Queens is home to some of the busiest and most dangerous roadways in New York City. High-speed traffic on the Long Island Expressway, congestion along Queens Boulevard, and heavy airport traffic near the Van Wyck Expressway contribute to thousands of crashes every year.
New York’s no-fault insurance system provides limited coverage for car accident victims in New York. But you may be eligible to seek additional compensation if your injuries meet the serious injury threshold.
The Queens car accident lawyers at Wingate, Russotti, Shapiro, Moses & Halperin, LLP have spent more than 50 years helping injured New Yorkers pursue compensation after serious motor vehicle accidents. We can review your case and advise you on the best strategy for pursuing maximum compensation.
Understanding New York’s No-Fault Insurance System
New York operates under a no-fault insurance system for car accidents. This means injured drivers and passengers typically seek initial compensation through Personal Injury Protection (PIP) benefits regardless of who caused the crash.
No-fault benefits may help cover:
- Medical expenses
- Lost wages
- Transportation costs related to treatment
- Certain out-of-pocket expenses
What Is the Serious Injury Threshold?
Under Insurance Law §5102(d), an injured person must demonstrate they suffered a qualifying serious injury before pursuing a personal injury lawsuit seeking additional compensation. This may include damages for:
- Pain and suffering
- Emotional distress
- Loss of enjoyment of life
- Future medical expenses
- Medical expenses not covered by no-fault insurance
- Lost wages beyond no-fault limits
- Loss of future earning capacity
- Rehabilitation costs
- Long-term care expenses
- Permanent disability or disfigurement damages
- Household assistance expenses
- Transportation costs related to treatment
Which Injuries Qualify as “Serious Injuries”?
New York law identifies several categories of injuries that may satisfy the threshold requirement. Examples include:
- Bone fractures
- Significant disfigurement
- Permanent loss of use of a body organ
- Permanent consequential limitation of use
- Significant limitation of the use of a body function or system
- Loss of a fetus
- Death
Permanent or Significant Limitations
Many accident victims suffer spinal injuries, herniated discs, nerve damage, or joint injuries that substantially limit mobility and daily functioning. To satisfy the threshold, victims often must demonstrate:
- Reduced range of motion
- Persistent pain
- Physical limitations
- Objective medical findings
- Long-term impairment
The 90/180-Day Category
Another important category involves injuries substantially preventing the victim from performing all normal daily activities for at least 90 out of the first 180 days following the accident. This is commonly referred to as the 90/180 rule.
Factors that may qualify car accident victims for the 90/180 rule include:
- Inability to work
- Difficulty walking or driving
- Inability to care for children
- Significant restrictions on daily routines
Why Insurance Companies Dispute Threshold Claims
Insurance companies aggressively defend no-fault insurance threshold claims because serious injury findings may expose them to significant financial liability. Common defense arguments include:
- The injuries were pre-existing
- The injuries are degenerative rather than accident-related
- Treatment was excessive or unnecessary
- Diagnostic findings are minor
- The victim recovered quickly
- The limitations are subjective rather than objective
Insurers often hire their own medical experts to review records and dispute the severity of injuries. Because of these tactics, accident victims should seek legal representation early in the claims process.
The Importance of Medical Documentation
Medical evidence is one of the most important factors in proving serious car accident injury claims. Engaging in a consistent treatment regimen and timely follow-up care can significantly strengthen your claim.
Effective documentation of your medical treatment may include:
- MRI results
- CT scans
- X-rays
- Surgical records
- Physical therapy notes
- Range-of-motion testing
- Physician narratives
- Pain management records
Steps To Take After a Queens Car Accident
The actions you take after a collision may significantly affect your ability to pursue compensation later.
- Seek Immediate Medical Care. Even injuries that initially seem minor may worsen over time. Seeking prompt medical evaluation protects your health, creates documentation connecting injuries to the accident, and helps establish the seriousness of your condition.
Delaying treatment may allow insurers to argue that your injuries were unrelated or not severe.
- Report the Accident. Always report the crash to law enforcement and, if possible, obtain a copy of the police report. The report may contain witness information, initial fault assessments, driver statements, and insurance information.
- Document the Scene. If possible, gather photos of vehicle damage, images of injuries, witness contact information, and roadway conditions. This evidence may become harder to obtain over time.
- Follow Your Treatment Plan. Insurance companies scrutinize treatment gaps closely. Following medical recommendations consistently will bolster your claim and help demonstrate the ongoing impact of your injuries.
- Speak With an Experienced Attorney. Meeting the serious injury threshold for a car accident usually requires detailed legal and medical preparation.
How a Car Accident Lawyer Can Help
Meeting New York’s serious injury threshold can be challenging, especially when insurance companies aggressively dispute the severity of injuries or argue that medical conditions existed before the accident.
An experienced attorney understands how to build a strong case supported by medical records, diagnostic imaging, and expert testimony that clearly demonstrates the impact of the injuries on the victim’s daily life.
In serious cases involving permanent limitations, fractures, or long-term disabilities, an attorney can pursue compensation for medical expenses and other losses, such as lost income, while preparing the case for trial if necessary. An attorney can:
- Investigate the crash
- Gather medical evidence
- Work with expert witnesses
- Negotiate with insurers
- Prepare the case for litigation if necessary
Speak With a Trusted Car Accident Lawyer in Queens
At Wingate, Russotti, Shapiro, Moses & Halperin, LLP, our attorneys have recovered more than $2 billion for injured clients. In fact, we’ve spent over 50 years advocating for accident victims throughout New York City.
Call (212) 986-7353 for a free consultation today.
FAQs About the New York Serious Car Accident Injury Threshold
What is the serious injury threshold in a New York car accident case?
The serious injury threshold car accident requirement is part of New York Insurance Law §5102(d). Under this law, accident victims generally must prove they suffered a qualifying “serious injury” before they can file a lawsuit seeking pain and suffering compensation and other non-economic damages outside the no-fault insurance system.
What injuries qualify under Law 5102(d) serious injury standards?
Several types of injuries may satisfy the Law 5102(d) serious injury requirement, including fractures, significant disfigurement, permanent loss or limitation of a body function, and injuries that substantially limit daily activities for at least 90 out of the first 180 days following the accident.
Why do insurance companies dispute serious injury claims?
Insurance companies often challenge no-fault insurance threshold claims to avoid paying larger settlements or verdicts. Insurers may argue that the injuries are minor, pre-existing, degenerative, or unrelated to the accident.
How can I prove a serious injury after a Queens car accident?
Proving serious injury car accident claims usually requires strong medical documentation and objective evidence. Important evidence may include MRI results, CT scans, X-rays, physician reports, range-of-motion testing, and testimony from medical professionals. Consistent treatment and timely medical care are also important because delays may weaken the claim.