Why Does my own Car Insurance Need to pay for my Medical Bills and Lost Income if the Other Driver was at Fault?

As Syracuse car accident lawyers, we get this question all the time. Why should my own car insurance have to pay my medical bills or lost income if it was the other driver’s fault?

Here’s why: New York has a no-fault law (New York Insurance law 5102) which was designed to minimize litigation involving minor car accidents. Under that law, no matter who was at fault, and no matter how minor or how serious the injuries, the car insurance for the car you were driving or riding in must pay up to $50,000 of your medical bills and/or lost income. This is called “personal injury protection” (“PIP”) insurance. You can sue the other driver (and thus get into his or her insurance policy) only for medical bills and wage compensation that goes beyond that first $50,000. You can also sue the at-fault driver for “pain and suffering” compensation, but only if you have a “serious injury” as defined by the no-fault law. Explaining what a “serious injury” is under the law is a bit complicated. If you hire us to represent you, our car accident lawyers serving Syracuse and the surrounding areas will sit you down and explain to you how you might qualify for a “serious injury” so as to bring a claim.

If you have additional insurance in your own auto insurance policy, your own car insurance may in fact be required to cover you for more than the $50,000 minimal amount above. There are two types of additional insurance to pay medical bills and lost income: “APIP” (additional personal injury protection) and “OBEL” (optional basic economic loss).

If you have purchased a $50,000 APIP policy, it means that you will have a total of $100,000 coverage from your own policy in lost wages and medical bills.

If you purchased $50,000 in OBEL coverage, you get to choose how to “spend” the additional coverage. After the first $50,000 from the original PIP policy is exhausted, you can use the $50,000 OBEL to pay for additional medical records or continuing lost income.

Our Syracuse car accident lawyers always recommend that our clients purchase either APIP or OBEL along with their auto insurance.

Your own insurance policy also becomes relevant (even if you were not at-fault) if you have something called SUM coverage, which means “supplemental underinsured motorist” coverage. Let’s say the at-fault car has only $25,000 in bodily injury coverage, but you have $50,000 of SUM coverage. If your injuries are significant enough to be “worth” $50,000 in coverage, the other guy’s insurance will pay you the first $25,000, at which point his insurance is “exhausted” (there is no more available). At this point, if you have SUM coverage in your own policy, your own insurance will pay you an additional $25,000 in SUM coverage. You get a total of $50,000, whereas if you had not had SUM coverage, you would have been stuck with just $25,000.

It’s important to get good the most SUM you can afford. We always advise getting as much as you can afford. SUM protects not only you, but your whole family, since your passengers also get the benefit of the SUM protection you purchase on your vehicle.

If you have been in a car accident and have questions about your rights, or if you think you might have a claim, or if your family member does, don’t hesitate to reach out to the Michaels Bersani Kalabanka team of Syracuse car accident lawyers. We represent injured car accident victims all over upstate New York.

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