- To file a lawsuit after a car accident, you must meet the New York serious injury threshold or have a basic economic loss exceeding $50,000.
- “Serious injuries” are legally defined by statute in New York.
- If you don’t meet the threshold or have less than $50,000 in basic economic loss, you’re limited to compensation through your no-fault PIP insurance.
- As an important exception, the serious injury threshold does not apply to victims of motorcycle accidents in New York.
If you’ve been hurt in a car accident, understanding New York’s Serious Injury Threshold (Insurance Law § 5102(d)) is one of the most important steps in your recovery. Because NY is a no-fault insurance state, you must first file a claim through your own insurance, no matter who was at fault for the accident. However, no-fault insurance may not cover all your losses, such as pain and suffering and medical bills that exceed policy limits.
To sue for pain and suffering compensation in New York, your injuries must meet a specific legal definition of “serious.” At Chopra & Nocerino, our experienced NYC car accident attorneys specialize in proving the severity of your injuries to maximize your settlement. If you are wondering if your injury meets New York’s serious injury threshold, contact us for a free case evaluation today.
How Does the Serious Injury Threshold Work?
In New York, meeting the serious injury threshold is essential for pursuing a personal injury lawsuit in certain cases. To pass this threshold, you must either:
- Suffer a serious injury: This can include conditions such as significant fractures, permanent disfigurement, or loss of a body part.
- Experience a basic economic loss: This means that your injuries result in a financial loss exceeding $50,000.
These two criteria help determine whether you can file a lawsuit for non-economic damages, such as pain and suffering, following an accident. It’s important to understand how this threshold applies, and the attorneys at Chopra & Nocerino can help guide you through this complex process with clarity and precision.
What Is a Basic Economic Loss?
A basic economic loss in New York refers to the direct financial losses you incur due to an accident-related injury. For your injury claim to move forward under New York’s no-fault system, this loss must exceed $50,000.
The components of basic economic loss include:
- Medical expenses: hospital bills. doctor visits. surgery costs, and rehabilitation and physical therapy
- Lost wages: Earnings lost due to being unable to work during recovery, and reduced earning capacity if the injury impacts your ability to return to your previous job or perform tasks at the same level.
- Other out-of-pocket expenses: Transportation costs for medical appointment. Homecare or other necessary services resulting from the injury
Once your economic losses meet the $50,000 threshold, you may pursue non-economic damages, like pain and suffering, in your personal injury claim. The experienced attorneys at Chopra & Nocerino can help you navigate this process and ensure you understand how your losses affect your case
What is Serious Injury?
Under New York law, a serious injury is defined as one that results in:
- Death
- Dismemberment
- Significant disfigurement. For example: burn injuries
- A fracture
- Loss of a fetus
- Permanent loss of an organ, limb, function, or system
- Permanent limitation in an organ or limb
- Significant limitation of body function or system use. For example: traumatic brain injuries
- A non-permanent injury that prevents you from performing regular activities for at least 90 of the 180 days immediately following the accident
New York is a no-fault state, which means car accident victims must carry personal injury protection (PIP) insurance. Even if the other driver is at fault, New York law requires that most drivers first turn to their PIP insurance to cover basic economic losses up to $50,000 per person.
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An important exception to the New York no-fault PIP rule exists for motorcycle accidents. If you were hurt in a motorcycle crash, you can sue the at-fault driver without filing a PIP claim first. No matter the circumstances of your case, our New York personal injury lawyers can help.
Understanding the 90/180 Day Rule in New York Serious Injury Threshold
Even if you did not suffer a fracture or permanent loss of a body organ, you may still meet the serious injury threshold under the “90/180-day” category. This category applies if a medically determined injury prevented you from performing substantially all of your usual and customary daily activities for at least 90 out of the first 180 days immediately following the accident.
Therefore, you need to understand if your injury qualifies because Courts often look for specific “Activities of Daily Living” when determining if you meet this standard. It is not enough to just feel pain while doing them; you must be effectively unable to do them.
Common examples of limitations that may qualify include:
- Employment: A doctor-ordered absence from work for 3 months or more.
- Household Duties: Inability to cook, clean, do laundry, or maintain the home.
- Personal Care: Needing assistance to dress, bathe, or groom yourself.
