Can You Sue In A No-Fault State?

Some states have no-fault car insurance laws. These laws, sometimes referred to at personal injury protection or PIP laws, make it so that the insurance company automatically pays in the event of an accident, regardless of who is at fault. No-fault laws also generally require all drivers to have auto insurance so that everyone is covered in the event of an accident.

These laws are designed to make the insurance companies the first point of recovery for monetary assistance after an accident, removing the need for litigation to pursue further compensation. However, what happens if the injuries and monetary losses from the accident are not fully covered by the insurance payout?

That’s where a New York and New Jersey personal injury lawyer comes in. There are special circumstances that allow car accident victims to sue in a no-fault state, but these circumstances almost always necessitate the help of an experienced attorney.

Pursuing a Claim in No-Fault States

Before a plaintiff can pursue a legal claim in a no-fault state, he or she must first collect compensation from their insurance company. However, most no-fault states also have laws that allow plaintiffs to file for additional compensation from the liable party. These laws do have limits, or thresholds, in place to limit lawsuits to only serious accidents and injuries.

These thresholds are generally based on the amount of medical expenses the injured person has paid or has been billed for, known as the monetary threshold, and the type of injury the victim suffered, known as the injury threshold.

Monetary Threshold

Most no-fault states also have a monetary threshold law that only allows victims to sue if their medical bills and expenses meet or exceed the monetary threshold. Though it varies from state to state, the threshold is typically around $1,000.

The monetary threshold can only be met from expenses actually accrued. This means that only medical bills the victim actually was billed for and/or paid count towards the threshold.  The victim cannot use future or uncertain expenses.

Most monetary threshold laws also state that the counted medical expenses must be reasonable and necessary. In a lot of cases, a medical bill is not enough to prove that the treatment was reasonable and necessary. Oftentimes a doctor or medical professional must testify that the treatment was a direct result of the accident, and that is was a necessary treatment.

Some states use formulas to determine if expenses were reasonable, while others have specific definitions of reasonable medical expenses, including hospitalization, surgery, and x-rays.

Injury Threshold

Victims of serious injury have the right to sue in most no-fault states. The confusion begins at the definition of a serious injury, as it tends to differ from state to state.

Death is always considered a serious injury in no-fault states, so if an insured dies in a car accident his survivors can file a lawsuit for coverage of costs like funeral expenses.

Most no-fault states have a list of what they consider to be serious injuries, though the laws can vary in how the injuries are described or named. Most of the lists include injuries like:

  • Fractures, or bone breakages
  • Permanent “disability,” “injury” or “loss of a body function”
  • Permanent or “significant” disfigurement
  • Dismemberment, or the “loss of a body member,” like an arm or an organ

No-fault states also differ on how these serious injuries can and must be proven in court. For example, in some states a victim must prove a disability with doctor testimony or medical evidence, while in other states a victim has a set time period to prove his injury is disabling.

Hire a Personal Injury Lawyer

If you live in a no-fault state, you can only benefit from hiring a personal injury lawyer. No-fault laws are confusing, and almost always vary greatly from state to state. You need an attorney to help you navigate your state’s laws, and decide if you have a case.

New York and New Jersey are no-fault states. Luckily, the lawyers at Kantrowitz, Goldhamer & Graifman, P.C. are here to help you. Contact a car accident lawyer from our team today to schedule a free consultation to learn about your rights after your accident.

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