TL;DR: New York is a no-fault state: your own insurer pays up to $50,000 in medical bills and lost wages regardless of fault, but you can only sue the at-fault driver for pain and suffering if your injury meets the "serious injury" threshold in Insurance Law § 5102(d). Nine categories qualify. Any broken bone automatically qualifies. Soft-tissue injuries can qualify through the "significant limitation," "permanent consequential limitation," or 90/180-day categories — but these require objective medical proof and are the most heavily contested issue in New York auto litigation.
Key takeaways
- New York is one of ~12 no-fault states — you cannot sue for pain and suffering after a car accident unless you clear § 5102(d).
- Any fracture automatically qualifies as a serious injury.
- Soft-tissue injuries can still qualify under "significant limitation," "permanent consequential limitation," or the 90/180-day rule.
- The threshold applies only to motor vehicle accidents — not slip and fall, construction, or assault cases.
- Objective medical evidence (MRI, EMG, quantified range-of-motion deficits) is what wins these cases.
- Pedestrians and bicyclists must clear the same threshold to sue the driver who hit them.
The most common question after a New York crash is "can I sue?" The answer depends almost entirely on one statute most people have never heard of.
What is New York's serious injury threshold?
New York's serious injury threshold (Insurance Law § 5102(d)) is the legal bar an injured person must clear to sue a driver for pain and suffering after a motor vehicle accident. Because New York adopted no-fault insurance in 1973 to keep minor claims out of court, lawsuits are reserved for injuries the law defines as "serious." If your injury doesn't fit one of the nine statutory categories, the court must dismiss your pain-and-suffering claim — no matter how clearly the other driver was at fault.
The 9 categories of serious injury in New York
| # | Category | How hard to prove |
|---|---|---|
| 1 | Death | Objective |
| 2 | Dismemberment | Objective |
| 3 | Significant disfigurement (visible scarring) | Moderate — jury question |
| 4 | Fracture | Objective — any broken bone qualifies |
| 5 | Loss of a fetus | Objective |
| 6 | Permanent loss of use of a body organ, member, or system | Hard — must be total loss |
| 7 | Permanent consequential limitation of use of a body organ or member | Contested — needs objective quantified findings |
| 8 | Significant limitation of use of a body function or system | Contested — needs objective quantified findings |
| 9 | 90/180 rule: a medically determined injury preventing your usual daily activities for at least 90 of the first 180 days | Contested — needs prompt, consistent medical proof |
Why a fracture changes everything
A fracture — any fracture, from a broken toe to a shattered femur — is an automatic threshold pass under category 4. The defense cannot move to dismiss a fracture case on threshold grounds. This is why two crashes with similar pain levels can have wildly different legal value: an X-ray showing a hairline fracture is worth more, legally, than months of documented soft-tissue pain.
How soft-tissue cases qualify (and why they get dismissed)
Herniated discs, bulging discs, and whiplash-type injuries can clear the threshold under categories 7, 8, or 9 — but New York courts require objective medical evidence: MRI findings causally linked to the crash, quantified range-of-motion deficits measured by a physician, and a treatment record without unexplained gaps. Insurers file threshold dismissal motions in most soft-tissue cases, and they win a large share of them. The three case-killers are: delayed first treatment, long treatment gaps, and pre-existing degenerative findings the defense attributes to age.
The 90/180-day rule, in plain English
If a medically determined (doctor-documented) injury prevented you from performing substantially all of your usual daily activities — work, childcare, household tasks — for at least 90 of the 180 days immediately after the crash, you meet the threshold even without a fracture or permanent limitation. The proof requirements are strict: contemporaneous medical records and evidence of actual curtailed activity, not just your own say-so after the fact.
No-fault benefits vs. lawsuit: two separate tracks
| No-fault (PIP) claim | Lawsuit (bodily injury claim) | |
|---|---|---|
| Who pays | Your own insurer | At-fault driver's insurer |
| Covers | Medical bills + 80% of lost wages (max $2,000/mo), up to $50,000 | Pain and suffering + all economic losses above no-fault |
| Fault required | No | Yes |
| Threshold required | No | Yes — 5102(d) |
| Deadline | File NF-2 within 30 days | 3 years (CPLR 214) |
Both tracks run simultaneously. Missing the 30-day no-fault deadline does not bar a lawsuit, and failing the threshold does not bar no-fault benefits — but mishandling either costs real money.
Who is exempt from the threshold?
The threshold applies to motor-vehicle negligence claims. It does not apply to motorcyclists (they're outside the no-fault system entirely), and it does not limit claims for economic losses exceeding $50,000, which are recoverable regardless of threshold.
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Start free intake →Frequently asked questions
Can I sue after a car accident in New York if I wasn't badly hurt?
Only if your injury fits one of the nine serious injury categories. Minor soft-tissue injuries that heal quickly generally do not qualify, and the no-fault system is the exclusive remedy for those claims.
Does a herniated disc meet the New York serious injury threshold?
Often, yes — when supported by MRI findings, quantified range-of-motion deficits, and consistent treatment. A herniation treated with surgery is rarely challenged on threshold grounds; a herniation with sparse treatment frequently is.
Is a broken bone automatically a serious injury in NY?
Yes. Any fracture qualifies under Insurance Law § 5102(d), regardless of severity.
Does the threshold apply to pedestrians and cyclists?
Yes — pedestrians and bicyclists struck by motor vehicles must also meet the threshold to recover pain-and-suffering damages, though their injuries typically clear it easily. Motorcyclists are not subject to it.
What if my MRI shows degeneration as well as a herniation?
This is the most common defense argument. It can be overcome with a physician's causation opinion linking the findings to the trauma — another reason prompt, consistent treatment is critical.