In New York, your own no-fault (PIP) insurance pays your medical bills first — up to $50,000 per person — no matter who caused the truck accident. Once that runs out, health insurance, MedPay, or workers' comp may cover the gap. If your injuries are serious, the trucking company's liability insurer may owe you more through a settlement or lawsuit.
That is the short answer. But truck accident medical bills often exceed $50,000, and each payment source has rules and deadlines that can cost you coverage if you miss them. Here is how each layer works.
How No-Fault Insurance Pays Medical Bills After a Truck Accident
New York is a no-fault state. Under New York Insurance Law § 5103, the insurer of the vehicle you were in at the time of the crash pays your first-party benefits first. That is true even if the truck driver was 100% at fault. This applies to drivers, passengers, cyclists struck by the truck, and pedestrians.
Basic no-fault coverage (also called Personal Injury Protection, or PIP) provides, under Insurance Law § 5102:
- All medically necessary treatment — doctor visits, hospital stays, surgery, physical therapy, imaging, prescriptions
- 80% of lost wages, up to $2,000 per month, for up to three years from the accident date
- $25 per day for up to one year for other out-of-pocket expenses tied to the injury
The basic no-fault limit is $50,000 per person. Some auto policies carry higher optional limits — check your declarations page.
What's in this video?
The Orlow Firm explains the sources that pay for medical bills after a vehicle accident in New York, including no-fault (PIP) insurance, health insurance, and the at-fault driver's liability coverage. The rules are the same whether the other vehicle was a car or a commercial truck.
Do Not Miss These Deadlines
New York's no-fault rules (DFS Regulation 68, 11 NYCRR 65) set firm timelines:
- 30 calendar days after the accident — you must notify the no-fault insurer in writing. Missing this can get your entire claim denied.
- 45 days after each date of service — medical providers must submit bills for payment to be considered.
If hospitalization or another good cause prevented timely notice, you can document that for a late filing. But the default rule is 30 days. Move quickly.
What Happens When No-Fault Runs Out After a Truck Accident
Truck accidents are not fender-benders. A crash with a loaded 18-wheeler can cause spinal damage, traumatic brain injuries, multiple fractures, and months of rehabilitation. Fifty thousand dollars goes fast.
When no-fault runs out, these sources can help:
Your health insurance. Once PIP is gone, your group health plan or individual policy covers further treatment under your normal deductibles and copays. Health insurers do not wait for the lawsuit to resolve — they pay on your regular billing cycle.
MedPay. This is an optional add-on to your auto policy. It pays without a deductible, without regard to fault, and without waiting. It can cover copays and costs your health plan leaves unpaid.
Additional PIP (APIP). If your policy includes higher optional PIP limits, those kick in after the basic $50,000 is gone.
Workers' compensation. If the truck accident happened while you were working — driving a delivery vehicle, operating a company truck, or in some cases commuting on the job — workers' comp is the primary coverage, not a backup to no-fault. Workers' comp pays all medically necessary treatment with no cap on medical benefits, plus two-thirds of your average weekly wage for lost time.
Can You Sue the Trucking Company for Medical Bills and Other Damages?
New York law limits the right to sue for pain and suffering to cases involving a "serious injury" as defined in Insurance Law § 5102(d). Under § 5104, serious injury includes:
- Death
- Dismemberment
- Significant disfigurement
- A fracture
- Loss of a fetus
- Permanent loss of use of a body organ, member, function, or system
- Permanent consequential limitation of use of a body organ or member
- Significant limitation of use of a body function or system
- A medically documented injury that prevents you from performing your normal daily activities for at least 90 out of 180 days following the accident (the "90/180-day rule")
Truck crashes often satisfy this threshold without difficulty. A broken bone qualifies. Permanent spinal damage qualifies easily.
When the threshold is met, you can bring a lawsuit against the truck driver, the trucking company, or both. Trucking companies sometimes face direct liability for things like failing to check a driver's safety record, violating federal Hours of Service limits on how long a driver can be on the road, or failing to maintain the truck in safe condition.
Federal law requires most commercial freight carriers transporting general freight in interstate commerce to carry at least $750,000 in liability coverage under 49 CFR § 387.9. The truck's insurer does not pay your bills during treatment — it pays at settlement or after a verdict. In the meantime, your own coverage carries the load.
What's in this video?
