In New York, you can step outside the no-fault system and sue the at-fault party for pain and suffering only if your injuries meet the “serious injury” threshold under the law. Otherwise, your recovery is limited to no-fault (PIP) benefits for medical expenses and lost wages. At Campbell & Associates, our car accident lawyers in Buffalo can examine the injuries you sustained in the crash and help determine whether your case qualifies to pursue full compensation beyond no-fault limits.
What is New York’s No-Fault Auto Insurance System?
New York follows a no-fault insurance system, meaning your own insurance pays for basic economic losses after a crash, regardless of who caused it. Personal Injury Protection (PIP) typically covers medical expenses, a portion of lost income, and certain out-of-pocket costs. This system is designed to provide quick access to benefits without requiring you to file a lawsuit.
When Can You Step Outside The No-Fault System and File a Lawsuit Instead?
You can step outside the no-fault system when your injuries meet the serious injury threshold defined in N.Y. Insurance Law § 5102(d). Qualifying categories include:
- Lasting disfigurement
- Fractures
- Serious limits on how your body functions
- Permanent limitation or loss of a body part
- A medically determined injury that disrupts your daily life for at least 90 of the first 180 days following the car accident
If your injuries fall into one of these categories, you may pursue an at-fault claim for pain and suffering and other non-economic losses you suffered in the crash.
How Do Courts in Buffalo Decide If an Injury Qualifies?
Meeting the serious injury threshold is not automatic. Insurance providers are known for challenging whether an injury meets the legal definition. Likewise, plaintiffs must have objective medical proof to support claims of serious injury. This means:
- Subjective complaints of pain won’t suffice
- Medical imaging, physician findings, and documented limitations are crucial
- Consistent treatment helps establish credibility
Courts look closely at both the medical records and how your injuries impact your daily life.
Why Do Claims Fail to Meet The Threshold?
Many accident victims assume their injuries qualify, but claims are frequently denied due to gaps in proof. Common issues include:
- Delayed medical treatment
- Lack of objective medical findings
- Incomplete documentation of limitations
- Gaps in care that insurers use to question the injury’s severity
In Buffalo cases, insurers frequently use these gaps to argue that injuries are minor, even when they’re not.
What Compensation Becomes Available If Your Injuries Qualify?
If you meet the serious injury threshold, you can pursue compensation beyond no-fault benefits, including:
- Pain and suffering
- Full lost income (not just PIP limits)
- Future medical expenses
- Long-term impact on your quality of life
This can significantly increase the value of your claim compared to no-fault benefits alone.
How Our Car Accident Lawyers in Buffalo Can Assist With Your Claim
Our Buffalo car accident attorneys will focus on building the medical and legal foundation needed to meet the serious injury threshold. That starts with identifying whether your injuries qualify and making sure the right evidence is developed early. This includes:
- Coordinating medical documentation that meets the legal standards
- Working with physicians to document objective findings
- Addressing gaps in treatment that insurers may use against you
- Presenting a clear connection between the crash and your injuries
They’ll also deal with insurance challenges directly, positioning your claim to move beyond no-fault limitations and into full compensation territory.
Step Outside The No-Fault System With Guidance From Our Car Accident Attorneys in Buffalo
To learn more about how our legal team at Campbell & Associates can help and arrange your complimentary consultation, call 716-992-2222 or send us a message online.
