Guide for Workers Claiming No-Fault Insurance Benefits

New York is among the states in the U.S which operate a no-fault workers’ compensation system. Worker’s compensation insurance, also known as no-fault insurance, is crucial for every small or large business. Besides providing medical care for injured workers, it also protects companies from bearing the compensation costs. If a worker receives an injury while working, they have a right to claim the no-fault insurance benefits without proving fault against the employer.

However, if by any chance the injury is a result of self-harm, a direct violation of company policy, or drug influence, they automatically lose the claim. It is therefore important for workers to understand their rights surrounding no-fault insurance benefits to guide them whenever such cases arise. This blog discusses what no-fault insurance is, who might qualify, how to claim it, what the benefits could cover, and everything an injured worker would want to know.

What is No-Fault Insurance?

As the name suggests, no-fault is a type of insurance designed to compensate employees for their injuries without proving fault against the opposite party. A worker is entitled to no-fault insurance benefits, no matter who is responsible for the injury. This means that fault does not affect benefits—they get the benefits without filing a lawsuit against the employer.

Who Qualifies For No-Fault Insurance Benefits?

Any employee who sustains injuries, whether caused by external accidental means or accidental in character and result, received in the course of and arising out of the injured employee’s employment is entitled to no-fault insurance benefits. Also, an employee who suffers disability due to occupational disease or a dependent of an employee whose death cause is an occupational disease qualifies for the benefits.

Claiming No-Fault Insurance Benefits in New York

Employees who suffer a work-related injury or develop an occupational disease while employed by a local government, state government, or private company must file a workers’ compensation claim through their state workers’ compensation board. As long as an organization has no-fault insurance coverage, any worker who sustains an injury at work is automatically entitled to compensation.

However, they first need to establish whether the injury is compensable—a New York personal injury lawyer can help here. This means that the insurer and the employer must agree if the injury is work-related and covered by the policy. Should the insurer dispute the claim, payments will be withheld until a judge or state workers’ compensation board mediates the case. It is important to note that the claim must be filed within two years of the date of the accident or injury or the date the worker was diagnosed with an occupational illness or disease.

What Do The Benefits Cover?

The benefits of workers’ compensation are generally awarded on a no-fault basis. For workers who are injured or killed while on the job, the insurance covers the following:

  • Medical care
  • Death
  • Disability
  • Rehabilitation benefits
  • Compensation for lost wages
  • Lawsuits

Bottom Line

Although workers’ compensation insurance aims at protecting employees who get injured at work, most of them are unsure of their rights after a work-related injury or disease. Also, since worker’s compensation laws are ever-changing, navigating the compensation process may prove difficult.

In these situations, you need an experienced personal injury lawyer to inform you of all your rights surrounding no-fault insurance benefits and to help you find the most effective way forward. To get help with filing a compensation claim, contact Napoli Shkolnik for a free case evaluation with a skilled lawyer.