In New York’s “no-fault” system, your own car insurance (or the policy for the car you were in) pays for your medical bills first, up to its Personal Injury Protection (PIP) limit, which is a minimum of $50,000. If your bills exceed this, you can file a claim with your health insurance or, if you have a “serious injury,” file a lawsuit against the at-fault driver for additional damages.
If you were hurt in a car accident in New York, one of your first questions is probably the same one we hear every day:
“Who pays my medical bills?”
New York is a no-fault state, which means your own insurance pays for your initial medical treatment — even if the other driver caused the crash. But the truth is more layered than that. Insurance deadlines, medical liens, serious-injury thresholds, and claim disputes can turn something that sounds simple into a stressful maze for injured people.
And because New York sees thousands of collisions every month — 19,116 crashes citywide in the first three months of 2025 (NYPD Collision Data) — you’re not alone. Many injured drivers don’t know which bills go to no-fault, which fall on health insurance, or when the at-fault driver becomes financially responsible.
This blog breaks it all down clearly.
What’s in This Guide
- How medical bills actually get paid after a NY car accident
- What “no-fault” covers — and what it doesn’t
- Why delayed injuries still qualify for coverage
- How bills affect your settlement (and when they come out of it)
- When the at-fault driver becomes responsible
- What NYC and Long Island crash data shows about rising medical costs
- How a car accident lawyer protects you from medical debt
Case Today (212) 977-2020
The First Layer: New York’s No-Fault (PIP) Insurance Pays Your Medical Bills
In New York, your Personal Injury Protection (PIP) coverage pays for your medical treatment right after the crash — regardless of fault.
Under NY Insurance Law § 5102, PIP covers:
- Emergency room visits
- Hospital treatment
- Diagnostic tests (MRI, X-ray, CT scan)
- Physical therapy
- Chiropractic care
- Prescription medications
- Surgical care
- Transportation to medical appointments
Most people have $50,000 in minimum PIP coverage.
But medical bills can stack up quickly — especially in NYC and Long Island, where average ER bills exceed $3,000 and MRIs can cost $1,200–$2,500.
Delayed Pain Still Counts — and It’s Extremely Common
Many victims don’t feel pain until the next day or later. Research on low-impact collisions published in ScienceDirect (2025) confirms that “minor” crashes often cause soft-tissue injuries, whiplash, and concussions with delayed onset.
In other words —
not feeling pain at the scene does NOT disqualify you from coverage.
What Happens When PIP Runs Out?
When your no-fault coverage is exhausted, the next layers kick in:
1. Your Health Insurance
Your private health insurance, Medicaid, or Medicare may step in — but they may assert a lien on your future settlement.
2. The At-Fault Driver (When You Meet the Serious Injury Threshold)
If you suffered a serious injury under New York law, you can pursue the at-fault driver for:
- Medical bills beyond PIP
- Future medical expenses
- Pain and suffering
- Lost wages
- Long-term treatment
NY’s “serious injury” definition includes:
- Fractures
- Surgery
- Significant limitation of use
- Permanent injuries
- Disability lasting 90 out of 180 days
Do Medical Bills Come Out of Your Settlement?
Sometimes, yes.
If:
- you went through your health insurance,
- Medicaid/Medicare covered treatment, or
- your bills exceeded PIP…
…then your medical providers or insurers may file a lien that must be repaid from your settlement.
But here’s the good part:
A car accident attorney negotiates these liens down — often dramatically.
Our team regularly reduces:
- Hospital liens
- Medicaid liens
- Medicare liens
- Private insurance liens
- Out-of-pocket balances
This keeps more of your settlement in your pocket, not the hospital’s.
NYC & Long Island Crash Trends Show Why These Bills Are Rising
According to NYPD crash data and the Long Island Region 2025 Injury Report:
- NYC sees a collision every 2 minutes
- Long Island sees a serious crash every ~7 minutes
- 31% of collision victims experience delayed injuries
- Average post-crash medical costs increased 12% since 2023
This matters because:
More crashes → more claims denied → more medical debt
Insurance companies look for any excuse to refuse payment — especially when there’s no police report or delayed treatment.
This is why documentation and early legal help matter so much.
What Part of Your Car Insurance Covers Medical Bills? A Quick Breakdown
PIP (No-Fault): First $50,000 of medical treatment
Optional APIP/OBEL: Additional coverage if purchased
Liability (At-Fault Driver): Pays the rest IF you’re seriously injured
Your Health Insurance: Secondary payer
Your Settlement: Pays medical liens or unpaid balances
So Who Actually Pays What? (A Simple Breakdown)
For most New Yorkers injured in a crash:
- No-fault pays first.
- Health insurance pays next.
- The at-fault driver pays if your injuries qualify.
- Your settlement covers liens or remaining balances.
Why You Should Contact a Car Accident Lawyer Early
Even “simple” cases get messy fast.
A car accident attorney helps by:
- Filing your no-fault claim on time (within 30 days)
- Preventing your medical providers from billing you improperly
- Fighting unfair denials
- Negotiating medical liens
- Connecting you with trustworthy doctors
- Preserving evidence
- Protecting you from insurance tactics
- Pursuing compensation from the at-fault driver
At Chaikin Trial Group, we see this every day:
People call us not because they’re greedy — but because:
- their bills are piling up
- insurance isn’t paying
- their injuries are getting worse
- they can’t work
- they’re scared of medical debt
You deserve clarity, support, and representation that actually cares.
If You Were Injured in a Car Accident in New York, We Can Help
Chaikin Trial Group Personal Injury Lawyers handle:
- Medical bill protection
- No-fault claims
- Serious injury lawsuits
- Lien negotiation
- Delayed injury cases
- Denied or lowballed insurance claims
Serving NYC, the Bronx, Queens, Brooklyn, Long Island, and Westchester.
