The New York Supreme Court, Appellate Division, Second Department reversed a trial court order granting summary judgment for defendants in a car accident case recently. The Court held the plaintiff did suffer from a “serious injury” to the spine as defined by statute following a car accident. See Yeu Jin Baik v. Enriquez, 124 AD3d 880 (2nd Dept. 2015).
New York is a no-fault car insurance state. There are three types of car insurance systems: fault, no-fault, and no-fault add-ons. In a typical fault system, the most common type of car insurance system, state law requires that whoever is at fault for the car accident must cover all of the damages. Usually, the police are called to the scene of the accident and write up an incident report, assessing fault. Insurance information is shared, and the victim contacts the driver-at-fault’s car insurance company to request compensation.
However, a fault system can pose a burden on the courts. The driver at fault often denies responsibility or his insurance agency refuses to reimburse all or some of the damages. The plaintiff then sues either or both the driver and the insurance company. It could be years of costly litigation before the plaintiff sees any reimbursement.
In a no-fault system such as New York, car insurance providers are required to provide coverage for property damage, medical expenses and lost wages to their drivers regardless of who was at fault in the accident. That way, a driver can immediately call up his insurance company and request that an adjuster come evaluate his car for repairs even though the other driver may have caused the crash. This allows the driver to receive almost immediate compensation for property damage suffered, and allows for coverage of medical expenses/lost wages related to any injuries caused by the accident.
In a fault add-on system, the state law requires that car insurance companies provide an optional add-on no-fault coverage. Drivers do not have to include it on their policy, but they do receive greater protection in accidents if they do.
It is estimated that some 50% of drivers on the road either do not have car insurance or are severely underinsured. No-fault car insurance protects people on the road from under- and uninsured motorists.
New York’s no-fault system is codified in the Insurance Law. If an individual sustains a “serious injury” as defined by Insurance Law Section 5102, the injured person can seek compensation for pain and suffering and other damages. No fault only pays for medical expenses related to the accident and lost wages. In this case, the plaintiff sued the driver-at-fault and his car insurance company for serious injuries she suffered to the cervical and lumbar regions of her spine and her left knee.
In this case, the defendants filed a motion for summary judgment, arguing that the plaintiff’s injuries did not constitute serious injuries as required by the Insurance Law because the plaintiff did not suffer a “permanent consequential limitation” or a “significant limitation of use” as defined in the case law.
If a defendant is to make this argument, medical evidence is required. A defense medical expert will review the plaintiff’s medical records and examine the plaintiff. The defense medical expert will then opine via an affidavit that while the plaintiff was injured, the injury either did not impair or limit the plaintiff.
The plaintiff has the opportunity to respond. Here, the plaintiff raised a genuine material dispute as to whether the spinal and knee injuries were serious injuries under the permanent consequential limitation of use or significant limitation of use categories of Insurance Law § 5102(d) . As such, it was improper for the trial court to grant the defense motion for summary judgment. The Second Department reversed the order.
Due to the intricacies involved in the insurance law it is imperative for car accidents victims to hire competent legal counsel soon after the accident.
If you or a loved one has suffered significant injuries as the result of a car accident and you need help pursuing compensation, contact the skilled personal injury lawyers at Gallivan & Gallivan today to discuss your potential claims.