Motor vehicle accidents are one of the leading causes of injury-related deaths in the United States, killing over 40,000 people each year. According to the CDC (Centers for Disease Control and Prevention), fatal car crash injuries alone result in nearly half a trillion dollars in annual damages. This does not account for the damages incurred by the nearly 3 million people injured in traffic accidents each year. Because driver negligence – such as speeding, texting, or drunk driving – causes most car accidents, civil courts are overwhelmed with accident injury litigation. In response to these statistics, some states have adopted no-fault insurance laws to reduce the amount of motor vehicle accident lawsuits.
No-fault insurance states have drastically different rules for obtaining personal injury damages after motor vehicle crashes than traditional insurance states. If you live in no-fault states such as Florida, New York, or New Jersey, you should immediately contact an experienced car accident lawyer for assistance with your claims.
Overview of No-Fault (Personal Injury Protection) Insurance Laws
No-fault insurance, also called personal injury protection (PIP) insurance, is a type of auto insurance coverage vehicle owners carry. PIP policies allow claimants injured in motor vehicle accidents to obtain medical and lost income compensation regardless of fault. This means you might immediately file a no-fault or PIP claim for damages even if you’re 100 percent liable for the accident. Pedestrians and cyclists injured in car accidents might also file no-fault claims with their personal insurers.
Many auto insurance companies offer optional no-fault coverage, but some states have adopted no-fault insurance laws. These laws require vehicle owners to carry PIP insurance in certain minimum amounts but also prohibit car accident victims from suing liable drivers, employers, vehicle owners, and mechanics for minor accident injuries. This exemption to tort liability for negligence means, if you’re not ‘seriously’ injured in a motor vehicle accident, you may not obtain personal injury damages from the negligent driver or their liability insurer. Your only remedy might be a no-fault insurance claim, even if your policy does not provide sufficient coverage.
State No-Fault Insurance Laws
About 20 percent of states have adopted no-fault insurance laws. However, every state has different no-fault statutes establishing minimum policy limits ($10,000 in Florida but $25,000 in New York), and the serious injury threshold claimants must meet to sue liable drivers. Some states, such as New York, allow you to file litigation if you suffered from a serious injury or incurred over $50,000 in economic damages, while other states only consider the seriousness of your injuries. Remember, it’s not the seriousness of the accident but rather the accident injuries that matter in no-fault states. A few states require drivers to purchase no-fault insurance, but you can waive coverage and file litigation. No two states’ no-fault schemes are the same, and very specific state laws apply to your claims. You should always connect with an experienced local car accident lawyer if you suffered an injury in a no-fault state.
Filing No-Fault Claims
Every state and insurance company has different requirements for filing no-fault claims, with many claimants able to file for benefits online. Because you do not have to prove liability, you might obtain no-fault benefits by submitting the following information to either your auto insurance company or, in the case of passengers, the vehicle owner’s insurance company:
- Police report
- Discharge papers and ER records
- Note from a doctor certifying your injuries
- Pay stubs
- Medical records and billing statements
No-fault insurance will generally cover medical bills and a portion of your lost income up to policy limits. Continue treating your injuries and submit receipts, such as for massage and chiropractic care, to your no-fault adjuster. Once you exhaust your no-fault benefits, you must speak with a local personal injury lawyer about whether you qualify to sue the negligent driver.
Understanding the Serious Injury Threshold
Every no-fault state has a serious injury threshold that claimants must meet to file negligence claims against liable drivers. If you meet this threshold, your case is handled based on standard liability laws, although you may still take advantage of your no-fault benefits to obtain financial relief during the litigation process. The following are examples of standard threshold injury categories in no-fault states.
Death
Fatal car accident injuries nearly always qualify eligible family members to file wrongful death litigation. All no-fault states permit claimants to sue or demand liability insurance settlements after fatal car crashes. Look for a local law firm that handles wrongful death as well as car accident litigation if your loved one was killed in a crash.
Significant and Permanent Loss of a Bodily Function
Most states recognize this category of serious injuries. If the car accident caused you to lose control of a bodily system, such as your ability to urinate or reproduce, you might sue the liable driver. This category also covers injuries impacting your senses (such as vision, hearing, smell, or touch) and spinal cord injuries significantly impacting your ability to walk or breathe. Severe traumatic brain injuries resulting in cognitive disabilities also qualify most claimants to obtain personal injury damages.
Importantly, the loss must be significant and permanent. Temporary hearing loss resulting from a concussion is not enough to meet the threshold. Your attorney must show that you permanently lost a significant portion of your hearing to obtain additional damages in no-fault states. Even losing consciousness after hitting your head is not considered ‘serious’ if it does not result in a significant disability. In such cases, you might be limited to claiming no-fault benefits. Most states have extensive case law where, over the years, judges have determined what does and does not qualify as a significant and permanent loss. Experienced personal injury attorneys in your jurisdiction can review the case law to determine whether you can sue the liable driver.
Significant and Permanent Scarring or Disfigurement
Car accidents resulting in injuries such as third-degree burns or amputations generally qualify claimants to demand damages from liable drivers. The scarring must be significant, not simply a surgical scar, to meet the threshold. However, some states consider scarring on noticeable or sensitive areas, such as the face, serious due to inherent psychological trauma. Local attorneys can review the case law in your state if you have residual injury scars from a car crash.