This video from The Orlow Firm explains what makes truck accident cases different from standard car accident cases — including federal regulations governing commercial drivers, the multiple parties who may be liable, and why evidence preservation matters more than in a typical vehicle crash.
Medical Liens: Who Gets Paid Back from Your Settlement?
If your health insurance paid for treatment and you later recover money from the trucking company, your insurer may want that money back. This right is called subrogation.
Under General Obligations Law § 5-335, most private health insurers cannot assert a reimbursement claim against your personal injury settlement in New York. You generally keep the full amount without paying your health insurer back.
There are exceptions. These entities can assert liens:
- Medicare — federal law governs Medicare liens, and they must be resolved before any settlement closes
- Medicaid — New York Medicaid has lien rights, subject to limits
- Self-funded ERISA plans — employer health plans that are self-funded are governed by federal ERISA law, which overrides New York's protection. If your employer's health plan is self-funded, that insurer may have lien rights.
- Workers' compensation — if workers' comp covered your treatment, it has a lien on your personal injury recovery under Workers' Compensation Law § 29
Under Lien Law § 189, hospitals that provided emergency or inpatient care can place a lien on your settlement for the cost of that care.
Letters of protection are another tool. Some providers will treat accident victims and agree in writing to be paid from the settlement rather than at the time of service. This gives you access to treatment even when PIP runs out and health insurance is uncertain.
Frequently Asked Questions About Truck Accident Medical Bills
Does the truck driver's insurance pay my medical bills right away?
No. Your own insurer pays first under New York's no-fault system, regardless of who caused the crash. The truck's liability insurer pays only through settlement or judgment — not while treatment is ongoing.
What if I don't have health insurance after a truck accident?
No-fault PIP covers up to $50,000 in medical bills regardless of your health insurance status. Pedestrians struck by a truck are entitled to no-fault benefits from the truck's insurer. If bills go beyond $50,000 and you have no health coverage, some providers offer letters of protection or payment plans. Medicaid may also cover treatment.
Can the trucking company refuse to pay my medical bills outright?
Yes — the trucking company's insurer will not pay bills as they come in during a pending case. It pays at settlement or after a verdict. Your immediate coverage comes from your own PIP and health insurance.
What is the 90/180-day rule in truck accident cases?
It is one way to meet New York's serious injury threshold. If a medically documented injury prevented you from performing your normal daily activities for at least 90 out of the 180 days after the accident, you can sue for pain and suffering outside no-fault. Your treating doctors need to document this clearly.
Do I have to pay back my health insurance from my truck accident settlement?
Under New York General Obligations Law § 5-335, most private health insurers cannot recoup from your personal injury settlement. The exceptions are Medicare, Medicaid, self-funded ERISA plans, and workers' compensation — those liens need to be addressed before the settlement closes.
Sources & Official Resources
New York Laws Cited
- Insurance Law § 5102 — Definitions (Basic Economic Loss, Serious Injury)
- Insurance Law § 5103 — Entitlement to First-Party Benefits
- Insurance Law § 5104 — Causes of Action for Personal Injury
- General Obligations Law § 5-335 — Health Insurance Subrogation Bar
- Lien Law § 189 — Hospital Liens on Personal Injury Recoveries
- Workers' Compensation Law § 29 — Workers' Comp Lien Rights
Regulatory Sources 7. DFS No-Fault Insurance FAQ — Coverage, Deadlines, and Procedures 8. DFS Regulation 68 (11 NYCRR 65) — No-Fault Claims Procedures
Federal Sources 9. 49 CFR § 387.9 — FMCSA Minimum Financial Responsibility for Motor Carriers
Contact The Orlow Firm
Medical bills after a truck accident add up fast, and the rules on who pays — and when — are more layered than most people expect. If you have questions about your no-fault rights, what your health insurance owes you, or what happens when injuries are serious, the attorneys at The Orlow Firm can walk you through your options.
Our team has handled personal injury cases throughout New York City for over 40 years, including truck accident cases across Queens and the surrounding boroughs. Consultations are free. We work on contingency — no fee unless we recover for you.
Call (646) 647-3398 for a free consultation. Se Habla Español.
Prior results do not guarantee a similar outcome.
Cases referenced for illustration: $997,997 recovery for a taxi driver struck head-on by a truck (back surgery); $675,000 recovery for a client rear-ended by a tractor-trailer (bilateral shoulder surgery). These figures show the scale of medical costs truck accidents typically generate — not a prediction of any particular case outcome.
