Detailed Answer
This explains how someone injured in an accident can recover past and ongoing medical and therapy costs under New York law. It is written for people with no legal background. This is general information and not legal advice. For guidance about your case, consult a licensed New York attorney.
Can medical and therapy costs be recovered?
Yes. In a New York personal injury claim based on negligence (for example, an auto collision or a slip-and-fall caused by someone else), you can pursue economic damages that cover past medical bills and the reasonable, foreseeable future costs of medical care and therapy related to the accident. These costs are commonly called “medical specials.” You may also be able to recover lost wages and other out-of-pocket expenses.
What must you prove to recover ongoing (future) treatment costs?
- Causation: That the treatment is related to the accident. Treating medical records and physician testimony that link the condition to the accident are essential.
- Necessity and reasonableness: That the recommended future treatment and therapy are medically necessary and reasonable in cost. Expert opinions (treating doctors, specialists, or life-care planners) usually establish this.
- Certainty: Courts require proof that future expenses can be estimated with reasonable certainty. You do not need absolute precision, but you must present a credible, evidence-based estimate.
- Present value: Because future costs occur over time, the claim will typically present the present cash value of anticipated future care so a jury or judge can award a lump-sum today.
How are future medical and therapy costs documented?
Common forms of proof include:
- Treatment notes and diagnosis from physicians, therapists, and specialists.
- Detailed cost estimates or invoices for planned procedures or therapy sessions.
- Expert reports (physician projections, life-care plans) quantifying future needs and costs.
- Receipts and paid bills showing past charges and payments.
- Work records showing lost earnings and need for future reduced earning capacity, where relevant.
Special rules in auto-accident cases
Auto accidents in New York have layered rules. New York’s no-fault insurance (Personal Injury Protection or PIP) often pays immediate medical bills up to policy limits. You can still recover uninsured economic losses and, if you meet the statutory threshold for “serious injury,” you may pursue pain and suffering damages from the at-fault driver. See New York Insurance Law section 5102 for definitions and thresholds related to no-fault and serious injury: https://www.nysenate.gov/legislation/laws/INS/5102
Deadlines and government claims
Time matters. For ordinary negligence claims against private parties, the statute of limitations is generally three years from the accident. See CPLR section 214: https://www.nysenate.gov/legislation/laws/CVP/214
If the claim is against a city, county, or New York State agency, different notice and timing rules apply. For many claims against local governments you must file a notice of claim within 90 days and then suit within specified time limits. See General Municipal Law section 50-e: https://www.nysenate.gov/legislation/laws/GEN/50-e
If your claim concerns medical malpractice rather than accident negligence, different time limits apply (for example, see CPLR 214-a). Review CPLR section 214-a for medical malpractice timing rules: https://www.nysenate.gov/legislation/laws/CVP/214-a
How insurers and liens affect recovery
- Health insurers, Medicare, and Medicaid may assert reimbursement rights or liens against a settlement or verdict for payments they made. Do not assume you keep all settlement dollars until you confirm lien obligations.
- No-fault PIP insurers that paid medical benefits may have subrogation or reimbursement claims depending on the situation.
- New York’s collateral source rules and state and federal lien laws can affect how much you actually receive. An attorney will check for liens and negotiate reductions where possible.
Settlement versus trial
Most cases resolve by settlement. A settlement that accounts for future medical needs requires careful valuation. Settlements can include structured payments or lump sums. At trial, a jury awards past and future medical expenses if the evidence supports them. Presenting credible expert testimony improves the chance of full recovery.
When to talk to an attorney
Consider consulting a lawyer if:
- Your injuries require ongoing or long-term care.
- Your medical bills are substantial or insurers dispute causation.
- There are potential liens from Medicare, Medicaid, or private insurers.
- Your claim involves a government defendant or a complex liability question.
A lawyer can assemble medical evidence, obtain expert reports to quantify future costs, handle lien resolution, and advise about the best timing and structure of any settlement.
Bottom line
Under New York law, you can recover past and future medical and therapy expenses from the party responsible for your injuries if you prove causation, necessity, and a reasonable estimate of future costs. Time limits and special rules (no-fault PIP, government defendants, liens) can affect your claim. Consult a licensed New York attorney to protect your rights and evaluate your case.
Disclaimer: This article is for general information only and is not legal advice. For advice about a specific situation, speak with a licensed attorney in New York.