New York State’s Serious Injury Threshold for Personal Injury Cases

New York State drivers may be surprised to learn that suffering an injury in a motor vehicle accident is not, by itself, enough to sue for personal injury. But what happens if you suffered a serious injury and your medical expenses exceed the compensation given by your insurance provider? If your injury meets New York State’s “serious injury” threshold, you might be entitled to more.

Under I.S.C. Law § 5401(a), the “No-Fault Law,” victims of motor vehicle accidents may sue the parties responsible if the injuries they sustained meet the “serious injury” threshold. The difficult part for most victims of a motor vehicle accident is determining whether they suffered a “serious injury” as defined by the law. There are a number of requirements needed to prove that your injury is a serious one and each requirement presents its own challenges. Keep in mind, however, that the serious injury threshold only applies to personal injury cases involving car accidents.

For help with your car accident injury case, call the New York car accident lawyers at The Carrion Law Firm. For a free case evaluation, call us at today (718) 841-0083.

What is the Serious Injury Threshold for Personal Injury Cases in New York State?

New York is a no-fault state for car accidents and most other vehicle accidents. This means that after a vehicle accident, victims may have to turn to their personal injury protection (PIP) insurance instead of filing a lawsuit against a negligent driver. To learn more about the serious injury threshold for personal injury cases, victims can reach out to our experienced New York car accident lawyers.

Generally, states either have fault or no-fault insurance systems for car accidents. If a state is a fault state, filing a claim with a negligent driver’s liability insurance or bringing a lawsuit against a negligent driver are the primary paths to recovery for victims. Suppose a state is a no-fault state for car accidents, like New York. In that case, victims must initially turn to their PIP insurance to recover compensation for losses unless their injuries meet the necessary criteria for a serious injury or result in losses that exceed a “basic economic loss,” according to I.S.C. Law § 5104(a). All drivers in New York are required to carry PIP insurance, not including motorcyclists.

Because New York is a no-fault state for most vehicle accidents, filing a lawsuit is not always an option for all victims. That doesn’t mean that bringing a claim against a negligent driver is always impossible, just that it may be more difficult for some victims. Personal injury protection insurance is meant to prevent the need for litigation in certain circumstances and to streamline the recovery process. When that is insufficient for victims based on their injuries and losses, filing a personal injury lawsuit after a car accident may be possible in New York.

Definition of “Serious Injury” and “Basic Economic Loss” in New York Car Accident Claims

Because New York is a no-fault state for most vehicle accidents, only certain injuries or considerable economic losses qualify victims to file a lawsuit against a negligent party for compensation instead of solely resorting to filing a claim with their PIP insurance. As a car accident victim, knowing which injuries and losses allow you to bring a compensation claim against a negligent driver in New York is important.

Serious Injuries

Only certain injuries qualify car accident victims to file a lawsuit against a negligent party in New York because of the state’s no-fault insurance laws. The following injuries are considered serious injuries, according to I.S.C. Law § 5102(d):

• Death
• Loss of a body part
• Fractures
• Loss of a pregnancy
• Significant scarring or disfigurement
• Permanently losing the use of a body part or system
• Permanent or major limitation in the use of a body part
• Significant limitation in the use of a body function or system
• An injury lasting for at least 90 days out of the first 180 days after the accident

Although some of these categories are obviously serious, like death or loss of a body part, others are less so. Proving that you have a “serious injury” under one of the last four categories can be challenging since there is much more room for insurance providers and attorneys to argue over the definition of each term used.

The final category of the New York’s serious injury state is known as the “90/180 Day Rule.” Simply put, an accident victim can prove that their injury is serious if they can present medical evidence of their inability to perform significant daily activities for at least 90 days out of the first 180 days after the accident. New York courts have spent considerable time attempting to clarify these categories in order to provide plaintiffs with a clear guide to proving whether their injuries were serious.

The term serious injury refers to a variety of common car accident injuries, including but not limited to traumatic brain injuries, paralysis, and loss of limb. Our New York car accident lawyers can explain the specific injuries that might qualify under the state’s serious injury threshold so that you can better understand whether or not you have a valid compensation claim against a negligent driver.

Basic Economic Loss

Regardless of your specific car accident injuries, you may be able to file a lawsuit against a negligent driver in New York if you sustained a certain amount of economic loss because of a negligent driver’s actions. According to I.S.C. Law § 5104(a), victims have reason to bring a claim despite New York’s no-fault system if they sustained losses greater than “basic economic loss.” According to I.S.C. Law § 5102(a), New York defines “basic economic loss” as up to $50,000 per person for expenses related to medical care for an injury, such as hospital stays, psychiatric services, and physical rehabilitation, among other common expenses. Our New York car accident lawyers can determine, based on your losses, if you qualify for a lawsuit according to these rules or whether you need to prove serious injuries to file your lawsuit.

