Learn about No Fault Benfits - NY vs. NJ

Host: By the way, what's your basic understanding of the difference between this, if you have just crossed the bridge, you are in New Jersey. It's a whole different state, they do have no-fault, but let's face it, Staten Islanders go to New Jersey for a lot things. To go shopping, to go the shore, to go the malls, to go to Atlantic City, to go wherever and they get into an accident in New Jersey, and now they come back home and they sit down and they talk to you or they maybe in their friend's car, they maybe a passenger in a car driving in New Jersey. Basic difference in no no-fault? Guest: The basic, to me there were three basic differences with no-fault actually. The first is that in New York, the no-fault follows the car that you are in. So, if we are in New York and I am driving you some place and we get into an accident, my medical bills will be paid by my insurance company and your medical bills will be paid my insurance company. If we are in New Jersey, it follows the person, not the car. So, I would pay, my vehicle would pay for me. You would have to go to your household vehicle to get your payment. Host: Everybody in the car has to go to their own household vehicle, with no-fault insurance. Guest: Correct. Host: And if there is no household vehicle? Guest: Then it would go to the vehicle. And the other difference is, in New York, the doctors don't necessarily have to get pre-authorization of pre-certification for certain treatments. They treat the client or the patient, they send their bill in, and typically they will get paid up until the IME denial. In New Jersey, except for the first seven days or ten days after the accident, whatever procedures the doctors want to do, they have to get certification from the insurance company before they can do it, otherwise the doctor won't get paid and the patient maybe responsible for that bill. Otherwise the other difference is that, in New York, like we said, you are entitled to $2000 a month lost wages and in New Jersey it's really low, it's about $100 a week, for the first year. Host: But you get, instead of 50,000 minimum -- Guest: You get 250,000. So, your are well-covered for medical, but you are not covered very well at all for lost wages. And also, for New York, it's up to three years for the lost wages. Host: Okay. I guess the other thing, throwing the other side of no-fault, is that threshold, those categories, it is, I think you have a list of just four or five in New Jersey and rest of the nine are in New York. Guest: Right, there are five in New Jersey, there are subtle differences. Some of the them on the same death -- starts both of them as the more serious injury. In New Jersey for instance, you have to show, I believe a displaced fracture, as opposed to New York where it's just a fracture. Host: It's amazing. Guest: To meet the threshold and the V-Series in New York is that, number nine, which is that non-permanent injury, where in New Jersey you have to show some sort of permanent injury. So, you don't have that 90-180 day rule in New Jersey.