Is New York a No-Fault State? PIP, the Serious Injury Threshold, and When You Can Sue
State: New York · Reviewed: 2026-08-26 · By: NowAccident Editorial Team · Review: New York attorney review.
Here is the answer that confuses everyone: New York is both.
It is a no-fault state for paying your medical bills. It is an at-fault state for suing over pain and suffering. And a single statute — nine categories long — decides which world you live in.
Quick Answer
Yes, New York is a no-fault state. Every policy must carry at least $50,000 in Personal Injury Protection (PIP), which pays your medical bills and part of your lost wages regardless of who caused the crash. In exchange, you cannot sue the at-fault driver for pain and suffering unless your injury meets one of the nine "serious injury" categories in Insurance Law § 5102(d). If it does, New York applies pure comparative negligence (CPLR § 1411): your recovery is reduced by your fault percentage, never barred by it.
📝 Record your accident with NowAccident → — the threshold is proven with medical evidence, and medical evidence starts on day one.
What does no-fault actually pay?
Under Insurance Law § 5102, "basic economic loss" is capped at $50,000 per person:
| Benefit | Detail |
|---|---|
| Medical and rehabilitation expenses | Necessary and reasonable — hospital, surgery, imaging, physical therapy, prescriptions, psychiatric care |
| Lost earnings | 80% of actual income, capped at $2,000 per month, for up to three years |
| Other necessary expenses | Up to $25 per day for one year — transport to appointments, household help |
| Death benefit | $2,000 to the estate, in addition to the $50,000 |
Who pays? Not necessarily "your" insurer.
- Driver or passenger → the insurer of the vehicle you occupied
- Pedestrian or cyclist → the insurer of the vehicle that struck you
- Rideshare passenger → the rideshare company's commercial policy
- Motorcyclist → nobody. Motorcyclists are excluded from New York's no-fault system entirely and must rely on their own health insurance — but they may sue the at-fault driver from the first dollar, with no threshold.
The 30-day rule. Written notice — normally Form NF-2 — must reach the correct insurer within 30 days (11 NYCRR § 65-1.1). Miss it without a "clear and reasonable justification" and the entire claim can be denied.
What no-fault does NOT cover: damage to your vehicle, pain and suffering, wages above $2,000/month, and medical expenses above $50,000.
Can you buy more?
Yes, and few people do until it is too late.
- OBEL (Optional Basic Economic Loss) — an additional $25,000, which you can direct to whichever category you need: medical, wages, or other expenses.
- APIP (Additional Personal Injury Protection) — extends first-party coverage above the $50,000 basic limit, commonly in increments up to $100,000.
If you earn more than roughly $2,500 a month, the basic 80%/$2,000 formula will not replace your income. That gap is the strongest practical argument for OBEL or APIP.
The serious injury threshold: the nine gates
This is the most important paragraph in New York auto law.
Under Insurance Law § 5104, you may step outside no-fault and sue the at-fault driver for pain and suffering only if you sustained a "serious injury" as defined in § 5102(d). The statute lists nine categories:
| # | Category | Notes |
|---|---|---|
| 1 | Death | |
| 2 | Dismemberment | Loss of a limb or significant portion |
| 3 | Significant disfigurement | Scarring a reasonable person would view as unattractive or objectionable |
| 4 | Fracture | Any bone fracture — the clearest, most objective gate |
| 5 | Loss of a fetus | |
| 6 | Permanent loss of use of a body organ, member, function, or system | Courts read "loss of use" as total |
| 7 | Permanent consequential limitation of use of a body organ or member | |
| 8 | Significant limitation of use of a body function or system | The most litigated category |
| 9 | The 90/180 rule | A medically determined non-permanent injury preventing you from performing substantially all your usual daily activities for at least 90 of the 180 days immediately following the accident |
What clears the threshold reliably: fractures, surgical intervention, permanent measurable limitation, significant scarring.
What gets fought: soft-tissue injuries, herniated and bulging discs, sprains and strains. These fall into categories 7, 8, or 9, and they turn entirely on objective medical evidence — MRI findings, quantified range-of-motion testing, and a physician's contemporaneous documentation.
The two reasons cases die at the threshold stage:
- Gaps in treatment. A two-month break in physical therapy lets the defence argue you recovered.
- No objective findings. A pain diary is not a range-of-motion measurement.
Insurers routinely schedule an Independent Medical Examination (IME) with a physician of their choosing, specifically to generate an opinion that the threshold is not met. Failing to attend can terminate your benefits.
📝 Objective evidence begins the day of the crash →
What can you sue for once you clear the threshold?
