Key Takeaways: New York generally requires a qualifying serious injury to recover non-economic damages, such as pain and suffering, after a car accident. No-fault insurance covers basic economic losses up to $50,000 regardless of fault, while proven economic losses above that limit can be pursued separately. For actions commenced on or after May 26, 2026, the former 90/180-day injury category no longer applies.
A $50,000 no-fault limit does not by itself determine whether an injured person can seek additional compensation. The serious injury threshold in New York car accident cases generally affects claims for pain and suffering, and the evidence must connect the injury to a category recognized by law. If you are dealing with serious injuries from car accidents in Cheektowaga, NY, understanding that distinction can help you identify what records and next steps matter.
The rules changed in 2026. For actions commenced on or after May 26, 2026, New York removed the 90/180-day category from the serious-injury definition; earlier actions may still be governed by the previous rule. The DFS circular letter describes the change and its effective date.
What Does No-Fault Insurance Pay for in New York?
New York no-fault insurance, also called personal injury protection or PIP, pays certain economic losses after an eligible motor vehicle accident without requiring the injured person to prove who caused the crash. Basic benefits cover up to $50,000 per person for eligible medical expenses, lost earnings, and certain other reasonable, necessary costs, subject to policy terms and statutory limits. The New York Department of Financial Services explains that the coverage is available regardless of fault.
PIP is not the same as compensation for non-economic damages, such as pain and suffering. In a typical covered car accident claim, an injured person generally must meet the serious-injury threshold to seek those damages from another party. No-fault benefits can still matter while treatment is underway, even if the person later pursues a separate claim.
Motorcycle riders and passengers are treated differently. They generally are excluded from no-fault benefits, so the usual PIP limit and serious-injury threshold do not apply to their own injury claims in the same way; the responsible party’s liability and proof of damages still matter. The state’s no-fault FAQ discusses the motorcycle exclusion.
What Counts as a Serious Injury Under New York Law?
Insurance Law § 5102(d) lists specific injury categories. The current definition for actions commenced on or after May 26, 2026, includes eight categories; the former 90/180-day category is addressed below because it may still matter to earlier actions. The New York statute sets out the definition.
- Death.
- Dismemberment.
- Significant disfigurement.
- A fracture.
- Loss of a fetus.
- Permanent loss of use of a body organ, member, function or system.
- Permanent consequential limitation of use of a body organ or member.
- Significant limitation of use of a body function or system.
- A medically determined, non-permanent injury that prevents substantially all usual and customary daily activities for at least 90 days during the first 180 days after the injury. This was the ninth category before the 2026 amendment and is not available for actions commenced on or after May 26, 2026.
For limitation-based categories, the issue is not simply whether a person still feels pain. Medical evidence must support the claimed loss or limitation and show how it affects the relevant body part or function. For example, brain injuries caused by car accidents can involve symptoms that are not obvious from appearance alone, so documented examinations and functional effects may be important.
How Do You Prove a Serious Injury?
Build a clear record from the beginning: seek medical care, describe symptoms accurately, follow treatment recommendations and keep appointments. Medical records should document the diagnosis, the timing of symptoms, treatment, and any limits on movement or daily activity. Gaps in care or inconsistent reports can make it harder to show how the injury developed and whether it continues.
For injuries involving a limitation, objective medical evidence can include imaging, diagnostic tests, physical examination findings or measured restrictions. A doctor’s records should explain the findings and connect them to the accident, rather than relying only on a patient’s description of pain. If symptoms persist, keeping treatment records consistent can help explain their duration and impact. Our article on proving chronic pain after a car accident discusses why that documentation matters.
Keep copies of bills, work records, and notes about activities you could not perform. For an injured person in Niagara Falls, NY, these details can help explain how the injury affects everyday life as well as what medical treatment was needed.
What Is the 90/180-Day Rule?
Before the 2026 amendment, this category applied when a medically determined, non-permanent injury prevented a person from performing substantially all of their usual daily activities for at least 90 days during the 180 days immediately after the accident. It was not enough to show some discomfort or a minor reduction in activity; the restriction had to be substantial and supported by medical evidence.
For actions commenced on or after May 26, 2026, this category was removed. The date the action is commenced, not merely the date of the crash, is important when assessing whether the former rule applies. A 2026 New York court decision discusses why the prior category remained relevant to an action filed before the amendment; see the court’s discussion.
Can You Sue for Economic Losses Over $50,000?
Yes. New York law distinguishes between basic economic loss covered by no-fault and eligible economic losses above that amount. A person may pursue proven economic losses exceeding the basic economic loss limit without meeting the serious-injury threshold, although they still must establish that the losses resulted from the accident and are legally recoverable. The distinction appears in Insurance Law § 5104.
Economic losses can include accident-related expenses or income losses that exceed the applicable no-fault benefits. Keep records showing the amount, cause, and connection to the crash. For information about other issues that can shape a claim, see our overview of New York personal injury laws.
What the Threshold Means for Your Claim
The threshold usually determines whether a covered car accident claimant can seek non-economic damages, while proven economic losses above basic no-fault benefits follow a different rule. The applicable serious-injury categories also depend on when an action was commenced, because New York removed the 90/180-day category for actions begun on or after May 26, 2026. In Niagara Falls, NY, preserve medical and financial records and get advice tailored to the accident and the applicable law.
Frequently Asked Questions
Does every car accident injury meet the serious-injury threshold?
No. The injury must fit a category in Insurance Law § 5102(d) to generally support a claim for non-economic damages in a covered car accident case. The category and the evidence needed depend on the injury and the law that applies.
Does the $50,000 no-fault limit cap every possible claim?
No. It is the limit for basic no-fault economic benefits, not necessarily the limit on all recoverable damages. Eligible economic losses above basic economic loss may be pursued separately if they are proved.
Does the 90/180-day rule still apply?
It no longer applies to actions commenced on or after May 26, 2026. It may remain relevant to actions commenced before that date, depending on the case.
What evidence helps show a serious injury?
Medical records, diagnostic testing, examination findings, and consistent treatment can help document the injury and its effects. Records linking the condition and limitations to the crash are particularly important for limitation-based categories.
How can a lawyer help with a New York car accident claim?
Our car accident legal services include reviewing the insurance issues, investigating the facts, developing a case strategy, and communicating with insurers. We offer a free initial case review to discuss a potential claim.
Cheektowaga Car Accident Lawyers at Dan Chiacchia Injury Attorneys Provide Sound Legal Guidance After a Serious Injury
When an insurer disputes whether your injury meets New York’s serious injury threshold, it can leave you uncertain about medical bills, lost income, and what comes next. Our Cheektowaga car accident lawyers at Dan Chiacchia Injury Attorneys provide individualized car accident representation, including fact investigation, legal guidance, and insurance negotiations. With more than 30 years of local experience, our team can help you understand the claim and the evidence that matters. To schedule a free case review, call us today at 716-648-3030 or submit our online contact form. Located in Hamburg, New York, we proudly serve clients throughout Western New York.
