Consumers Warned to be Wary of New Rules in No-fault Auto Accident Claims

New York City, NY � As snow, sleet, and freezing rain sweep across New York, automobile accidents become an increasing danger. The New York State Trial Lawyers Association warns that new State insurance regulations could leave unwary New Yorkers who are involved in an accident out in the cold.

New York's automobile "no-fault" law requires an insurance company to pay drivers, passengers and pedestrians up to $50,000 for legitimate accident-related medical expenses, lost earnings and incidental costs, no matter who is to blame. The purpose of this law is to speed compensation without lengthy and expensive legal battles over fault and money owed.

But in April 2002, a revised New York State insurance regulation set a number of traps that could deny consumers the no-fault compensation to which they are entitled. In October, the State's highest court upheld these changes. NYSTLA therefore warns those injured in an auto accident to be aware of these new rules in order to avoid having benefits claims denied.

To avoid benefits claims denial, NYSTLA offers the following "Consumer Tips":

THREE IMPORTANT TIPS TO FILING BENEFIT CLAIMS UNDER NEW NY INSURANCE RULES

1) To claim no-fault benefits, you still must send a Notice of Accident form (the NF-2) to the insurer of the car you were in when the accident occurred. Pedestrians should still send it to the insurer of the vehicle that hit them. But now you get only 30 calendar days after the accident to send this notice, down from 90 days previously.

If you are in an accident, it is now especially crucial not to delay sending this form! Some people put this off, thinking maybe their injuries will heal on their own. Or they wait and send the NF-2 only after they belatedly learn that their health plan doesn't cover auto accident injuries (most don't). Many people mistakenly think the insurance for the car that caused the accident is supposed to pay, so they lose time by sending it there first.

The very short notice deadline can cause trouble for any accident victim who doesn't find out the identity of the responsible insurer right away. Some examples of how this can occur: If you were a pedestrian, it could take weeks to get a police accident report, which includes the insurance company and policy number. Thousands of New Yorkers are covered through the Assigned Risk Plan, and if you are in an accident with such a driver, you may have to ask the Plan for the name of the insurer.

If the driver of the car in which you were riding is uncooperative, you may have to determine his or her insurer through a time-consuming Department of Motor Vehicles registration search.

The new regulations do allow you to provide written proof of a "clear or reasonable" reason for missing the deadline, BUT you shouldn't count too much on this provision helping you. Insurers are largely allowed to define what is meant by "clear and reasonable." Since they're the ones who would have to pay, they'll look at your excuse very skeptically.

2) If you or your lawyer can't identify the insurer on time, at least send a notice right away to the New York State Motor Vehicle Accident Indemnification Corporation. The MVAIC is where accident victims file a claim if they do not have an insurance policy and are injured by or while riding in an uninsured vehicle or by a hit and run driver. It's not likely that the MVAIC will pay you benefits, but filing with them could help make the case that you did everything possible to notify "a" carrier within 30 days.

3) If you are claiming lost earnings, make sure your employer sends proof to the insurer on time. Another change affects filing for lost earnings benefits. Basic no-fault coverage entitles you to receive 80% of your accident-related lost earnings for up to $2,000 a month paid over a maximum of three years. Under the previous regulation, there was no specific time period for when your employer had to send the insurer proof of your wages, disability and loss of income. Now the employer must do so within 90 days of the accident. If you are claiming lost earnings, you may need to hound your boss to get this information to the insurer on time. Remember, it's you, not your employer, who is penalized for missing this new deadline.

The New York State Insurance Department says it wrote these new rules to better combat no-fault insurance fraud. However, the New York State Trial Lawyers argues that there are much better ways to fight fraud and that these new rules make it much easier for insurance companies to deny benefits to honest people injured in unfortunate accidents. The New York State Trial Lawyers Association will continue its fight to change these rules while informing consumers of the new steps they must take to insure that they and their loved ones are compensated in the case of an automobile accident.

This is one in a series of consumer tips from the New York State Trial Lawyers Association. For further information, visit www.nystla.org.

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DISCLAIMER: The above statements do not constitute legal advice. Consumers may wish to consult a lawyer for advice on individual situations.