What You Need to Know About No-Fault Insurance

Because your own insurance company pays you directly for injuries that result from an automobile accident, in a no-fault state, there are limits and restrictions on when you can bring a lawsuit against the other driver or other responsible party. 

In most no-fault states, you can only sue a negligent driver or vehicle owner if your injury meets a specific threshold defined in your state’s law. This threshold may be a monetary one (medical expenses that are more than a specified amount) or one based on the type of injury, usually defined as a “serious” or “permanent” injury. Typically, this requires a broken bone, extended period of disability or time out of work, an injury requiring surgery, permanent disability or impairment.

Each state has its own rules about the kinds of automobile insurance that vehicle owners are required to keep, as well as the limits that must be maintained on those policies. Some states that have no-fault laws, such as Pennsylvania, allow drivers to choose either no-fault coverage or traditional automobile coverage that allows the motorist to sue the negligent driver or vehicle owner for all damages resulting from the accident.
Where a choice is available, traditional coverage may carry a lower premium since the insurance company is not obligated to pay its own policyholder for damages sustained in an accident.

No-fault insurance typically covers medical expenses, lost earnings and other expenses resulting from injuries you or your passengers receive in a motor vehicle accident. This can include payment for rehabilitation, transportation to and from medical appointments, and funeral expenses if injuries from an accident result in death.
Your no-fault insurance will not cover pain and suffering. You will only be able to recover damages for pain and suffering if your injury meets the threshold for a lawsuit against a third party responsible for the accident.

Although no-fault coverage applies even if you were the party responsible for the accident, you must satisfy certain requirements to receive payment from your insurance company. This may include providing documentation of medical and transportation expenses, providing a written or recorded statement to your insurance company about the accident and your injuries, and attending a medical examination by a doctor chosen by your insurance company.
Most no-fault insurance companies will ask you to attend this kind of examination to verify your injuries and to determine whether you need continuing medical treatment. If the doctor does not agree with your physician about your injuries or need for future medical treatment, your no-fault insurance company may deny future claims for medical or related expenses. The insurance company can also deny your no-fault claim if you do not cooperate with their requests.

If you have been involved in a car accident in a no-fault state and are not sure if you can sue for your injuries, or if your no-fault insurance company has denied your claim for continuing medical treatment or expenses, you should consult with a personal injury or no-fault lawyer. Find a qualified personal injury or no-fault attorney by posting a summary of your legal issue on our site and letting attorneys come to you.