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In some no-fault states drivers are unable to file a liability claim unless the injuries you sustained in the accident are thought to be serious under the state’s law.
If you have been injured in a car accident in one of the states that have a no-fault car insurance rule you can only make a claim if your injuries are serious and meet specific thresholds.
Some parts of the United States have certain thresholds that mean you can only claim for medical expenses if they are more than a specific dollar amount. Other parts of the country have an injury threshold meaning that your injuries need to be severe enough for you to make a claim. Some states use both thresholds which allow an injured person to make a claim regardless of which threshold has been met.
How do Serious Injury Thresholds Work?
When you have been involved in a car accident and the definition that your state has set out has been met you can make a no-fault insurance claim. You can make this claim under personal injury protection coverage, but you’re not just limited to this. You can also make a third-party claim using the insurance company that the at-fault driver is with. You may also want to make a personal injury lawsuit against the driver too. In cases such as these you can make a claim for your non-economic damages such as pain and suffering. Non-economic claims are not available in a no-fault claim.
Serious Injury Thresholds in Different States
District of Columbia:
Disfigurement or substantial (Permanent) scarring, impairment, or total impairment lasting 6 months.
Florida: Permanent scarring/disfigurement and permanent injury
Hawaii: Permanent and substantial loss or use of a body part, permanent and substantial loss or use of a function or serious and permanent disfigurement that results in emotional or mental distress.
Kansas: Permanent loss of body function, permanent fracture of compound or weight-bearing bone, permanent disfigurement, permanent displaced fracture of a bone, permanent injuries.
Kentucky: Permanent loss of body function, permanent fracture of compound or weight-bearing bone, permanent disfigurement, permanent displaced fracture of a bone, permanent injuries.
Michigan: Serious and permanent disfigurement, impairment of a bodily function.
Minnesota: Permanent injury or disfigurement, disability for 60 days.
New Jersey: Significant disfigurement or scarring, dismemberment, loss of fetus, displaced fractures, permanent injury.
New York: Bone fracture, permanent limitation of use of an organ, significant disfigurement, significant limitation of a body system or function, substantial full disability for 90 days.
North Dakota: Disability for more than 60 days, permanent and serious disfigurement
Pennsylvania: Serious injury.
Utah: Permanent disability, bone fracture, permanent disfigurement.
Explanations of Categories of Injuries
Bone fracture: The fracture or probable fracture of a bone as shown in a doctor’s statement and an x-ray, showing that it was caused by the accident. Some states require that the fractured bone is a weight-bearing one. Some states define serious injury as the compound, splintered, crushed, compressed, or displaced fracture of any bone. Some states merely look for a fracture in a vertebrae or bone and full breaks.
Permanent injury: Some states allow the victim of a permanent injury to make a liability claim. They can do this even if the injury is not severe.
Disabling injury: Some states use the term ‘Disabling’ instead of ‘Permanent’ injuries. However in states such as these it is imperative that your medical records show you have suffered some sort of loss of the function of some part of your body. You do not have to show that you have suffered from a total loss. The loss of function in some states has to be significant wheres in other states the loss does not need to be. Some rules require that a disability lasts more than 60 days, whereas some rules state that the injury has to be permanent whilst also being disabling.
Negotiating the Threshold
The threshold can be negotiated due to the occasional vague definition of categories of injury and the interpretation of medical evidence. This may therefore mean that you don’t need to have a substantial disability, for example, in order to make a liability claim. If you would like to negotiate the threshold please contact the at-fault driver’s insurance company.
If you have sustained an injury due to being involved in a car accident that was another driver’s fault, please speak to a personal injury lawyer because you may have a personal injury claim.
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