No-fault, and the serious injury threshold

Two systems, doing two different jobs

No-fault is your own insurer paying for treatment and part of your lost earnings, up to the basic economic loss limit of $50,000 unless extra coverage was bought. It does not care who caused the crash. It is designed to get bills paid quickly and it usually works.

What it does not do is compensate you for the injury. Pain, permanent limitation, the shoulder that no longer lifts overhead, none of that is economic loss and none of it is covered. That comes from a claim against the driver who caused it.

And New York only allows that claim if the injury is serious as the statute defines the word.

The eight categories

Insurance Law § 5102(d). An injury has to fall into at least one of these for a pain-and-suffering claim to survive. Fault is a separate question. You can be entirely blameless and still have the claim dismissed for failing the threshold.

The reverse is also true, and it is new. Clearing the threshold is necessary but it is no longer sufficient. For motor vehicle claims brought on or after May 26, 2026, CPLR § 1411(b) bars recovery altogether where your share of the fault is greater than the combined fault of everyone you are suing. Below that line your recovery is reduced by your percentage, as it always was. Above it there is no recovery at all, however serious the injury. This applies to claims under Insurance Law Article 51, motor vehicle. A fall or a dog bite is still governed by CPLR § 1411(a), where fault reduces a recovery and never bars it. There is more on this on our car accident page.

1. Death
2. Dismemberment
3. Significant disfigurement
   Scarring is the common one. Whether it qualifies is judged by how a reasonable person would view it, not by measurement.
4. A fracture
   Any fracture. This is the most clear-cut category in the statute and the reason a broken bone changes a case immediately.
5. Loss of a fetus
6. Permanent loss of use of a body organ, member, function or system
   Read strictly by the courts: loss of use has to be total.
7. Permanent consequential limitation of use of a body organ or member
   Less than total, but permanent, and significant enough to matter.
8. Significant limitation of use of a body function or system
   Need not be permanent, but must be more than mild or slight.

There used to be a ninth, and it mattered most

Until this year the list had a ninth entry, usually called the 90/180 category: a medically determined injury of a non-permanent nature that kept you from performing substantially all of your usual and customary daily activities for at least 90 of the 180 days after the crash.

Part EE of Chapter 58 of the Laws of 2026 deleted it, for actions commenced on or after May 26, 2026. That is a bigger change than it sounds. The 90/180 route was the ordinary way to meet the threshold for an injury that was genuinely disabling for months but left no fracture and no permanent finding, which describes a great many back, neck and soft-tissue injuries. Those claims now have to fit one of the eight categories above or they do not proceed at all.

One detail decides which version of the law applies to you, and it is not the one people assume: the cutoff runs from the date the action is commenced, when the court papers are filed, not the date of the crash. An accident from last year, filed today, is measured against the amended eight-category definition. If you were hurt before May 2026 and have not yet filed, this is worth a conversation now rather than later.

The deadlines that end cases before the merits

30 days — to file the no-fault application with the insurer

Written notice of the claim. Miss it without a reasonable excuse and no-fault benefits can be denied outright, regardless of how badly you were hurt.

45 days — to submit medical bills to the no-fault insurer

Runs from the date of each service, not from the accident. Providers usually handle it, usually is not always.

90 days — notice of claim, if a municipality is involved

General Municipal Law section 50-e. A city bus, a county plow, a pothole claim. Ninety days from the accident, and it is unforgiving.

2 years — wrongful death

EPTL section 5-4.1, running from the date of death rather than the date of the injury.

3 years — personal injury

CPLR section 214. The one people know, and the one that lulls them, because the short deadlines above have usually passed by the time anyone thinks about it.

The three-year figure is the one everyone knows, and it is the reason the short deadlines get missed. By the time most people start thinking about a lawyer, the 30-day and 90-day windows have already closed.

What we do with this

The threshold is a question of proof, not persuasion. That means the useful work happens early: making sure you are examined promptly, that the records say what the examination actually found, that gaps in treatment do not open up, and that the no-fault paperwork is filed before the clock runs.

If you were hurt in a crash in Onondaga or Cortland County, the call costs nothing and it is worth making before the first deadline rather than after.

Questions people ask

What does no-fault actually pay for?

Medical treatment, a portion of lost earnings, and certain out-of-pocket costs, up to the basic economic loss limit of $50,000 unless additional coverage was purchased. It pays regardless of who caused the crash. What it does not pay for is pain and suffering.

If no-fault pays my bills, why would I need a claim at all?

Because no-fault stops at economic loss. Compensation for the injury itself, pain, suffering, permanent limitation, the things that do not come with a receipt, is only available through a claim against the at-fault driver, and only if your injury meets the serious injury threshold.

What is the serious injury threshold?

A statutory gate in Insurance Law section 5102(d). New York does not let every injured driver sue for pain and suffering; the injury must fall into at least one of eight defined categories. If it does not, the claim is dismissed no matter who was at fault.

Is a broken bone automatically a serious injury?

A fracture is one of the eight enumerated categories, which makes it among the most clear-cut ways to meet the threshold. It still has to be documented as a fracture in the medical records, which is a question of proof rather than of argument.

What happened to the 90/180 rule?

Part EE of Chapter 58 of the Laws of 2026 removed it, for actions commenced on or after May 26, 2026. It had been the usual route for an injury that was disabling for months but left no fracture and no permanent finding, so its removal falls hardest on soft-tissue claims.

My accident was before May 2026. Which version applies to me?

The cutoff turns on when the action is commenced, not when the crash happened. An older accident filed after May 26, 2026 is measured against the amended eight-category definition. If you were injured before the change and have not filed, the timing is worth discussing now.

I felt fine at the scene and sore three days later. Does that hurt my claim?

It is common, and it is a reason to be seen promptly rather than a reason to give up. Gaps in treatment are the most frequent argument raised against a threshold case, so the record of when you were examined and what was found matters a great deal.

How long do I have to bring a claim in New York?

Generally three years for personal injury under CPLR 214 and two years for wrongful death under EPTL 5-4.1. If a municipality is involved a notice of claim is due in 90 days, which passes long before most people have thought about a lawyer.

What if the other driver had no insurance?

Uninsured and underinsured motorist coverage on your own policy exists for exactly that situation, and it carries its own notice requirements and its own deadlines separate from everything else on this page. Tell us early if the other driver was uninsured, was underinsured, fled the scene, or was never identified at all.

Related: what changed for car accident claims in 2026 ·personal injury ·car accidents ·what to do after a car accident ·Syracuse & Onondaga County