US-New YorkCan my insurance company refuse to pay a claim if I was partially at fault?
Yes, in New York, your insurance company can reduce or deny your claim if you were partially at fault — especially under no-fault auto insurance, where benefits are limited and fault affects liability claims.
What the Law Says
New York follows a 'pure comparative negligence' rule for liability claims and operates under a mandatory 'no-fault' auto insurance system. This means your recovery in a lawsuit may be reduced by your percentage of fault — and your no-fault benefits are available regardless of fault, but with strict limits and deadlines.
Under New York’s no-fault law, drivers must carry Personal Injury Protection (PIP) coverage. PIP pays for medical expenses, lost wages, and other out-of-pocket costs up to $50,000 — regardless of who caused the accident. However, this coverage does not cover pain and suffering, and it only applies to economic losses.
To sue the at-fault driver for additional damages (like pain and suffering), you must meet New York’s 'serious injury' threshold — defined in Insurance Law § 5102(d). Even then, if you’re found partially at fault, your total award is reduced by your share of negligence.
New York uses 'pure comparative negligence' — meaning you can still recover damages even if you’re 99% at fault, but your recovery is reduced proportionally. However, for liability claims against another driver, your ability to sue at all depends on whether your injuries meet the statutory seriousness standard — not just your degree of fault.
Statutory TextNo-fault benefits shall be payable without regard to negligence or fault...
— Insurance Law § 5103(a)(1) — Payment of benefits
Statutory TextA covered person is entitled to first-party benefits... up to a maximum of $50,000 per person...
— Insurance Law § 5102(a) — Definitions
Statutory TextSerious injury means... a personal injury which results in death, dismemberment, significant disfigurement, a fracture, loss of a fetus, permanent loss of use of a body organ, member, function or system...
— Insurance Law § 5102(d) — Definition of serious injury
What Courts Have Said
New York courts consistently uphold the no-fault framework and strictly interpret the 'serious injury' threshold and comparative fault reductions.
Court affirmed denial of PIP benefits because the insured failed to submit proof of treatment within 45 days of the accident, showing strict compliance with procedural requirements.
Reaffirmed that plaintiffs must meet the 'serious injury' threshold under § 5102(d) before pursuing a negligence claim — fault percentage is irrelevant if the threshold isn’t met.
What to Do
File your PIP claim with your insurer within 15 days of the accident — delays can jeopardize benefits.
Seek prompt medical treatment and keep detailed records to support both PIP and potential liability claims.
If injured, consult an attorney before accepting a settlement — your partial fault may be overstated, and the 'serious injury' threshold must be properly documented.
Preserve evidence (photos, witness statements, police report) to accurately assess fault percentages.
Sources
Not legal advice. This article is general information based on publicly available sources, written for educational purposes. Laws change and individual situations vary. Consult a licensed attorney in your jurisdiction before acting on anything you read here. Last reviewed: 2026-06-08.