Ensuring the At-Fault Party’s Insurer Accepts Liability for Medical Expenses in New York

Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a qualified attorney to discuss your particular circumstances.

Detailed Answer

In New York, after a motor vehicle accident caused by another driver, you can recover medical expenses through:

1. No-Fault (PIP) Benefits: Under Insurance Law § 5102, you may claim up to $50,000 in Personal Injury Protection (PIP) benefits from your own insurer regardless of fault. File your PIP claim within 30 days of the accident and submit:
• A fully completed PIP claim form;
• All medical bills and treatment records;
• A doctor’s certification of necessity for treatment.
2. Third-Party Liability Claim: Once you exhaust or reach the no-fault limits, or when your injuries qualify for a liability claim (e.g., serious injury as defined in CPLR § 5104), you can demand payment from the at-fault driver’s insurer. To ensure acceptance of liability:
• Gather strong evidence: accident reports, witness statements, photos of vehicle damage, and all medical documentation.
• Send a formal demand letter by certified mail. Detail the facts, injuries, itemize medical bills, and cite Insurance Law § 5102 (PIP) and Insurance Law § 5103 (liability) obligations.
• Include an authorization allowing the insurer to request and review your medical records.
• Allow 30 days for the insurer to respond. If it issues a reservation of rights or denial, review the stated reasons and address any deficiencies promptly.
• If liability remains disputed, file a lawsuit in New York Supreme Court before the three-year statute of limitations expires (CPLR § 214).

By completing each step thoroughly and maintaining clear records, you maximize your chance that the at-fault insurer will accept liability for your medical expenses.

Helpful Hints

• Seek immediate medical treatment to document injuries contemporaneously.
• Keep a detailed treatment journal: dates, providers, procedures, and out-of-pocket costs.
• Obtain the at-fault driver’s insurance information at the scene.
• File your PIP claim within 30 days to avoid denial under Insurance Law § 5102.
• Use certified mail or a trackable delivery method for all demand letters.
• Preserve all correspondence with insurers—phone logs, emails, letters.
• Consider hiring a personal injury attorney if the insurer delays or denies payment.
• Monitor statute of limitations deadlines to preserve your right to sue (CPLR § 214).