No-fault insurance is one of the most important protections for Bronx families after car accidents, but it’s also one of the most confusing. Many working families don’t understand that no-fault insurance can pay their medical bills and replace lost wages—even if they don’t have car insurance, even if the accident was their fault, and even if they work “off the books” for cash.
This guide explains no-fault insurance in plain language in a way that makes sense for Bronx families who speak Chinese, Korean, Spanish, or English.
What Is No-Fault Insurance? (Simple Explanation)
No-fault insurance means that, after a car accident, your own car insurance company (or the insurance of the car involved in your accident) must pay for:
- Your medical bills
- Your lost wages from missing work
- Other expenses related to your injuries
The word “no-fault” means it doesn’t matter who caused the accident. Even if the accident was 100% your fault, no-fault insurance still pays your bills. Even if you’re not sure who was at fault, it still pays.
This is very different from other types of insurance claims where you have to prove the other driver was at fault and then fight with their insurance company for months or even years.
What Does No-Fault Insurance Cover?
No-fault insurance in New York covers up to $50,000 in benefits for each person injured in an accident. This includes:
1. Medical Expenses (Most Important)
- Emergency room visits
- Ambulance rides
- Hospital stays
- Surgery and medical procedures
- Doctor appointments
- Physical therapy and rehabilitation
- Chiropractic care
- Prescription medications
- Medical equipment (wheelchair, crutches, back brace, etc.)
- Home health care if you can’t care for yourself
- Transportation to medical appointments (bus fare, car service)
2. Lost Wages (Very Important for Working Families)
- Up to $2,000 per month for work you miss because of injuries
- Maximum total of $50,000 across all benefits
- Covers any kind of work—full time jobs, cash jobs, self-employment, gig work
Important: No-fault pays 80% of your lost wages, not 100%. So if you normally earn $1,000 per week, no-fault pays $800 per week.
3. Other Essential Expenses
- Up to $25 per day (maximum $50,000 total) for services you can’t do because of injuries:
- Housework and cleaning
- Childcare
- Caring for elderly parents
- Cooking meals
- Grocery shopping
What No-Fault Insurance DOES NOT Cover:
- Vehicle damage (that’s a separate claim)
- Pain and suffering
- Emotional distress
- Permanent disability compensation
For these damages, you need to file a lawsuit against the driver who caused the accident—but only if your injuries are “serious” under New York law.
Who Qualifies for No-Fault Benefits?
Almost everyone injured in car accidents qualifies:
Drivers:
- If you have car insurance, your own insurance pays
- If you don’t have car insurance but were driving someone else’s car, that car’s insurance pays
- If you were driving without any insurance, you can still claim from the other driver’s insurance
Passengers:
- The insurance of the car you were riding in pays
- If that car has no insurance, the other car’s insurance pays
- Passengers are almost always covered—you just need to know which insurance to file with
Pedestrians Hit by Cars:
- The insurance of the car that hit you pays
- Even if you were jaywalking or crossing against the light, you’re still covered
- Even if the driver left the scene (hit-and-run), there are special funds available
Bicyclists Hit by Cars:
- If you own a car with insurance, your own insurance pays
- If you don’t own a car, the insurance of the car that hit you pays
Motorcycle Riders:
- New York doesn’t require motorcycle insurance to include no-fault coverage
- But if you have a car with insurance, that car’s insurance covers you
- If not, you claim from the other vehicle’s insurance
The 30-Day Deadline: The Most Important Rule
You must file your no-fault insurance claim within 30 days of the accident. This is not flexible. If you miss the 30-day deadline, you lose all no-fault benefits—even if you have serious injuries.
The clock starts on the accident date, not when:
- You realize you’re injured
- You see a doctor
- You get the police report
- You hire a lawyer
What you must file within 30 days:
- Form NF-2 (Application for No-Fault Benefits)
Where to get this form:
- Your insurance company must mail it to you (if you report the accident)
- Download from New York State Department of Financial Services: www.dfs.ny.gov
- Your lawyer can get it for you
- Hospital social workers may have copies
Why insurance companies “forget” to send forms: Insurance companies make money by denying claims and delaying payments. They know many Bronx families don’t speak English well, don’t understand the system, and will miss the 30-day deadline. Don’t let them trick you. Get the form yourself and submit it immediately.
