How to Handle Your Medical Bills After a New York Car Accident
A car accident can leave you with unexpected injuries and overwhelming medical bills. In New York, the no-fault insurance system determines how medical expenses are covered, regardless of who was responsible for the accident. However, there are limitations to this coverage, and if your medical costs exceed what your Personal Injury Protection (PIP) covers, you may be left wondering what your next steps should be.
By understanding your options, you can ensure that your medical bills are covered and that you don’t end up paying out of pocket for expenses that should be covered by insurance or legal compensation.
Understanding New York’s No-Fault Insurance System
What is No-Fault Insurance?
New York is one of several states that operate under a no-fault insurance system. This means that after a car accident, your own insurance policy will cover your medical expenses, regardless of who was responsible for the crash.
The primary goal of no-fault insurance is to:
- Ensure quick medical treatment without waiting for fault to be determined
- Reduce the number of lawsuits for minor injuries
- Provide basic financial protection to all drivers, regardless of fault
Each driver is required by law to carry Personal Injury Protection (PIP) coverage, which helps pay for medical expenses, lost wages, and other accident-related costs.
How No-Fault Insurance Covers Medical Bills
If you’re injured in a car accident in New York, your PIP coverage will pay for:
- Emergency medical care (ambulance rides, ER visits, surgery)
- Hospital stays and treatments
- Doctor visits and follow-ups
- Rehabilitation and physical therapy
- Medications and medical equipment
- Diagnostic tests (X-rays, MRIs, CT scans, etc.)
- Transportation costs to and from medical appointments
- Lost wages (if you’re unable to work)
This coverage applies regardless of who was at fault in the accident, which means you can receive treatment immediately without having to establish who was responsible.
PIP Coverage Limits in New York
While PIP coverage is helpful, it is not unlimited. New York state law requires drivers to carry a minimum of $50,000 in PIP coverage per person, which includes:
- Medical expenses up to $50,000
- Lost wages (up to 80% of your salary, with a cap of $2,000 per month)
- Daily expense reimbursement (up to $25 per day for household or transportation costs)
If your medical bills exceed this limit, you will need to explore other options to pay for your remaining expenses.
What If My Medical Bills Exceed My PIP Coverage?
PIP insurance is meant to cover minor to moderate injuries, but serious injuries often result in medical expenses that far exceed the $50,000 PIP limit. If this happens, you have several options:
Using Health Insurance to Cover Medical Bills
Once your PIP benefits are exhausted, your health insurance may cover additional medical expenses. However, there are a few things to consider:
- Not all health insurance plans cover auto accidents. Some policies specifically exclude car accident-related injuries, so you’ll need to check with your provider.
- Deductibles and co-pays may still apply. Your health insurance may cover additional expenses, but you may be responsible for out-of-pocket costs like co-pays and deductibles.
- Health insurance companies may seek reimbursement. If you receive a settlement from the at-fault driver, your health insurer may place a lien on your settlement to recover the costs they paid for your medical treatment.
Filing a Claim Against the At-Fault Driver
If your injuries are severe and exceed your PIP coverage, you may be able to file a personal injury claim against the at-fault driver to recover additional compensation.
In New York, you can sue for medical expenses, lost wages, pain and suffering, and other damages if your injury meets the “serious injury threshold.”
To qualify for a lawsuit, you must prove that your injuries meet at least one of the following conditions:
- Bone fractures
- Significant disfigurement
- Permanent disability or loss of function in a body part
- Injuries that prevent you from performing daily activities for at least 90 out of 180 days
If your injuries qualify, you can file a lawsuit against the at-fault driver’s insurance company to recover compensation beyond your PIP benefits.
Negotiating Medical Bills with Hospitals and Providers
If you don’t have additional insurance and can’t sue the at-fault driver, you may be able to negotiate with medical providers to reduce your bills. Many hospitals and doctors offer:
- Payment plans that allow you to pay over time
- Medical bill reductions for uninsured or underinsured patients
- Hardship programs that offer financial assistance for low-income patients
Hospitals may also place a lien on your lawsuit settlement to recover unpaid medical bills if you win compensation.
How to File a No-Fault Insurance Claim in NY
Step-by-Step Guide
- Notify your insurance company within 30 days. Failing to report the accident in time can result in your claim being denied.
- Complete a No-Fault Application (NF-2 Form). This form is required to begin your claim process.
- Submit medical bills and records. Your insurer will need proof of treatment and accident-related expenses.
- Use no-fault-approved medical providers. Some doctors do not accept no-fault insurance, so always confirm before treatment.
- Follow up on claim approval. Insurance companies typically process no-fault claims within 30 to 45 days.
If your claim is denied, you have the right to appeal or hire an attorney to challenge the decision.
Can You Sue for Medical Bills After a Car Accident in New York?
Yes, but only under specific conditions. You can sue the at-fault driver if:
- Your injuries exceed PIP coverage
- Your injuries meet New York’s serious injury threshold
- The other driver was negligent
A lawsuit can help you recover:
- Additional medical expenses beyond PIP
- Future medical costs for ongoing care
- Pain and suffering damages
Filing a lawsuit is complex, and it’s highly recommended to consult with a personal injury attorney to maximize your compensation.
What to Do If Your No-Fault Claim Is Denied
If your no-fault insurance claim is denied, you have options:
- Request an appeal and submit additional medical records or proof
- Speak with a personal injury attorney to challenge the denial
- Consider filing a lawsuit if your claim was unfairly denied
Frequently Asked Questions About Medical Bills After a Car Accident in New York
Does no-fault insurance cover all my medical expenses?
No-fault insurance covers medical bills up to $50,000, including hospital visits, doctor’s appointments, and rehabilitation. However, if your medical expenses exceed this limit, you may need to use health insurance, sue the at-fault driver, or negotiate medical bills with your healthcare provider.
Can I choose my own doctor under PIP coverage?
Yes, but only if the doctor accepts no-fault insurance. Some healthcare providers do not accept PIP claims, so it’s important to confirm before seeking treatment. If your preferred doctor does not accept PIP, you may need to find an alternative provider or use your health insurance.
What happens if my no-fault insurance claim is denied?
If your claim is denied, you can file an appeal with your insurance company. This often requires submitting additional medical documentation or accident reports. If your insurer continues to deny your claim, consulting with a personal injury attorney may help you challenge the decision and recover your rightful benefits.
Can I use my health insurance to cover medical expenses after an accident?
Yes, health insurance can cover expenses beyond what no-fault insurance pays. However, some policies exclude auto accident injuries, so you should check with your insurer. If your health insurance does cover accident-related care, they may place a lien on any settlement you receive from the at-fault driver.
What if I don’t have health insurance and my PIP benefits run out?
If your PIP benefits run out and you don’t have health insurance, you may need to negotiate a payment plan with your healthcare provider. Some hospitals and doctors offer financial assistance programs for accident victims. If another driver was at fault for the accident, you may also be able to file a lawsuit to recover additional medical expenses.
Contact Marvin A. Cooper, P.C. Today
Dealing with medical bills after a car accident can be confusing and overwhelming. If you’re struggling with denied claims, unpaid bills, or lawsuits, an experienced attorney can help.
If you need legal assistance, contact Marvin A. Cooper, P.C. today for a free consultation to discuss your options.