Who Does the Serious Injury Threshold for Personal Injury Cases in New York State Apply To?

New York’s serious injury threshold applies to covered persons under the state’s no-fault insurance laws. This includes various individuals, not just passenger car drivers or victims.

After a car accident in New York, excluding those that result in serious injury or certain financial losses, victims’ primary remedy is to file a claim with their personal injury protection insurance. This rule applies to passenger car drivers injured in vehicle accidents, pedestrians, passengers, bicyclists, and even negligent drivers themselves. According to I.S.C. Law § 5102(j), any other person entitled to first-party benefits is also considered a covered person and thus possibly required to file a claim with their PIP coverage instead of filing a lawsuit.

That means if you were struck by a negligent driver as a pedestrian or a bicyclist and did not sustain a serious injury, you may be unable to file a lawsuit in New York. To learn more about how the state’s no-fault laws impact pedestrians and other victims, reach out to our New York car accident lawyers.

Are There Exceptions to the New York State Serious Injury Threshold for Personal Injury Cases?

Although New York’s serious injury threshold applies to most vehicle accidents, it does not apply to all of them. Notably, motorcyclists are excluded from the no-fault insurance system in New York.

In New York, motorcyclists are not required to purchase personal injury protection insurance. In fact, motorcyclists cannot file a claim with their PIP coverage after an accident, even if they have such coverage from another vehicle they drive. This means that injured motorcyclists do not have to meet a serious injury threshold to file a compensation claim against a negligent driver in New York.

Because filing a lawsuit may be motorcycle accident victims’ most reliable path to recovery after an incident, it is crucial to reach out to our New York personal injury lawyers immediately after a crash. Our attorneys can help you identify the negligent driver and bring a successful compensation claim well within New York’s three-year statute of limitations for motorcycle accident lawsuits.

How Might the Serious Injury Threshold for Personal Injury Cases Impact Victims in New York State?

The serious injury threshold for personal injury cases in New York can profoundly impact victims and their ability to recover sufficient compensation after a car accident. In order to learn how your case fits into the state’s no-fault system, reach out to our New York car accident lawyers.

Car accident injuries can vary in severity, forever altering a victim’s quality of life. Although New York’s definition of serious injuries might appear broad, it does limit which victims are permitted to seek compensation through a lawsuit. If your injuries do not meet the necessary criteria, you may not be allowed to bring a compensation claim against a negligent party.

In order to prevent the serious threshold from barring you from recovery via a lawsuit, it is crucial to seek medical attention immediately after an accident. By creating immediate medical documentation of their injuries, victims can more easily connect their injuries and financial losses to a negligent driver’s actions.

Although some serious injuries that qualify victims to file a lawsuit are permanent, it is necessary to create evidence that shows their cause. In other circumstances, serious injuries are not permanent and must only exist for a specific period of time, for at least 90 of the 180 days after an accident. Suppose you do not seek medical attention quickly enough. In that case, you may not be able to recover compensation via a lawsuit in New York, despite your injuries initially qualifying you to do so.

Our New York car accident lawyers can help you take the necessary steps after an accident to prevent the state’s no-fault insurance laws from unnecessarily preventing you from recovering compensation through a lawsuit against a negligent party.

Proving an Injury Meets the Serious Injury Threshold in a New York State Injury Case

When a victim is injured, it’s natural to think that the injury is serious. However, simply claiming that you believe your injury is serious will not be enough to win your case. Several requirements must be met to prove that your injuries meet the threshold for “serious injuries” in a personal injury case involving a car accident in New York.

Quantified Injuries

One requirement to meet New York’s serious injury threshold is that your injuries must be “quantified.” This means that you must provide medical records stating the nature, severity and extent of your injuries, all treatments required, expected recovery time, and other details. This may include evidence showing an observable decrease in something like range of motion, or it may include evidence of a short-term or long-term disability. The records will quantify the extent that you are disabled or the degree by which your range of motion is reduced compared to “normal functioning.” New York courts have consistently held that a medical provider’s findings, without support or testing, are not enough to establish a serious injury under New York law, and additional records supporting these claims are required.

Certified Medical Records

Your medical records must also be certified to prove that you sustained a serious injury and can file a car accident lawsuit in New York. This means that medical records must be submitted to the court in a form that is admissible as evidence. Generally, this comes in the form of a sworn, signed affidavit from your doctor stating that the records are authentic copies. It is important to understand that you will not be able rely on unsworn medical records to prove your serious injury claim, only those that have been certified. Our Buffalo car accident lawyers ensure that your medical records are certified and can be used as evidence in a lawsuit against a negligent driver.

