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Can I File a Lawsuit If I Was Seriously Injured in a Car Accident in a No Fault State?

“No fault” auto insurance laws apply in twelve states as well as the District of Columbia. In these states, unless an exception applies, the “no fault” system works to the advantage of an at-fault driver and to the disadvantage of an injured victim. In cases of serious injury, however, it is usually possible to escape the “no-fault” system even if the car accident occurred in a “no-fault” state.

How “No-Fault” Works

Under a “no-fault” system, every driver with a car registered in-state is legally required to purchase Personal Injury Protection (PIP) or some equivalent form of insurance. In the event of an accident, an injured party is expected to file a claim against his own insurance policy, instead of filing a claim against the other driver’s liability insurance policy as is the common practice in “fault” states. The injured party is also barred from filing a personal injury lawsuit against the at-fault driver.    

PIP Insurance

PIP insurance has several disadvantages for an injured car accident victim:

  • High deductibles – a PIP insurance policy may cover only 80 percent of medical bills, for example.
  • No compensation for pain and suffering, which could amount to several times the amount awarded for medical bills in a “fault” state.
  • No compensation for property damage (although you can file a property damage lawsuit against the other driver even in a “no-fault” state).
  • Your claim might be denied if you were driving while intoxicated at the time of the accident, even if you are eventually acquitted.  

The Loopholes

The “no-fault” auto insurance system contains major exceptions that generally allow seriously injured victims to escape the foregoing restrictions. Although these exceptions kick in under conditions that vary from state to state, they typically include situations where:

  • Your medical bills exceed a certain threshold amount such as $4,000
  • Your medical bills exceed your PIP policy limits
  • Your injuries were “serious”, as that word is defined by state statute (such as permanent loss of function of a body organ, or an injury that prevents you from performing ordinary life activities for 60 days or more)  

How a Lawyer Can Help

In all likelihood, the most important way that a lawyer will be able to help you in the foregoing scenario will be in establishing that your injury is “serious” under the definition provided by the applicable state statute, so that you can escape the “no-fault” system altogether and aggressively pursue your claim against the at-fault driver either at the negotiating table or in court.

A good car accident lawyer will also be able to negotiate confidently with insurance companies, and he will know when to file a lawsuit to motivate the insurance company to issue a serious settlement offer. If you end up in court, your lawyer should be able to navigate the byzantine rules of evidence and civil procedure that typically confound non-lawyers representing themselves.

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