If you've been in a car accident in New York, the no-fault system is going to govern almost everything that happens next medically and financially — usually before any lawyer gets involved. Here's how the process actually works in practice.
Step 1: The accident and the 30-day notice
After a crash, the injured person (or their attorney) must file Form NF-2 with the insurer of the vehicle they were in — within 30 days. Miss that window without a good excuse and the carrier can deny the entire claim on procedural grounds alone.
This deadline is the single most-missed step in the no-fault process, and the easiest way to lose a case before it starts.
Step 2: Medical treatment and provider billing
The injured person seeks treatment. Each medical provider (doctor, hospital, physical therapist, MRI facility) submits an assignment of benefits and bills the insurance carrier directly using NF-3 forms within 45 days of treatment.
The carrier has 30 days from receipt of each bill to pay it, deny it, or request more information (called a 'verification request'). Verification requests pause the clock — and carriers use them aggressively.
Step 3: IMEs and peer reviews
Insurance carriers commonly send claimants to an Independent Medical Examination (IME) — a doctor of the carrier's choosing who evaluates whether ongoing treatment is medically necessary. They also order peer reviews, where a doctor reviews the file (without seeing the patient) and gives an opinion.
An adverse IME or peer review is the most common trigger for treatment denial. The IME report becomes the carrier's defense at arbitration.
Step 4: Denial
When the carrier denies a bill, they must issue Form NF-10 within 30 days, listing the specific reason. Common reasons: lack of medical necessity (citing the IME or peer review), late notice, failure to attend an IME, or services not covered by no-fault.
The denial doesn't end the claim — it just shifts the fight to arbitration or court.
Step 5: AAA arbitration
Almost every disputed no-fault claim in New York ends up at the American Arbitration Association (AAA), which administers no-fault arbitration through the Forthright platform. The claimant submits a filing package; the carrier submits a response; an arbitrator decides the case, usually on the papers.
Winning depends almost entirely on the quality of the file: complete medical records, properly-formatted bills, point-by-point rebuttals of the IME and peer review, and clean proof of timely notice. That's where most cases are won or lost.
Frequently Asked Questions
How does no-fault insurance work in New York?
Your own auto insurer pays your medical bills and lost wages after a crash, up to $50,000, regardless of fault. You file an NF-2 within 30 days, providers bill directly, and disputes go to AAA arbitration.
Who pays no-fault claims in NY?
The insurer of the vehicle you were occupying at the time of the accident. For pedestrians struck by a vehicle, the striking vehicle's insurer pays.
How long do no-fault benefits last?
Medical benefits can continue for as long as treatment is medically necessary, with no fixed end date. Lost wage benefits cap at 3 years from the date of the accident.
Need expert help on your case?
Need help preparing a no-fault arbitration file or rebutting an IME? We've handled thousands of NY no-fault cases from the insurance side — now we work for you.
Request Consultation