We began our discussion on New York no fault benefits in Part I of our series. We continue the discussion here in Part II and focus on what steps have to be taken in order to obtain No Fault Benefits.

How do I obtain No Fault Benefits?

The car accident occurs and the clock starts to run. You must take a series of steps to protect yourself and insure that the no fault benefits will be furnished.

Identify the No Fault Carrier and report the accident

  • The no fault carrier is the insurer for the vehicle that you were occupying during the accident.
  • If you were injured in a motor vehicle that you own, then contact your auto insurer at the claims number provided in your policy.
  • If the injury occurred while you were a passenger in a car owned by a member of your household, you are covered under the owner’s policy and are eligible for no fault benefits through that policy.
  • If you are hurt while a passenger in any other private passenger vehicle, the insurer for that vehicle will be obligated to furnish no fault benefits

If you are neither the owner or a resident relative of the vehicle’s owner, it can be a bit trickier.

For example, if you were injured while riding as a passenger in a taxi-cab or an airport limousine, you will need to obtain the police report of the accident. The police report will have the identity of the carrier, the name of the policy holder and in some cases, the policy number. Once you can identify the no fault carrier, you can contact the claims office for that carrier (there is usually an 800 number to report the claim). This should be done promptly – do not wait.

What if I am struck by a car or bus while I am a pedestrian?

The no fault carrier for the vehicle which struck you is obligated to furnish no fault benefits. This applies even if you are the owner of a motor vehicle. So long as you were stuck by a car and injured while a pedestrian, the no fault carrier for the offending vehicle will be responsible for providing no fault benefits.

How much time do I have to notify the No Fault Carrier?

This is very important. You have 30 days (and that is it!) from the date of the accident to notify the carrier of the accident and your claim for no fault benefits.

  • The notice must be in writing and
  • set forth details sufficient to identify yourself along with
  • “reasonably obtainable information regarding the time, place and circumstances of the accident”
  • A copy of the Police Report should be provided to the no fault carrier to satisfy the notification requirement.

What happens after I contact the carrier and provide notice of the accident?

The no fault carrier will mail you a number of documents. These will include an Application for No Fault Benefits.  The application must be filled out completely, signed in three places and returned to the no fault carrier promptly. We recommend that this completed form be mailed to the carrier by certified mail so that there is no question that the form is actually received by the carrier. The application for no fault benefits seeks information such as your name, date of birth, address, social security number as well as a description of your injuries.

The completed application must be returned to the no fault carrier within 30 days of the accident if the original notice (described above) was not in writing.

It is important to involve an attorney in this process at the earliest possible date to ensure that the application is properly completed and timely returned to the no fault carrier.

What Information do I provide to my doctors and other providers?

The carrier will assign a claim number to your case. This claim number must be provided to each of your health care providers along the following information:

  • The date of your accident
  • The identity of the Carrier
  • Your date of birth

Each of your providers will have you sign a form assignment of benefits. Signing this form allows your doctors and other health care providers to bill the no fault carrier directly for services rendered to you. If there is a dispute between the provider and the carrier and you have signed an assignment of benefits form, the provider and not you will be responsible for resolving the dispute.

What if I am coming up to the 30 day time period and I have not reported the accident or do not know who the no fault carrier is?

This happens all too frequently. It is in situations like that where it is critical to contact a personal injury lawyer and get legal advice immediately. The sooner that an attorney is involved in your claim, the better it will be for you. The stakes are high and you don’t want to risk being on the hook for payment of potentially large medical bills.

Call us if you have any questions on these or any other issues related to no fault law in New York.

We discuss bus passengers, motorcycles and other exceptions to the rules in the next part of this series.