The statutory accident benefits system operates on a "no-fault" basis. You, as well as your family members and dependants, can often receive benefits even if you did not have car insurance at the time of the accident.
2. What kind of benefits can I receive?
Income Replacement Benefits - these benefits are designed to reimburse you for some of the money you lose as a result of being unable to work due to an injury suffered in a car accident. Benefits are not payable for the first week and you must meet a disability test to qualify for the benefits. Non-earner Benefits - you may receive these benefits if you are 16 years of age or older and have suffered a complete inability to carry on a normal life as a result of the accident within 104 weeks after the accident. Caregiver Benefits - these benefits may be payable if you (the injured person) were living with a person in need of care (such as a young child or an elderly parent) prior to the accident and were not being paid for these services. If you do not submit a treatment plan, the insurance company could refuse to compensate you for treatment. Attendant Care Benefits - this benefit may provide compensation for services of an aide or an attendant who is assisting you due to your injury. Funeral and Death Benefits - when a person dies due to a car accident, his or her estate may be entitled to reimbursement of funeral expenses to a maximum of $6,000.
The deceased's spouse, dependants and caregivers may also be entitled to death benefits. Death benefits are usually only payable if the deceased died within 180 days after the accident, or, if the deceased was continuously disabled as a result of the accident, within 156 weeks after the accident. A spouse may receive $25,000 if the deceased was married. Visiting Expenses - if you sustained injury in a car accident, your family members and individuals who were living with you at the time of the accident may be entitled to reimbursement for all of their reasonable and necessary expenses incurred as a result of coming to visit you during your treatment or recovery. The visitors will only be reimbursed for expenses incurred within 104 weeks after your accident, unless your injury is catastrophic.
Housekeeping and Home Maintenance Expenses - you may receive compensation for reasonable and necessary housekeeping and home maintenance expenses, if your injury resulted in a substantial inability to do your housekeeping and home maintenance and you normally performed home maintenance services before your accident. Psychological and Mental Injuries - your family members and dependents (whether related or not) may be entitled to receive benefits if they have suffered psychological injuries as a result of your accident.
If you have car insurance or if you are a listed driver on someone else's auto insurance policy, your own insurer will likely be responsible for providing you with benefits.
It is important to remember that statutory accident benefits will generally only compensate you for losses that are not covered by some other private insurance policy or employment benefits plan.
3. What can I do if the insurance company denied my claim for benefits?
If you are having problems recovering benefits to which you are entitled, you may be entitled to sue the insurer in court or try to enforce payment through arbitration. A car accident lawyer in brooklyn can provide further details with respect to this.
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