When the Rules of No-Fault Car Insurance Don’t Apply

Gabriel A. Assaad
Partner Gabriel Assaad represents victims of negligence and medical malpractice nationwide.

Car accidents happen every day all across the United States. Last year, there were over 6.2 million police-reported crashes, according to the National Highway Traffic Safety Administration (NHTSA). With so many accidents, the financial ramifications to both individuals and states can be significant. The NHTSA states that car crashes cost over $240 billion per year. As a result, nearly every state has set mandates requiring drivers to carry at least a minimum amount of auto insurance. Auto insurance pays for the property damage and injuries to drivers and passengers after an accident and helps protect people from financial hardship related to a car crash. States take different approaches to auto insurance, and Washington, DC is what is known as a no-fault state.

What Is No-Fault Auto Insurance?

In most states, when an accident occurs, the person who is responsible for causing the crash must pay for the damages sustained by everyone involved. In 12 states, including Washington, DC, the system is different. In these no-fault states, one’s own insurance policy covers the damage sustained in a car accident—regardless of who is to blame. No-fault insurance is designed to save money, process claims faster, and reduce the instances of litigation over small claims.

Exceptions to No-Fault Insurance Allow Victims to Pursue Legal Action

In the majority of accidents in a no-fault state, an accident victim must seek compensation from his own insurance company and will not receive any financial support from the at-fault driver. There are some accidents and injuries that are extremely severe, however, and the law makes allowances for Glowing Green Exception Signthose victims. In these special circumstances, a crash victim can pursue legal action even in a no-fault state. Those circumstances fall under two main categories:

  • Monetary threshold. Accident victims can sue if their medical bills are significant and surpass the limits of no-fault insurance. Receipts and doctor testimony are often necessary to prove the monetary threshold. The monetary threshold can also apply to lost wages if the injuries cause the victim to miss work.
  • Injury threshold. The injury threshold addresses serious, long-lasting injuries and how they can affect both daily life and the ability to work.

What Exactly Is the Monetary Threshold in DC?

The monetary threshold is different in every state with no-fault insurance. In Washington, DC, the district has set the following requirements for drivers:

  • $25,000 personal injury protection
  • $10,000 property damage

While some drivers may elect to purchase more coverage, every driver must have at least these amounts to cover medical bills and property damage. When it comes to the monetary threshold, the accident victim must first exhaust his own policy before pursuing legal action against the at-fault driver. Once a victim has bills totaling $25,000 paid by his own insurance, he may be permitted to sue the at-fault driver for any additional money that is spent in relation to treating injuries sustained in the accident. It is also possible to obtain compensation for lost wages.

What Injuries Are Considered Serious Enough to Meet the Injury Threshold?

The injury threshold addresses the pain and suffering a victim can experience after an accident, and it requires the victim to have a serious injury. Defining an injury as “serious” can be open to interpretation, and each state has different definitions as to what constitutes an injury that meets the threshold. In general, a serious injury includes:

  • A permanent disability
  • Loss of a limb or body organ
  • Bone fractures
  • Permanent or significant disfigurement

Often, testimony from a doctor is necessary to back up the claim of a serious injury.

Working With Your Insurance Company Is Necessary in a No-Fault State

Typically, lawyers advise clients not to discuss their accident or injuries with an insurance adjustor. However, in a no-fault state, the law usually requires victims to cooperate with insurance companies. Failure to cooperate could mean the termination of benefits and prevent the victim from receiving compensation.

The rules for compensation after an accident are unique in no-fault states. To ensure you and your family receive the support you need to be healthy and stable, call an experienced attorney who can help you understand your rights and offer advice about how best to proceed. The skilled legal team at Kennedy Hodges, LLP handles accident cases nationwide from our offices in Houston and DC, and we may be able to help you pursue a claim even in a no-fault state. Take a moment to fill out our online contact form to learn more and schedule a free, no-obligation consultation.