New York’s automobile-insurance system separates first-party no-fault benefits from a liability claim against the person or entity that caused the collision. Understanding that distinction is essential, because the two claims involve different benefits, proof, deadlines, and legal standards. New York also enacted significant motor-vehicle liability changes effective May 26, 2026, which make older online explanations inaccurate for newly commenced actions.
What Is New York No-Fault Insurance?
No-fault insurance, also called Personal Injury Protection or PIP, is designed to pay qualifying economic losses promptly without first deciding which driver was negligent. Basic no-fault coverage generally provides up to $50,000 per eligible injured person for combined basic economic loss arising from the use or operation of a motor vehicle, under Insurance Law § 5102(a). Within that limit, basic economic loss generally includes reasonable and necessary accident-related medical and rehabilitation expenses, 80% of lost earnings up to $2,000 per month for as long as three years, and up to $25 per day for certain other reasonable and necessary expenses for up to one year. Policy terms, statutory offsets, deductibles, eligibility rules, and available additional coverage can affect the amount actually paid.
No-Fault Does Not Pay for Every Loss
No-fault is personal-injury coverage. It does not pay to repair the damaged vehicle, and it does not by itself compensate an injured person for pain, suffering, emotional harm, or loss of enjoyment of life. Property damage is generally handled through collision coverage or a property-damage claim, while non-economic damages ordinarily require a liability claim and satisfaction of New York’s serious-injury requirement.
The 30-, 45-, and 90-Day No-Fault Timeframes
Under 11 NYCRR 65-1.1, written notice of the no-fault claim generally must be provided within 30 days after the accident. Medical bills are generally subject to a 45-day submission period, and proof of lost earnings and certain other expenses is generally subject to a 90-day period. The regulation contains provisions addressing justified late submissions, but a claimant should not rely on an exception when timely filing is possible.
What Is the Serious Injury Threshold?
For a covered person seeking non-economic damages from another covered person for negligence in the use or operation of a motor vehicle in New York, Insurance Law § 5104 generally requires a “serious injury.” The current definition in Insurance Law § 5102(d) includes a personal injury which results in:
- Death;
- Dismemberment;
- Significant disfigurement;
- A fracture;
- Loss of a fetus;
- Permanent loss of use of a body organ, member, function, or system;
- Permanent consequential limitation of use of a body organ or member; or
- Significant limitation of use of a body function or system.
The legal question is not resolved simply by using one of these phrases in a medical record or a complaint. The injury category, accident causation, medical history, objective findings, course of treatment, claimed limitations, and defense medical evidence may all become disputed.
The 2026 Change: The 90/180-Day Category Was Deleted
For decades the statutory definition also included a medically determined injury or impairment of a nonpermanent nature that prevented the injured person from performing substantially all of the material acts constituting that person’s usual and customary daily activities for not less than 90 days during the 180 days immediately following the occurrence. Part EE of Chapter 58 of the Laws of 2026 deleted that category from Insurance Law § 5102(d). The amendment took effect May 26, 2026 and applies to actions and proceedings commenced on or after that date.
A website that still lists the 90/180-day category as part of the current New York serious-injury definition is using outdated statutory language for any action governed by the 2026 amendment. The eight categories listed above are what remain. The practical effect falls hardest on claimants whose injuries were seriously disabling for months but ultimately resolved. Those claims frequently proceeded under the 90/180-day category. They must now satisfy one of the eight remaining categories.
A Second 2026 Change: Fault Is Now Decided First
Part EE also amended Insurance Law § 5104(a). In an action to recover damages for non-economic loss under Article 51, liability for non-economic loss cannot be fixed unless and until the trier of fact has determined the existence of a serious injury — and the trier of fact must first determine the party or parties at fault before determining whether an injury is a serious injury.
This sequencing requirement operates together with the new comparative-fault bar discussed in Article 4. Where a jury allocates fault to the claimant beyond the statutory line, the case can end at that point, before the threshold or damages are ever reached. Fault investigation has therefore moved to the front of a New York automobile case rather than sitting alongside the medical proof. Older commentary describing fault and the serious-injury threshold as parallel, independent questions no longer describes New York procedure accurately. The order in which they are decided is now fixed by statute, and it can be outcome-determinative.
No-Fault Benefits and a Liability Lawsuit Can Proceed at the Same Time
An injured person may receive no-fault benefits while a liability claim is investigated. The no-fault carrier focuses on first-party economic benefits and may require applications, medical verification, examinations, or wage proof. The liability carrier focuses on fault, serious injury, damages, policy limits, and defenses. Payment of a medical bill by no-fault does not establish that another driver was negligent, and a liability dispute does not automatically eliminate properly payable no-fault benefits.
What Evidence Commonly Matters?
The claim should be organized around accurate evidence: emergency records, diagnostic testing, specialist findings, prior medical records involving the same body part, treatment recommendations, work restrictions, proof of income loss, photographs, witness evidence, and a clear chronology. Treatment decisions belong to the patient and the medical provider. From a legal perspective, unexplained gaps, inconsistent histories, or unsupported assumptions may create disputes that are easier to address when identified early.
Frequently Asked Questions
Does a fracture automatically satisfy the serious-injury definition?
A fracture is one of the listed statutory categories. Other issues may remain, including whether the fracture was caused by the accident, whether the claimant is a covered person, comparative fault, damages, insurance coverage, and whether the action is timely.
Can I recover pain-and-suffering damages if no-fault paid my bills?
No-fault payment and a pain-and-suffering claim are separate issues. In a covered New York motor-vehicle negligence action, non-economic damages generally require proof of a statutory serious injury, along with liability and causation — and, in an action commenced on or after May 26, 2026, a fault allocation that does not bar recovery under CPLR § 1411(b).
Which law applies if my accident happened before May 2026?
Part EE applies to actions and proceedings commenced on or after May 26, 2026. An accident that predates the amendment can still be governed by the new rules if the action is commenced after that date. The filing date, accident date, parties, coverage status, and procedural posture should all be reviewed before deciding which version controls a particular matter.
ARAVANA LAW — WE DO JUSTICE.
This article is general information, not legal advice. It is based on authorities verified through July 25, 2026. The 2026 amendments are new and will be construed by the courts; new legislation, regulations, judicial decisions, or case-specific facts may change the analysis. Reading this article does not create an attorney-client relationship.
OFFICIAL AUTHORITIES REVIEWED
- New York Insurance Law § 5102 — Definitions, including § 5102(d)
- New York Insurance Law § 5104 — Causes of action for personal injury, including new § 5104(d)
- NYS DFS Insurance Circular Letter No. 3 (2026) — 2026 Motor Vehicle Insurance Reforms
- New York Senate Bill S9008-C, Part EE — Chapter 58 of the Laws of 2026, signed May 26, 2026
- 11 NYCRR 65-1.1 (Regulation 68) — no-fault claim procedure (NYCRR index)
- NYS DFS — Auto Insurance Resource Center
- NYS DFS — Filing Claims Under Your Own Policy
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