- Mobility: Inability to drive a car or walk significant distances without assistance.
- Childcare: Inability to lift or care for your children.
Your testimony alone is not enough. To win a claim under the 90/180-day rule, these limitations must be supported by objective medical evidence. This means your doctor must have specifically restricted you from these activities during that time period based on X-rays, MRIs, or other diagnostic tests.
Factors Considered in Proving Serious Injuries
While some injuries are easy to categorize, others are less clear and require medical documentation to determine whether you meet the “serious injury threshold,” sometimes referred to as the SIT. Factors that may help determine if you meet the New York SIT include:
- Imaging test results
- Percentages indicating your lost range of motion
- Clinical determination of the injury’s permanence and severity
- Daily impact on your quality of life
- Visible disfigurement that a reasonable person would find objectionable
Ultimately, you will bear the evidentiary burden of proving your injuries and the at-fault party’s liability. However, without legal support, it can be difficult to show that you meet the SIT. Our skilled legal team can answer your questions and gather evidence to prove that you sustained a serious injury under New York law.
What Happens If You Don't Meet the New York Serious Injury Threshold?
If you do not meet the New York serious injury threshold and your basic economic loss is less than $50,000, you are limited to no-fault PIP coverage. You can claim compensation for economic losses up to the limit, including medical bills, lost income, and certain qualifying expenses related to your injury. However, PIP does not cover non-economic damages, such as:
- Physical pain and suffering
- Emotional distress and mental anguish
- Loss of enjoyment of life
If You’ve Met the Serious Injury Threshold, What Are Your Next Steps?
Once you’ve met the serious injury threshold in New York, you have to take the proper steps to protect your rights and ensure you pursue the compensation you deserve. Below are the next steps to take:
- Consult with an experienced personal injury attorney: Speak with a lawyer who specializes in serious injury cases to understand your legal options. A knowledgeable attorney can help assess the strength of your claim and guide you through the complex legal process.
- Gather all medical records and documentation: Gather documentation of your injuries, treatments, and related medical costs. This includes hospital bills, doctors’ notes, diagnostic tests, and anything that supports the severity of your injuries.
- Apply for additional no-fault or medical insurance benefits: If you’ve already used the initial $50,000 in no-fault insurance benefits, you may qualify for additional no-fault coverage if you have what’s called Additional PIP (Personal Injury Protection). If you don’t have Additional PIP coverage, you can apply for benefits through your medical insurance provider. This ensures that your ongoing medical treatment and expenses continue to be covered.
- File a lawsuit: If you meet the serious injury threshold, filing a lawsuit can be your path to seeking compensation for pain and suffering, along with other non-economic damages. Your lawyer will help prepare the necessary paperwork and represent you in court.
- Prepare for negotiation or trial: Many cases are settled before reaching trial, but if your case goes to court, you need to be prepared. Your lawyer will negotiate on your behalf to ensure you’re offered fair compensation and will aggressively advocate for you in court if needed.
The legal process can be overwhelming, but Chopra & Nocerino is here to help every step of the way. With their expertise and aggressive approach, you can feel confident that your rights are protected and your claim is in good hands.
Can I Sue for Pain and Suffering Without PIP?
In New York, you can generally pursue a lawsuit for pain and suffering without PIP (Personal Injury Protection) if you meet the serious injury threshold. PIP is primarily used for covering medical costs and lost wages, but it doesn’t limit your right to sue for non-economic damages, such as pain and suffering, if your injuries are severe enough.
However, if you haven’t met the serious injury threshold, you may be barred from seeking compensation for pain and suffering under New York’s no-fault system. Consult with a personal injury lawyer to clarify your options based on the specifics of your case.
Contact the New York Injury Lawyers, Chopra & Nocerino
Chopra & Nocerino is a top-rated personal injury law firm with the skills and resources needed to demand the full and fair compensation you deserve. We are real New Yorkers who refuse to back down when at-fault parties and their insurers try to minimize the value of our clients’ claims. Over the years, we have won hundreds of millions in high-value case results for injury victims throughout the five boroughs and Long Island.
Call (855) NYC-HURT or reach out online to schedule a free case review with our experienced New York auto accident lawyers. Para servir mejor a todos los miembros de nuestra comunidad, ofrecemos servicios en español.