How to Prove Lost Wages (Even for Cash Jobs)
Many Bronx workers have jobs that don’t give regular paychecks:
- Restaurant workers paid mostly in tips
- Construction workers paid in cash
- House cleaners paid per house
- Food delivery workers (DoorDash, Uber Eats)
- Rideshare drivers (Uber, Lyft)
- Small business owners
- Informal work (babysitting, hair braiding, home repairs)
Insurance companies try to deny lost wage claims from workers without formal pay stubs. Don’t let them. You can prove your income with:
Documents that prove cash income:
- Bank deposit records
- Rent receipts showing you have money to pay rent
- Utility bill payment records
- Money transfer records (Western Union, MoneyGram, Zelle, Venmo)
- Prior year tax returns (even if you didn’t report all income)
- Business receipts or ledgers
- Customer lists or appointment books
Statements from people who know about your income:
- Letter from your employer (even handwritten on plain paper)
- Statements from co-workers
- Statements from customers or clients
- Your own sworn statement about what you earn
Hypothetical Example: Imagine Maria works cleaning houses and earns $600 per week in cash. She was injured in a car accident and missed 6 weeks of work ($3,600 in lost wages). To prove her income, Maria could provide:
- Bank deposit records showing weekly cash deposits
- Statements from three regular customers saying they paid her $100-$150 per cleaning
- Her own detailed statement about her work schedule
- Her rent receipts showing she could afford $1,200/month rent
In this hypothetical, Maria could recover $2,880 in lost wages (80% of $3,600) through no-fault insurance, plus all medical bills paid.
Common No-Fault Insurance Denials (And How to Fight Them)
Insurance companies deny no-fault claims for technical reasons, hoping you’ll give up. Here are the most common denials and how to overcome them:
Denial Reason #1: “You filed too late”
- Reality: You filed within 30 days, but they’re lying or claiming they never received it
- Solution: Always send no-fault forms by certified mail with return receipt, or have your lawyer file electronically with proof. If you genuinely filed late, there may be extensions for hospitalization or other reasons—a lawyer can help
Denial Reason #2: “Treatment not medically necessary”
- Reality: Insurance hired their own doctor who reviewed your records (without examining you) and claimed you don’t need treatment
- Solution: Your treating doctors must write detailed letters explaining why treatment is necessary. A lawyer can coordinate this.
Denial Reason #3: “Pre-existing condition”
- Reality: You had back pain or neck pain before, so insurance claims the accident didn’t cause your current problems
- Solution: Medical records comparing your condition before and after the accident, plus detailed doctor explanations. Important: Pre-existing conditions that are made worse by accidents still qualify for benefits.
Denial Reason #4: “Failure to attend Independent Medical Examination (IME)”
- Reality: Insurance demanded you see their doctor in a process called an “IME,” and you missed the appointment
- Solution: These exams are required. You will need to attend an IME but you have rights:
- You can bring someone with you
- You can request interpretation services
- You can record the examination
- Insurance must give reasonable notice and schedule exams near your home
- If the appointment was impossible to attend (you were hospitalized, no childcare, etc.), you may be able to reschedule
Denial Reason #5: “You didn’t respond to verification requests”
- Reality: Insurance sent you forms or letters demanding information, and you didn’t respond
- Solution: Open ALL mail from insurance companies immediately. If you don’t understand it, bring it to a lawyer that day. Many denials happen because:
- Forms were sent to wrong address
- Forms were in English and you couldn’t read them
- You didn’t realize they were important
Special No-Fault Rules for 2025
New Documentation Requirements: Insurance companies now demand more detailed medical records. Your doctor must:
- Clearly link each injury to the car accident
- Use specific diagnostic codes
- Write narrative explanations, not just check boxes
- Document your complaints at every visit
Choose doctors experienced with no-fault insurance cases. Many Bronx doctors understand these requirements.
