Since New York is a “no-fault” state, claiming compensation after a car accident is relatively easy. That’s because this robust insurance system paves the way for anyone involved in a car accident to claim compensation for certain losses, regardless of their fault. However, if you want to step outside the no-fault system, you need to file a lawsuit, and you are only allowed to file a lawsuit under very limited circumstances.
One of the ways you can step outside the system is by satisfying New York’s serious injury threshold. In this post, the team at Alex Yadgarov & Associates will step into the shoes of an accident lawyer in New York and explain what qualifies under this threshold and how it affects your compensation claim.
What is the Serious Injury Threshold in New York?
The serious injury threshold in New York is the legal standard that determines whether a victim of a car accident can step outside New York’s no-fault insurance system and file a personal injury lawsuit to claim additional compensation. You satisfy this legal threshold when you prove that the accident resulted in what New York law recognizes as a “serious injury.”
Why Does the Serious Injury Threshold Matter?
In New York, under the no-fault insurance system, your Personal Injury Protection (PIP), you can claim up to $50,000 to cover medical expenses, lost income, and other relevant expenses. However, your insurance coverage is restricted to purely economic losses. It does not take into account non-economic losses such as pain and suffering and emotional distress. At the same time, the insurance may not be able to cover all your short-term and long-term expenses.
By meeting the threshold, you will be allowed to step outside the no-fault system and claim compensation for non-economic losses. Plus, since there is no upper limit, you can claim an amount that more accurately reflects the short-term and long-term losses you have suffered due to the accident.
What Injuries May Meet the Serious Injury Threshold?
The injuries New York law considers “serious injuries” are defined in Section 5102 (d) of New York Insurance Law. They include:
- Death
- Dismemberment
- Significant disfigurement
- Fracture
- The loss of a fetus
- The permanent loss of the use of a body organ, member, function, or system.
- The permanent consequential limitation of the use of a body organ or member
- The significant limitation of the use of a body organ or system.
It is worth noting that if the victim could prove that an injury limited or impeded their daily and customary activities for at least 90 days of the first 180 days after the accident, it was also considered a serious injury. This was known as the “90/180 rule.” However, following the latest revision of the law, this category is no longer considered.
What Evidence Helps Prove the Serious Injury Threshold?
If you want to prove a serious injury, you must heavily rely on “medical evidence.” The medical evidence you can present to help with your case includes
- Surgical records
- Diagnostic imaging (X-ray, MRI, and CT scans)
- Physician reports
- Physical therapy records
- Surgical records
- Medication prescriptions
- Expert medical testimony
Common challenges in Serious Injury Claims
When stepping outside the no-fault system, our advice as your accident lawyer in NYC is prepared for a fight. Even when your injuries are genuine, there will be obstacles to proving your case. They include the following:
- Insurance companies disputing the severity of injuries
- Gaps in treatment
- Pre-existing medical conditions
- Lack of objective medical evidence
- Disagreements between medical experts
Strong documentation can help overcome most of these challenges. At the same time, make sure to work with the best car accident lawyer in NYC you can find. Never underestimate the importance of a good lawyer.
What are the common challenges in serious injury claims?
When stepping outside the no-fault system, our advice as your accident lawyer in NYC is prepared for a fight. Even when your injuries are genuine, there will be obstacles to proving your case. They include the following:
- Insurance companies disputing the severity of injuries
- Gaps in treatment
- Pre-existing medical conditions
- Lack of objective medical evidence
- Disagreements between medical experts
Strong documentation can help overcome most of these challenges. At the same time, make sure to work with the best car accident lawyer in NYC you can find. Never underestimate the importance of a good lawyer.
Conclusion
The serious injury threshold is a legal standard that can change the direction and value of your claim. The difference between limited to no-fault benefits and being able to pursue full compensation for non-economic damages rests on how you approach this threshold. With proper medical documentation and a solid legal strategy, you will be able to satisfy this threshold and claim the compensation you deserve.
If you’re looking for a reliable and experienced attorney to handle your accident claim, Alex Yadgarov & Associates is the firm for you. We have decades of experience helping New Yorkers get the compensation they deserve. Cotact us today and schedule your free consultation.