Other Permanent Injury
Although normally covered by the other categories, most states allow claimants to obtain damages if doctors certify that they sustained any permanent injury. This means that, even after obtaining all reasonable medical care, there is no further treatment available. Injuries such as brain death, paralysis, and amputations are considered permanent.
Significant Economic Loss
Some, but not all, states allow claimants to sue liable drivers if their injuries resulted in significant economic loss. For example, if an injury resulted in $20,000 worth of medical damages and $50,000 in lost income, you might hold the negligent driver liable for your losses.
Short or Long-Term Disability
A few states allow injured claimants to obtain personal injury damages if the injury results in a short or long-term disability. This is generally measured from the date of the accident until you return to work. For example, if you can not perform most activities of daily living – such as walking, cooking, or bathing – for at least 90 days following the crash, you might meet the threshold. Expectant mothers put on strict bed rest after a car accident, even if a healthy child was born, might still obtain damages under this category.
Remember that every no-fault state has different threshold categories and case law. An experienced car accident lawyer in your jurisdiction can determine whether your injuries meet a no-fault state’s threshold standards.
Threshold Injuries and Common Disputed Injury Claims in No-Fault States
Most insurance adjusters and courts agree that the following serious car accident injuries meet the no-fault threshold requirement:
- Extensive burns (second or third-degree)
- Amputations
- Broken bones
- Paralysis
- Mild to severe traumatic brain injuries
- Miscarriage
- Loss of bowel control
- Blindness or hearing loss
- Death
However, the most common dispute arises when it comes to the most common car accident injury: non-paralyzing back and neck trauma.
High-impact car accidents, especially rear-end collisions, send an incredible amount of force through passengers’ bodies. Your musculoskeletal system absorbs most of the accident force, often resulting in slipped discs, whiplash, and painful muscle strains. These ‘soft tissue’ injuries do not generally meet the threshold unless they cause corresponding nerve damage. Substantial case law exists addressing when back and neck injuries qualify claimants to sue liable drivers for damages. Do not give up on your claims without speaking with a qualified car accident lawyer in your state. They may push your claims over the threshold standard with dedicated legal advocacy.
Third-Party Civil Claims Not Subject to No-Fault Insurance Laws
Even if your injuries do not meet the threshold, most no-fault laws only protect liable drivers, vehicle owners, and their employers. You might have a claim against third parties for additional damages based on the facts of your case. These claims might include the following:
- Premises Liability: Pedestrian accidents resulting from negligent roadway designs, such as failing to provide safe crosswalks or lighting, might give rise to premises liability claims against the state. These may fall outside the no-fault system, entitling claimants to demand damages from negligent public entities.
- Dram Shop Liability: If a drunk driver caused the crash, many states allow claimants to demand damages from bars, restaurants, or even private social hosts for serving alcohol to minors or habitual alcoholics.
- Criminal Conduct: DUI and reckless driving accidents resulting in criminal, as opposed to traffic, charges might entitle claimants to demand restitution during criminal proceedings. Restitution is generally limited to the defendant’s ability to pay, but you might obtain basic compensation for medical bills and lost income after car accidents, even if your injuries do not meet the threshold.
- Medical Malpractice: If a medical professional failed to properly treat or diagnose your car accident injuries, worsening your condition, you might have a separate claim for medical malpractice against the provider and medical facility.
- Workers’ Compensation: Injuries sustained in on-the-job car accidents go through your employer’s workers’ compensation insurance. You may demand more substantial medical damages and lost income through workers’ comp in such cases. Reputable personal injury law firms might handle both car accident and workers’ compensation cases.
If no-fault benefits are not enough, an experienced car accident lawyer can obtain damages from liable third parties. They can also argue that the totality of their injuries has caused a significant disability and fight to obtain settlements from liable insurers.
Fighting Threshold Injury Determinations in Court
If you believe you suffered from a threshold injury, an attorney will demand damages from the liable driver’s insurance provider. Liability insurers in no-fault states will immediately challenge you on threshold grounds unless you suffered a catastrophic injury. You might be required to attend independent medical examinations and provide expert medical testimony related to your claims. If the liability adjuster denies coverage based on the state’s no-fault law, a personal injury litigator may take your case to court.
You are not prohibited from filing personal injury litigation in no-fault states, but a judge must determine whether your injuries meet the state’s threshold requirements before litigation proceeds. Legal counsel can present a strong case, based on state law, that you should be permitted to pursue litigation and obtain bodily injury damages. If the judge decides in your favor, liability adjusters might quickly settle your claims. The right attorney might even make such a strong argument on your behalf that adjusters offer fair settlements before the judge rules on threshold.
Contact an Attorney for Help Filing No-Fault Claims and Obtaining Car Accident Damages
Car crash victims injured in no-fault states have the benefit of obtaining immediate compensation but might not be permitted to sue the liable driver. A reputable personal injury law firm near you can discuss your no-fault rights. Even if your injuries do not meet the threshold, compassionate lawyers might still obtain no-fault benefits and hold third parties liable for your damages. If necessary, your personal injury attorney will fight to prove that your injuries meet the serious injury threshold in your jurisdiction. There’s no risk or fee associated with contacting a reputable car accident law firm if you have questions about your no-fault claim.