Telemedicine Restrictions: During COVID, many people saw doctors by video call. Insurance companies now often refuse to pay for telemedicine appointments unless:
- You physically cannot travel to the doctor
- You’ve already had in-person visits establishing the injury
- The video visit is for medication management only
Increased IME Demands: In 2025, insurance companies schedule “Independent Medical Examinations” faster and more frequently. These doctors are not actually ‘independent.’ They’re doctors hired by the insurance company who usually say you’re not really injured.
Before your IME:
- Bring all medical records
- Bring someone with you as a witness
- Describe all your pain and limitations honestly
- Don’t exaggerate, but don’t minimize either
- The doctor may seem nice, but they work for the insurance company
When No-Fault Insurance Isn’t Enough
$50,000 sounds like a lot of money, but it disappears quickly with serious injuries:
- One week in the hospital can cost $30,000-$50,000
- Surgery costs $15,000-$100,000
- Physical therapy for months costs over $10,000
- Lost wages for 6 months at $2,000/month = $12,000
If your medical bills and lost wages exceed $50,000, or if you have permanent injuries, you need to file a personal injury lawsuit against the at-fault driver for full compensation.
You can receive both:
- No-fault benefits up to $50,000 (paid quickly)
- Personal injury compensation from the at-fault driver (paid after settlement or trial)
No-fault benefits don’t reduce your personal injury claim. You get both.
How the Law Office of Steven Louros Helps with No-Fault Claims
Many Bronx families struggle with no-fault insurance because:
- Forms are confusing
- Deadlines are strict
- Insurance companies use technical language
- Medical providers don’t fill out forms correctly
- English-only paperwork excludes non-English speakers
We provide free help with:
No-Fault Application Filing:
- We complete all forms correctly in your language
- We submit forms with proof of filing
- We meet all deadlines
- We coordinate with your medical providers
Fighting Denials:
- We appeal unfair denials
- We gather medical evidence
- We document your lost income from any source
- We represent you at IME appointments
- We force insurance companies to pay what they owe
Maximizing Benefits:
- We identify all available insurance policies
- We help you see the right doctors who document properly
- We calculate your full lost income (including cash work)
Pursuing Additional Compensation:
- We recover compensation for pain, suffering, and permanent disability
- We’ve recovered over $500 million for injured New Yorkers
Your Questions Answered
Q: I don’t have car insurance. Can I still get no-fault benefits? A: Yes. You claim through the insurance of the car that hit you or the car you were in. If neither car is insured, there are special state funds for uninsured drivers.
Q: I’m undocumented. Will filing a no-fault claim cause immigration problems? A: No. Personal injury law and immigration law are completely separate. We’ve helped thousands of undocumented families recover no-fault benefits with zero immigration consequences.
Q: My employer pays me cash. Can I still recover lost wages? A: Yes. We help workers without pay stubs document their income through bank records, employer letters, and other evidence.
Q: How long does it take to receive no-fault payments? A: Insurance must pay approved medical bills within 30 days of receiving properly completed forms. Lost wage payments follow the same timeline.
Q: The insurance company is calling me with questions. What should I say? A: Say: “My lawyer will contact you” or “Send your questions in writing to my lawyer.” Don’t answer insurance company questions without legal help.
Q: I already settled my no-fault claim for $10,000. Can I still sue for more? A: Maybe. If you settled only the property damage claim, you can still pursue injury claims. If you signed a full release of all claims, you cannot. This is why you should never sign anything without a lawyer reviewing it first.
Free Consultation—In Your Language
Don’t navigate the complicated no-fault insurance system alone. The Law Office of Steven Louros offers:
Free consultations with no obligation Service in Chinese (中文), Korean (한국어), Spanish (Español), and English No fees unless we win your case Over 50 years serving Bronx families Over $500 million recovered for injured New Yorkers
We understand the Bronx because we’ve been part of this community for half a century. We know the hospitals, and the challenges working families face, and how to fight insurance companies that try to deny claims from immigrants and low-income workers.
Contact us today:
- Call: (212) 481-5275
- Visit: 1261 Broadway, Suite 507, New York, NY 10001
- Online: www.LourosLawNY.com
Your family deserves every benefit the law provides. Let us help you get it.
