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What is New York’s Serious Injury Threshold?

February 1, 2020 in

Victims of motor vehicle accidents may be surprised to learn that not every resulting injury will warrant a personal injury lawsuit. This is due to New York’s “Serious Injury” threshold. Every individual involved in a car accident can obtain no-fault insurance benefits under the state’s No-Fault Law. However, to sue, the victim must prove their injury meets the “Serious Injury” requirement.

New York's serious injury threshold

What New York State Considers a Serious Injury

A viable personal injury lawsuit can arise out of a motor vehicle accident if one of the following injuries has occurred:

  • Death
  • Dismemberment
  • A significant disfigurement
  • A fracture
  • The 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 injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less than 90 days during the 180 days immediately following the occurrence of the injury or impairment.”

This definition is in accordance with Section 5102(d) of the New York Insurance law. Most of these categories are straightforward, such as death and fracture. While the last four can be more complicated, as there is more room to argue on each particular definition. Numerous cases have attempted to clarify and define each of these categories. One thing that is definite, is that your injuries must be objectively verified by way of diagnostic testing. New York courts have consistently held that an injury will not be considered “serious” if there are no objective medical tests confirming your pain and/or limitations. The last category is what’s known as the 90/180 Day Rule. Basically, accident victims can file a lawsuit if they are able to present medical evidence that they could not perform significant daily activities for at least three out of the first six months following an accident.

Proving a Serious Injury Case

If you believe your case qualifies as a “serious injury,” you can definitely expect an argument from the insurance company or the at-fault driver’s attorney. A simple conclusory statement from your physician will typically not be sufficient in proving your case, especially if your injury falls within one of the last four “serious injury” categories listed above. There must be clear evidence of the connection between your injury and the accident, the methods by which the medical provider arrived at their conclusion, as well as details of their findings. Added difficulties can ensue if there have been any gaps in your treatment. Courts tend to question the reliability of a medical expert’s opinion if they did not continuously treat you after the accident. Additionally, a pre-existing condition or trauma that occurs subsequent  to an accident injury can further complicate your claim. Medical evidence must clearly establish that the injury you are suffering from is indeed the result of the accident for which you are suing.

Why You Need a Lawyer

Proving a serious injury case is often difficult, in and of itself, let alone having to deal with an insurer that is disputing your claim or the at-fault party’s attorney. Obtaining legal representation will protect you in communications or negotiations with other parties and will ensure you do not accept an underestimated settlement offer. The collection of evidence needed for a successful claim, including obtaining existing supporting documentation,  medical records, witnesses and/or expert testimony, will be completed on your behalf. As a result, your sole focus can remain on your health and recovering from your serious injury.

Speak to a New York Serious Injury Lawyer

You deserve fair compensation if you have suffered a serious injury as a result of a motor vehicle accident caused by another person’s negligent actions. A qualified and experienced New York City car accident lawyer at Sullivan Papain Block McGrath Coffinas & Cannavo, P.C. is ready to help you. Give us a call at (212) 732-9000 or complete our online contact form to schedule a free consultation today.

Our office is open and we are working remotely. If you have any questions regarding your case or a new case, call or email us and we will connect you to an attorney immediately. Close