providers must bill within 45 days of service; wage proof is due within 90 days. Late submissions must be excused on reasonable justification. The carrier must forward verification forms within 10 business days of the NF-2, request any additional verification within 15 business days of receiving the forms, follow up on unanswered verification within 10 calendar days after the 30th day, and pay or deny within 30 calendar days of complete proof of claim on a specific NF-10. Overdue benefits accrue interest at 2% per month, and the claimant's attorney's fee for collecting overdue or wrongfully denied benefits is shifted to the carrier (§ 5106(a); 11 NYCRR 65-3.8, 65-3.9, 65-3.10). The case law adds the preclusion doctrine: defenses not raised in a timely denial are generally lost.

2.3 Dispute resolution

Section 5106(b) gives the claimant — and only the claimant — the option of arbitration in lieu of suit. No-fault arbitrations are administered by the American Arbitration Association under DFS-promulgated procedures (11 NYCRR 65-4), with conciliation review first, expedited hearings, and a master arbitration layer (§ 5106(c)) before any resort to the courts under CPLR Article 75. The economics matter: medical providers take assignments of benefits from patients and arbitrate denials at volume, which is why no-fault arbitration dwarfs every other AAA caseload in the state.

3. The third-party (tort) side

3.1 The § 5104 bar and the serious-injury gate

In an action between covered persons for injuries arising from negligent use or operation of a motor vehicle in New York, there is no recovery for non-economic loss unless the plaintiff sustained a serious injury, and no recovery for basic economic loss (which the PIP system already pays) (§ 5104(a)). "Serious injury" (§ 5102(d)) means death, dismemberment, significant disfigurement, a fracture, loss of a fetus, permanent loss of use of a body organ/member/function/system, permanent consequential limitation, significant limitation, or the 90/180-day disability category.

The threshold is a question of law in the first instance (Licari v. Elliott, 57 N.Y.2d 230 (1982)); it requires objective medical proof (Toure v. Avis, 98 N.Y.2d 345 (2002)); causation can defeat otherwise objective proof where treatment gaps, intervening events, or degeneration intervene (Pommells v. Perez, 4 N.Y.3d 566 (2005)); and contemporaneous quantitative measurements are helpful but not mandatory (Perl v. Meher, 18 N.Y.3d 208 (2011)).

Note the asymmetry: economic loss above $50,000 is recoverable in tort without any threshold showing. A high-earner with $300,000 in lost income and no qualifying injury still has a viable suit — for the excess economic loss only.

3.2 Where the money comes from

The tort recovery is funded by the defendant's liability coverage — floor of 25/50 BI / 50/100 death / 10 PD — then by the plaintiff's own SUM coverage where the defendant is uninsured or underinsured. Since the 2017 amendments to § 3420(f)(2-a) (policies issued or renewed from mid-2018), SUM is written at limits equal to the insured's bodily-injury limits unless waived down in writing. Mandatory UM at 25/50 covers in-state uninsured and hit-and-run accidents; SUM adds underinsurance protection and nationwide/Canada territory, offset by the tortfeasor's actual payment. Where no household policy exists at all, MVAIC (Article 52) is the payer of last resort, with its own short deadlines.

3.3 Litigation timing

The negligence action carries New York's three-year personal-injury limitations period (CPLR § 214), two years for wrongful death (EPTL 5-4.1), and a 90-day notice-of-claim plus one-year-and-90-day suit window when the defendant is a municipality (GML §§ 50-e, 50-i) — a trap on every bus and sanitation-truck case. SUM claims are contract claims with policy-prescribed notice conditions and a six-year contract limitations baseline, but the consent-to-settle and prompt-notice conditions in the Regulation 35-D endorsement do the real gatekeeping.

4. Machinery the statutes don't show you

4.1 Fee schedules

No-fault medical benefits are paid not at billed charges but at regulated rates: Insurance Law § 5108 caps provider charges at the schedules prepared by the Workers' Compensation Board, adopted into no-fault by Regulation 83 (11 NYCRR Part 68). A provider who accepts a no-fault patient accepts the schedule; balance-billing the patient for amounts above it is prohibited. Practically, this is why $50,000 of basic economic loss stretches further than a commercial health-insurance ledger would suggest, and why so much arbitration volume is pure fee-schedule coding combat — the difference between two CPT interpretations multiplied across thousands of assigned claims.

