When No-Fault Insurance is Not Enough – In this article, New York lawyer Christopher T. McGrath explains that not all victims of motor vehicle accidents necessarily have a legal claim. New York’s “threshold” requirements for these types of cases mean that only “serious injury” claims may be pursued. Mr. McGrath describes how the law defines “serious injuries” arising from accidents involving cars.
When you have been injured in an automobile accident, New York’s No-Fault Law mandates that your accident-related medical bills, including lost earnings and incidental costs, up to $50,000.00 are paid. These are called your economic damages, but who pays the bills when they exceed $50,000.00? Who is going to help you and your family if you are never able to work again because of your injuries? Additionally, who pays for your non-economic damages? For example, who is going to compensate you for your disability and pain and suffering experienced since the accident?
New York’s Insurance Law requires that you suffer a “serious injury” before filing a lawsuit in connection with a motor vehicle accident to recover these additional damages. If you do not suffer a “serious injury,” regardless of how much pain and suffering you experience, you cannot bring a personal injury lawsuit to recover for your non-economic damages.
So, how do you know whether or not you have suffered a “serious injury”? Simply put, New York has specifically defined the term, and your injury must fall within its definition. While this may seem unfair, it is nonetheless true. It is important to understand what constitutes a “serious injury.”
In New York, a “serious injury” means a personal injury which results in one of the following:
3. Significant disfigurement;
4. A fracture;
5. Loss of a fetus;
6. Permanent loss of use of a body organ, member, function or system;
7. Permanent consequential limitation of use of a body organ or member;
8. Significant limitation of use of a body function or system; or
9. A medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment.
As you can see from the list above, some of the “serious injur[ies]” noted are vague. For example, what is considered “significant disfigurement”? Is a scar good enough? What about a scar that is not readily apparent or hidden beneath clothing? Are all burns “significant disfigurement”? To visit another category, above, if you break the cartilage in your nose, is that a “fracture” under the definition of “serious injury”? Does a fracture include a chipped tooth or chipped teeth?
Because of this language, you can see why this entire area of law is a heavily litigated area. There are literally thousands of New York legal opinions addressing these issues. When injured in a car accident, after receiving the medical care you require, you would do well to consult with an attorney experienced in handling these types of claims. An experienced and skilled attorney can mean the difference between being limited to “No-fault” benefits and having a court recognize that you have sustained a “serious injury” warranting a trial.
 If you would like to read more about the No-Fault law and “serious injury,” then visit the New York Insurance Department website at http://www.ins.state.ny.us/ or, to read the Insurance Law directly, visit the New York Insurance Department’s Insurance Law page at http://www.ins.state.ny.us/r68/r68_art51.htm.