Steps in a No Fault Claim
The most important thing to do as soon as you’re involved in an auto accident is file that no-fault application. It must be received by the insurance company, in writing, within 30 days from the date of the accident or they will not pay your medical bills or lost wages if you were working at the time. They will also refuse to pay for mileage you’re entitled to for the first year after the accident as well as prescriptions and a number of other benefits to which you’re entitled based on your policy. It’s really a shame when people come to us 35 or 40, or even 45 days after their accident and tell us they haven’t filed their application. At that point, it’s really an uphill battle to get those benefits reinstated through the insurance company. That application is number one. As soon as we meet somebody, we say, “We’ve got to get this application in right away, verify that it was received, and get everything else set up.”
Then, we immediately try to locate the ambulance that took you to the hospital. They need to know the claim information because obviously you didn’t have it in the ambulance. If they don’t bill it to the insurance carrier in time and get paid, they will look to you for payment. It’s the same with the hospital. Obviously, you didn’t have the claim information when you arrived there, but they need that information so that they can successfully bill the appropriate insurance company. You don’t want them to bill your private insurance or Medicaid, or anything like that. You want the bill submitted to your no-fault.
We can set up the claim for your lost wages through your employer. If you’re working at the time, you can usually get 80% of your gross wages, up to a maximum of $2,000 a month, and – if you have additional coverage – more than that. It may take time to set that up because you have to get a document from your employer to verify the amount and send that document to the insurance company. You will also file a New York State Disability Application with your employer which will also pay some of your wages. All of that takes time, and we set it up as soon as we can – usually within a few weeks.
You also want your mileage reimbursement to get going right away, and they’ll pay your mileage for the first year after the accident – often, up to a limit of $25 a day but, if you have more coverage, it could be higher and can really help keep you afloat while you’re visiting your doctors and recuperating from the accident.
Obviously, the most significant expense is usually the medical bills you or the insurance company will pay. You certainly don’t want to be obligated to pay those, because they can be very substantial. Insurance companies are not looking to do you any favors so, if you submit your application late without a very, very good reason, they will probably deny your claim.