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Understanding New York’s “Serious Injury” Threshold for Auto Accidents

Understanding New York’s “Serious Injury” Threshold For Auto Accidents

New York uses a no-fault insurance system. That means you turn to your insurance company after a car accident for help covering your medical expenses. Personal injury protection or PIP coverage helps compensate you for your reasonable and necessary expenses. However, medical expenses can quickly use up your coverage limits if you’ve suffered significant injuries. Are you left to cover the remaining balance? Potentially thousands of extra dollars in medical expenses?

At The Mandel Law Firm, we want to help injured car accident victims understand their legal rights following a crash with a careless driver. Under Article 51 of New York Insurance Law, you may be eligible to file a personal injury lawsuit seeking compensation for your financial losses if your injuries meet the “serious injury” threshold. What is New York’s serious injury threshold? We can explain.

New York’s Serious Injury Threshold

In New York, when you turn to your insurance policy’s PIP coverage following a car accident, that coverage provides:

  • Payment for reasonable and necessary medical expenses
  • Up to 80 percent of lost wages
  • Reasonable expenses like household help and transportation to medical appointments

However, PIP coverage only pays up to the limit of your policy. In most cases, that tops out at $50,000 in New York. What happens when your medical expenses exceed your coverage limits? Are you responsible for paying your treatment costs?

Thankfully, New York allows accident victims to step outside the no-fault coverage system, allowing them to file personal injury lawsuits seeking compensation for their financial losses. However, you can only hold the at-fault driver accountable in court if your injuries meet New York’s serious injury threshold.

What is the serious injury threshold? New York Law defines a “serious” injury as one that meets the following conditions:

  • Death
  • Dismemberment
  • Significant disfigurement
  • Bone fractures
  • Loss of a fetus
  • Permanent limitation of a body organ or limb
  • A significant limitation of the use of a body part or organ system

A serious injury can also include a medically determined injury or impairment that is not permanent, but that prevents an individual from performing substantially all of the person’s daily living activities for no less than ninety days during the 180 days immediately following an accident.

Proving an Injury Meets the Serious Injury Threshold

It may seem simple to prove that a significant injury meets New York’s serious injury threshold so you can file a personal injury lawsuit. However, it takes substantial evidence to build your case and prove you deserve maximum compensation for your financial losses.

Your medical records are one of the most potent pieces of evidence that can help your case. Seeking immediate medical treatment following an accident is vital. Additionally, you must follow your medical provider’s orders, keep follow-up appointments, and stay the course regarding treatment. If you wait too long to seek medical help or there are gaps in your treatment, the opposing side may claim your injuries are not significant, jeopardizing your case.

In addition to your medical records, other evidence can help support your claim and show the other driver’s careless actions caused the accident, entitling you to compensation for your injuries. This evidence may include:

  • Police report
  • Witness statements
  • Photographs of the scene
  • Dashcam or video surveillance
  • Cellular phone records

If you are coping with the life-changing aftermath of a serious injury, gathering the information you need to mount a legal battle can seem overwhelming. Connecting with an experienced New York car accident attorney is the best way to protect your legal rights and seek maximum compensation for your injuries.

Discuss Your Case with a Knowledgeable New York Car Accident Attorney

How do you move forward following a car accident with a careless New York driver? Start by discussing your situation with a skilled New York car accident attorney at The Mandel Law Firm. Contact or call our NYC office today at (646) 779-1441 to arrange a confidential legal consultation. Don’t let another day pass without getting the help you need.


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