Auto Accidents

Auto accidents are a fact of life, but when they occur they can result in serious injury, lost wages, property damage and additional personal expenses. If you are involved in a auto accident, follow the checklist below:

  1. Get move yourself to safety, if you cannot move then put your hazard lights on. Move your car out of traffic, if you can safely do so.
  2. Call the police or if the accident is serious call 911. Make sure you get a copy of the police report.
  3. Seek medical attention as soon as possible
  4. Call Gelbman Legal Group.

It is a good idea to take pictures of all the damage to your car as well as of your injuries. Exercise caution and don’t endanger yourself in traffic when taking pictures.

New York is a No-Fault State

New York in a ‘No-Fault’ state. That means you file your claim with the insurance carrier for the vehicle you were in (usually your own insurer) or the insurer of the vehicle that struck you if you are a pedestrian regardless is at fault for the accident. No-Fault covers economic losses such as medical expenses, lost earnings and other reasonable and necessary expenses incurred as a result of a motor vehicle accident. The basic No-Fault coverage is $50,000 per injured person.

You must report your claim and file a No-Fault application with the insurance carrier. The law requires that you must notify the No-Fault Carrier, in writing, of your claim, and identify yourself and the time, place and circumstances of the accident. You must file your claim application as soon as reasonably practicable, but no more than 30 days after the date of the accident. Failure to file the claim application in a timely manner may result in a denial of benefits. Usually, the No-Fault insurance carrier will mail you the necessary forms directly. Gelbman Legal Group can provide you with the application form and assist you with filing the it.

Once your No-Fault application has been filed, the No-Fault insurance carrier is responsible for the medical bills resulting from the accident (assuming the bills are submitted on time.) Make sure you give your doctor the name and address of the No-Fault insurance carrier and your claim number and have them submit their bills directly to the insurer for payment. Any bills you get for medical treatment related to the accident should be sent to the No-Fault carrier. In either case, medical bills must be submitted to the insurance carrier within 45 days of treatment

In addition to medical bills, No-Fault generally pays a maximum of $25 per day for all non-medical expenses for up to one year after an accident. Non-medical expenses include, but are not limited to, cost of transportation to and from medical appointments, household help and childcare. You document all non-medical expenses in order to be compensated. However, your specific policy may provide for “additional” coverage. Typical No-Fault coverage includes:

  • 80% of your normal lost wages up to $2000.00 per month for up to three [3] years after the accident,
  • Prescriptions for accident related injuries,
  • Travel expenses for accident related medical treatment, and
  • Household help, if your doctor prescribes such help as necessary while you are recovering from your injuries – including costs of child care while you visit medical providers.

You May Also Be Eligible for NYS Disability

You may also be eligible for New York State Disability Benefits to cover those parts of your wages not reimbursed by the No-Fault insurer. NYS Disability is available for up to 26 weeks after a 1 week waiting period and will cover up to 50% of your normal wages up to $170.00 per week.

Options If Your Claims Are Not Paid

What if the insurer denies your claim? If you and your doctor feel that you were unfairly denied No-Fault benefits, you demand arbitration by an independent arbitrator to determine whether the denial was justified. If the arbitrator finds that the denial was not justified, they will specify what benefits should be paid and for what period of time. It is important to remember that the arbitrator can only rule on medical bills and lost wages that were submitted and denied by the No-Fault carrier so you should continue to submit your medical bills to the insurer. To claim lost wage benefits, your doctors must continue to document that you are disabledand cannot work. You must begin the arbitration process no later than six years from the date of the accident. Generally, you resolve your claims for personal injuries against the other driver before filing for arbitration because the arbitration decision may affect the evidence that you are allowed to present in your case against the at-fault driver.

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