Explain Gaps in Treatment

If there is a gap in your treatment for any period of time after a car accident in New York, you must explain it to the court to prove you sustained a serious injury. If you voluntarily refuse or stop treatment while also claiming a serious injury, you must offer some explanation as to why. Without this, the courts are unlikely to believe that your injury is, in fact, serious, which can negatively impact your compensation claim. A defendant might also claim that your injuries were caused by a different accident if you didn’t seek treatment close in time to your accident.

Explain Pre-Existing Conditions and Injuries

Lastly, you must explain any pre-existing injuries or conditions that you suffered prior to your serious injury claim. Basically, your medical evidence must show that the serious injury you suffered in a car accident is distinct from your pre-existing condition. This can be accomplished with a report from your doctor explaining the pre-existing condition in detail. Our Niagara Falls car accident lawyers can distinguish serious injuries sustained in a collision from pre-existing conditions, so that your compensation claim is unaffected.

How Much Can You Recover in a Car Accident Claim if You Sustained a Serious Injury in New York State?

If you recently sustained a serious injury in a car accident in New York, you may be able to recover considerable compensation in a lawsuit against a negligent party. Contact our New York car accident lawyers immediately after a collision to recover the amount you deserve.

Economic Damages

Vehicle accident victims that sustain serious injuries or financial losses that qualify them to file a lawsuit may recover total compensation for their economic losses. In a compensation claim against a negligent party, our attorneys can help you compile proof of damages, which details the medical bills, lost wages, and other out-of-pocket expenses you incurred because of a negligent driver. After proving a defendant’s fault and the existence of your serious injuries, your economic losses may be tallied up to determine the amount you can recover against a negligent driver. Because there is no limit on economic damages in New York, car accident victims can recover total compensation for the financial losses against a negligent driver when they file a lawsuit.

Non-Economic Damages

Victims who sustain serious injuries in car accidents may experience considerable pain and suffering in New York. Emotional distress, anxiety, depression, and post-traumatic stress disorder often accompany life-altering injuries from vehicle accidents. In an attempt to compensate victims for such difficulties and alleviate the challenges they face, New York allows for non-economic damages in car accident lawsuits.

If you sustained a serious injury in New York and are eligible to bring a compensation claim against a negligent driver, you may be able to recover non-economic damages. This type of compensation can help your emotional recovery after an accident as you heal from injuries and other losses. As there is no cap on non-economic damages in car accident claims in New York, our attorneys can help you recover considerable compensation against a negligent driver.

What if You Can’t File a Lawsuit in New York State Because of the Serious Injury Threshold?

If you can’t file a car accident lawsuit because your injuries don’t meet the definition of serious injury in New York, compensation is still available. Regardless of your circumstances, contact our attorneys immediately so you can recover compensation for your losses as soon as possible after a car accident in New York.

When filing a lawsuit against a negligent driver isn’t an option because of New York’s serious injury threshold for car accident claims, there are other ways for victims to recover compensation. The first is to file a claim with your PIP insurance. Victims may also be able to file a claim against a negligent driver’s liability insurance or their own health insurance.

While filing a lawsuit may be preferable for car accident victims in New York, it is not always possible because of the state’s no-fault insurance system. To learn more about your options as a victim, reach out to our New York car accident lawyers. Even if it appears as though you don’t have a claim because of your injuries, it is always wise to seek a consultation with our attorneys to better understand your options for compensation.

How a Lawyer Can Help with “Serious Injury” Claims for Car Accidents in New York State

Serious injury cases are complex and often difficult to prove in New York. Recovering from a serious injury is hard enough on its own without the added stress of collecting records, filing court documents, and arguing with insurance providers. Settlement negotiations can be tense, and you may feel pressured into accepting a settlement offer that is lower than what you deserve. Obtaining legal representation can make all the difference for car accident victims in New York.

Once you have obtained legal counsel from one of our Syracuse personal injury lawyers, your only responsibility is recovering from your serious injury. Our attorneys will thoroughly assess your case and acquire any medical records, witness statements, or experts needed to prove your claim. Our experienced New York car accident lawyers will also handle settlement negotiations on your behalf to fight for maximum compensation.

When navigating a serious injury claim after a car accident, don’t go through it alone. Turn to our skilled lawyers who can help prove that you sustained a serious injury because of a negligent driver’s actions, enabling you to recover the compensation that you deserve in New York.

Call Our New York Car Accident Lawyers About Your Case Today

If you were recently hurt in a car accident and sustained serious injuries, call our Albany personal injury attorneys for help. For a free case evaluation with the New York car accident lawyers at The Carrion Law Firm, call today at (718) 841-0083.