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: New York Legal Blog

New York No-Fault Law Law-What Yon Need To Know-Part 2

By Mark Siesel, Esq.

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In part 1 of this post, e discussed the initial stages of a no- fault claim when you are injured in a New York car crash. Now we will discuss what is required to be successful in your claim or lawsuit against the other car that caused the accident. Under Insurance Law Section 5102 (d), also known as the No-Fault Statute, which was established in 1973, in order to obtain compensation for your injuries, you must suffer what is known as a "serious injury" in the automobile accident. A serious injury includes:
1. Death;
2. Dismemberment;
3. Significant Disfigurement;
4. A fracture;
5. Loss of a fetus;
6. Permanent loss of use of a body organ or member;
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 non-permanent impairment that prevents the person from being able to perform their usual and customary activities for 90 of the 180 days immediately following the accident.

The first five sections of the "serious injury" definition are much easier to define and prove. For example, if you suffer a broken arm in the accident, you automatically meet the no fault threshold of serious injury. Similarly, if the accident causes the loss of a body part or severe scarring, these injuries will automatically satisfy the "serious injury" requirements. However, we do constant battle with insurance companies in determining whether an injury has caused a "significant limitation of a body function or system", and whether an injury has resulted in a "permanent consequential limitation of use of a body organ or member." So what is a "significant limitation" of a body function or system, or a "permanent consequential limitation of a body organ or member?" According to the law, in order for you to have suffered a "significant limitation", the limitation on the body part must be more than simply "minor, mild or slight." Further, the limitation must be objectively determined by a medical provider, and not simply substantiated by your "subjective" complaints of pain. As to "permanent consequential limitation" of a body organ or member, in addition to being more than "minor, mild or slight", the doctor must determine that the injury to your back, neck, or other body part is to some extent permanent, as established by the doctor's records and reports.

In order to beat the other driver's insurance company and be successful in your New York car crash case, we must prove first that the other driver was at fault for the accident, either in whole or partially. If we prove the other driver's responsibility for the accident, we must then establish through your treating doctor's reports how your injuries have affected you in your ability to perform activities of daily living, such as your job, or being unable to perform household chores. Further, the doctor must quantity disability such as loss of range of motion of your neck, back, arm, or whatever part of your body was injured in the accident. If we have this medical proof, we have the basis for a successful No-fault case in New York.

Full post as published by New York Legal Blog on April 06, 2010 (boomark / email).

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