Two things, and they are separate:
- Non-economic damages — pain and suffering, loss of enjoyment of life, emotional distress. Available only if the threshold is met.
- Economic losses exceeding basic economic loss — future medical care, long-term lost earnings, diminished earning capacity. These are recoverable to the extent they exceed the $50,000 PIP limit. (Motorcyclists, excluded from PIP, may sue from the first dollar.)
How is fault apportioned in a New York lawsuit?
Under CPLR § 1411, New York applies pure comparative negligence. Your damages are reduced by your percentage of fault, and never eliminated by it.
| Your fault | Recovery on a $200,000 claim |
|---|---|
| 0% | $200,000 |
| 20% | $160,000 |
| 50% | $100,000 |
| 80% | $40,000 |
Compare this to the four states plus D.C. — Alabama, Maryland, North Carolina, Virginia, and Washington D.C. — where 1% of fault bars recovery entirely, and to the majority of states where crossing 50% or 51% does the same.
New York is among the most plaintiff-friendly fault regimes in the country. Which is precisely why an adjuster's efficient move is not to deny liability, but to argue your percentage upward. That argument is defeated by photographs, witnesses, and a same-day note — not by indignation.
What insurance does New York require?
| Coverage | Minimum |
|---|---|
| Bodily injury liability, per person | $25,000 ($50,000 if death results) |
| Bodily injury liability, per accident | $50,000 ($100,000 if death results) |
| Property damage liability, per accident | $10,000 |
| Personal Injury Protection (PIP) | $50,000 per person |
| Uninsured motorist (UM), bodily injury | $25,000 / $50,000 |
Shorthand: 25/50/10, plus mandatory PIP and UM.
Two observations. First, the $10,000 property damage minimum is low — well under half the price of an average new vehicle. Second, UM coverage is mandatory in New York, unlike most states. It protects you against uninsured and hit-and-run drivers. UIM (underinsured) coverage — for drivers who have insurance but not enough — is optional and worth buying.
Does New York cap damages?
New York places no statutory cap on non-economic damages in ordinary auto negligence cases. Appellate courts do review awards for whether they "deviate materially from what would be reasonable compensation" under CPLR § 5501(c), which functions as a practical ceiling shaped by comparable cases rather than a fixed number.
The real ceiling in most claims is not a statute. It is the at-fault driver's policy limits.
Frequently Asked Questions
Is New York a no-fault state for car accidents? Yes for benefits — PIP pays regardless of fault. No for lawsuits — you may sue an at-fault driver if you clear the serious injury threshold.
What is the serious injury threshold in New York? The nine categories in Insurance Law § 5102(d): death, dismemberment, significant disfigurement, fracture, loss of a fetus, permanent loss of use, permanent consequential limitation, significant limitation, and the 90/180 rule.
Is a herniated disc a serious injury in New York? Not automatically. It must be supported by objective evidence — imaging plus quantified limitation of use — and it is one of the most heavily litigated questions in New York personal injury law.
Does no-fault cover my car repairs? No. PIP covers economic loss from bodily injury only. Vehicle damage is handled through collision coverage or a liability claim against the at-fault driver.
Do motorcyclists get no-fault benefits in New York? No. Motorcyclists are excluded from PIP and must use their own health insurance — but they may sue the at-fault driver for all damages without meeting the threshold.
Can I still recover if I was mostly at fault? Yes. Under CPLR § 1411, a plaintiff 80% at fault may still recover 20% of their damages, provided the threshold is met.
How long do I have to file a no-fault claim? Thirty days from the accident, in writing, to the correct insurer.
📝 The threshold is won or lost with medical evidence gathered early. Record your accident with NowAccident — free, three minutes.
Sources
- New York Insurance Law §§ 5102, 5104, 5106
- 11 NYCRR § 65-1.1 and Regulation 68
- New York CPLR §§ 1411, 5501(c)
- New York State Department of Financial Services — Minimum Auto Insurance Requirements
- New York Vehicle and Traffic Law, Article 6 (financial responsibility)
Disclaimer
This article provides general information about New York law as of the last updated date. It is not legal advice, not insurance advice, and does not create an attorney-client relationship. Whether a given injury meets the § 5102(d) serious injury threshold is a heavily litigated, fact-specific question decided on medical evidence. Coverage terms are governed solely by your policy. Consult a licensed New York attorney about your claim and verify current statutes on the New York State Senate's official statute site.
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General information only. NowAccident is not a law firm and does not provide legal advice. Rules and facts change; confirm current requirements with the cited government source or a qualified professional.