Rear End Collision
$2,300,000
Insurer offered$85,000
Spinal cord injury after a rear end crash. The insurer offered $85,000.
Serving New York
New York Insurance Law 5104: The No Fault Lawsuit Threshold
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In New York, Insurance Law 5104 is the rule that stops most crash victims from suing for pain and suffering unless they prove a serious injury. It is the reason your medical file matters more than the police report. Top USA Law builds the proof that clears the threshold. Call (877) 411-5291 for a free case review.
What does Insurance Law 5104 say?
New York Insurance Law section 5104 subsection (a) says that in any action between covered persons arising from the negligent use of a motor vehicle in New York, there is no right to recover for non economic loss unless the injured person has suffered a serious injury, and no right to recover for basic economic loss. Two rules live in that one sentence.
First, pain and suffering, the damages that make up most of a serious car accident recovery, are off the table unless your injury fits one of the categories defined in New York Insurance Law section 5102 subsection (d). For lawsuits filed on or after May 26, 2026, eight categories remain, because Chapter 58 of the Laws of 2026 (Part EE) removed the 90 day daily activities category. Second, the first 50,000 dollars of medical bills and lost wages are handled by no fault insurance and cannot be sued for a second time.
The section applies between covered persons, which in practice means almost everyone in a crash involving insured New York vehicles: drivers, passengers, pedestrians and cyclists struck by a car. A motorcyclist is not a covered person under the no fault law, which is why a rider can sue without meeting the threshold.
How do you clear the 5104 threshold?
You clear it with medical proof, not with the facts of the crash. The insurer for the at fault driver will move to dismiss your lawsuit by arguing that your injury is not serious. Your side answers with a doctor's sworn report that identifies the category, states the objective findings behind it, and explains why the injury was caused by this crash rather than by age or a prior condition. The categories most often litigated are permanent consequential limitation and significant limitation.
What evidence usually decides a threshold motion?
- Imaging that shows a structural injury, such as a fracture, herniation or tear, taken soon after the crash.
- Range of motion measurements in degrees, compared to normal, recorded at the first visit and again months later.
- A treatment history without long unexplained gaps, or a written explanation for any gap.
- A doctor's opinion that the limitation is permanent or significant and was caused by the collision.
- Records showing which daily activities you could not do and a doctor's instruction to limit them, which support the limitation opinion.
A worked example
A passenger in a Queens rideshare crash suffers a torn rotator cuff and has surgery four months later. The surgery report, the pre operative MRI and a post operative range of motion test showing a measured loss of overhead reach together establish a permanent consequential limitation. The insurer's motion to dismiss fails, and the case proceeds to a settlement that includes pain and suffering. The same injury, treated with two urgent care visits and nothing more, would likely be dismissed at the threshold stage.
What happens if the court finds no serious injury?
The pain and suffering claim is dismissed. You keep your no fault benefits and any claim for economic loss above 50,000 dollars, but the value of the case drops sharply. Because the motion is usually decided on the paper record, the records you create in the first weeks after a crash decide the outcome months later.
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Results in cases like this
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Traumatic brain injury caused by an impaired driver. The insurer offered $50,000.
Every case is different. Past results do not guarantee, warrant, or predict a similar outcome.
Where we help in New York
How Top USA Law handles the threshold in New York
We treat section 5104 as the first battle in every New York car accident case. Within days of your call we identify the category we intend to prove, coordinate treatment with doctors who document objectively, and prepare the sworn medical narrative before the insurer asks for it. Paul Perkins, Of Counsel, is licensed in New York and litigates threshold motions. Start with the New York car accident lawyer page or call (877) 411-5291.
Related New York statute guides
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Frequently Asked Questions
Who counts as a covered person under section 5104?
A covered person is generally any owner, operator or occupant of an insured New York motor vehicle, and any pedestrian or cyclist injured by one. The threshold in New York Insurance Law section 5104 applies to lawsuits between covered persons. A motorcycle is not a motor vehicle under the no fault law, so a motorcyclist is outside the threshold.
Can I still get my medical bills paid if my injury is not serious?
Yes. Your no fault benefits under New York Insurance Law section 5103 pay medical bills and lost wages up to 50,000 dollars regardless of whether your injury meets the threshold. Section 5104 limits only the lawsuit for pain and suffering and for the first 50,000 dollars of economic loss.
Does the threshold apply if the other driver was drunk?
Yes. The threshold in section 5104 does not have an exception for intoxicated or reckless drivers. The driver's conduct matters for fault and for the value of the case, but you still must prove a serious injury under Insurance Law 5102(d) to recover pain and suffering.
How long do I have to meet the threshold?
There is no separate deadline for the threshold itself. You must file the lawsuit within three years under New York CPLR section 214, and the serious injury proof is developed inside the case. The filing date, not the crash date, decides which version of the serious injury definition applies, and records from the first six months still carry the limitation categories.
Last reviewed by Paul Perkins, Esq., September 2026.
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