4.2 IMEs and EUOs as conditions precedent

The mandatory endorsement makes the eligible injured person's appearance at independent medical examinations, and at examinations under oath, conditions of coverage when reasonably requested. The Appellate Division's line of cases treats nonappearance at two properly noticed IMEs or EUOs as a breach of a condition precedent that defeats coverage retroactively — one of the few defenses with that reach. The flip side: the carrier's notices must themselves be timely under the 65-3.5/65-3.6 verification timetable, and scheduling defects routinely sink the defense in arbitration.

4.3 Priority of payment

When more than one policy could respond — a passenger with her own car at home, injured in a friend's vehicle — 11 NYCRR 65-3.12 fixes the order: in general the insurer of the vehicle occupied pays, the pedestrian claims against the striking vehicle's insurer, and narrow exceptions route certain claimants (for example, a vehicle owner injured as a pedestrian by their own parked car, or occupants of a bus who have household coverage) to other policies. Carriers sort out double payments among themselves; the regulation is explicit that priority disputes must not delay payment to the claimant.

4.4 What no-fault never touches

Vehicle damage is outside Article 51 entirely. Collision and comprehensive coverage are optional purchases; the only mandatory property protection is the $10,000 liability minimum for damage the insured does to others' property. Property-damage claims between drivers proceed on ordinary fault principles, and New York's small-claims and arbitration forums absorb most of them.

4.5 The 2002 overhaul, in one paragraph

The current Regulation 68 dates to a wholesale revision effective in 2002 that compressed the claimant deadlines (notice from 90 days to 30; provider billing from 180 days to 45) in response to organized fraud — staged accidents and medical mills exploiting the long windows. The same era produced the reasonable-justification safety valve and most of the current verification choreography. Older case law citing 90-day notice or 180-day billing periods is construing the pre-2002 regulation; check the accident date before relying on it.

5. How the pieces interact: a worked hypothetical

Client D, a 40-year-old passenger in her friend's sedan, is injured when an uninsured driver runs a light in Queens. She has a fractured radius, $68,000 in medical bills over two years, and three months out of work at $4,000/month gross.

1. PIP: D claims no-fault from the friend's carrier (vehicle occupied). It pays her medical providers at fee-schedule rates and pays her $2,000/month wage benefit (80% of $4,000 is $3,200, capped at $2,000) until the $50,000 aggregate exhausts. Notice went in within 30 days; bills within 45; wage proof within 90.
2. Threshold: the fracture satisfies § 5102(d) per se, so D may pursue non-economic damages.
3. Tort/UM/SUM: the tortfeasor is uninsured, so the liability claim is worthless. D is covered for UM/SUM under the friend's policy as an occupant — and potentially under her own household policy — at SUM limits equal to the host's BI limits (post-2018 default). She arbitrates the SUM claim under the policy endorsement.
4. Excess economic loss: bills beyond the exhausted $50,000 and the uncompensated slice of wages (the $1,200/month over the cap, the 20% reduction) are recoverable in the SUM claim as economic loss above basic economic loss, plus pain and suffering for the fracture.
5. If the hit-and-run driver had never been identified and no household or host policy existed, MVAIC would have been the only source, with its 90-day notice-of-intention deadline.

6. Recurring failure modes

• Blown 30-day no-fault notice. The single most common intake error. The reasonable-justification escape hatch exists but is litigation, not a plan.
• Treating the NYAIP policy as second-class. Assigned-risk policies carry every mandatory coverage and every Regulation 68 obligation; adjust expectations on service, not on rights.
• Ignoring the SUM consent-to-settle condition. Settling with a tortfeasor's carrier for policy limits without the SUM carrier's written consent can forfeit the SUM claim.
• Pleading every § 5102(d) category and proving none. Threshold motions are won and lost on objective, contemporaneous-ish medical evidence tied to specific categories.
• Forgetting that property damage is outside no-fault. The $10,000 PD minimum and ordinary fault rules govern the vehicle.

7. One-paragraph summary

New York requires every registered vehicle to carry 25/50/10 liability (50/100 for death), $50,000 of no-fault PIP, and 25/50 UM. The no-fault carrier pays medicals, 80% of wages to $2,000/month, and $25/day incidentals promptly, on a regulated 30-day pay-or-deny clock with 2% monthly interest for lateness. In exchange, pain-and-suffering suits between covered persons require a § 5102(d) serious injury, while economic loss above $50,000 remains freely recoverable. SUM coverage — now default-equal to liability limits — and MVAIC backstop the uninsured and underinsured cases, and DFS supervises the whole machine through Regulation 68, the complaint process, and the assigned-risk plan.