New York’s serious injury threshold explained

New York’s no-fault system pays your basic medical bills and lost wages after a car crash, whoever caused it. In exchange, the law limits lawsuits. You cannot recover for pain and suffering from the driver who hit you unless you have a “serious injury” as the Insurance Law defines it.¹

That definition decides many New York car accident cases, and it changed in 2026. This guide explains what the threshold is, which injuries qualify today, and how courts and insurance companies test the medical proof.

What the threshold limits

Insurance Law § 5104(a) applies when a “covered person” sues another covered person over the negligent use or operation of a motor vehicle in New York. In that lawsuit there is “no right of recovery for non-economic loss, except in the case of a serious injury, or for basic economic loss.”¹

Non-economic loss means pain and suffering and similar harms that are not about money.² Basic economic loss is the first $50,000 per person of medical expenses, lost earnings and certain other costs, which no-fault pays.² So you cannot sue the other driver for losses no-fault already covers. You can pursue economic losses above basic economic loss, and you can pursue pain and suffering only if you prove a serious injury.¹

The serious injury categories

Under Insurance Law § 5102(d), “serious injury” means a personal injury that results in one of the categories below. The first eight are the current law, quoted from the statute.² The last row is the category the Legislature deleted in 2026.³

Neck, back and joint cases are often fought over the two “limitation” categories. The Court of Appeals has said a limitation that is only “minor, mild or slight” is insignificant under the statute.⁵⁶

What changed in 2026

New York’s 2026 budget legislation, Part EE of Chapter 58 of the Laws of 2026, amended the threshold rules.³ The Department of Financial Services reports that these amendments took effect on May 26, 2026, and apply to all actions and proceedings commenced on or after that date.⁴

• The 90/180-day category is gone. Before the amendment, § 5102(d) also covered “a medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment.” Part EE deleted that language.⁴
• Fault is decided first. The jury must decide who was at fault before deciding whether an injury is serious, and no one can be held liable for non-economic loss until the jury finds a serious injury.¹
• A $100,000 cap for some at-fault drivers. Non-economic damages are capped at $100,000 for an at-fault injured person who was driving an uninsured vehicle they were responsible for insuring (unless the lapse was under 30 days), or who was convicted of impaired driving or of a felony committed at the time of the crash. The cap does not apply in death cases.¹
• More-at-fault claimants are barred. In personal injury cases governed by the no-fault article, a claimant whose fault is greater than the fault of the defendant, or of all the defendants combined, cannot recover.⁹ Our comparative negligence guide explains how fault affects recovery.

How courts read the old 90/180-day category

Cases already filed under the earlier definition still turn on how courts read it. In Licari v. Elliott, the Court of Appeals explained that the threshold was meant to weed out frivolous claims and limit recovery to significant injuries.⁵ The category required objective evidence of a “medically determined injury or impairment,” not just the injured person’s description.⁶ In Perl v. Meher, the Court rejected a 90/180 claim where the plaintiff was able to do some work from home less than three months after the accident and her doctors’ records said nothing about what activities she could and could not do.⁸

Objective proof and range of motion

The leading case on medical proof is Toure v. Avis Rent A Car Systems. The Court of Appeals held that “subjective complaints alone are not sufficient.”⁶ Your claim needs objective medical evidence.

Toure described two ways a doctor can supply it. First, “an expert’s designation of a numeric percentage of a plaintiff’s loss of range of motion can be used to substantiate a claim of serious injury.”⁶ Second, a qualitative assessment may work if it “has an objective basis and compares the plaintiff’s limitations to the normal function, purpose and use of the affected body organ, member, function or system.”⁶

Imaging matters, but it is not the whole story. In Pommells v. Perez, the Court explained that “proof of a herniated disc, without additional objective medical evidence establishing that the accident resulted in significant physical limitations, is not alone sufficient to establish a serious injury.”⁷

Measurements do not have to be taken right away

Some courts once dismissed cases because the treating doctor did not measure range of motion right after the crash. In Perl v. Meher, the Court of Appeals rejected that rule. “We therefore reject a rule that would make contemporaneous quantitative measurements a prerequisite to recovery.”⁸ In that case, a doctor examined the plaintiff shortly after the accident and took numerical range-of-motion measurements years later. The Court reinstated the order denying the defendants’ summary judgment motion.⁸

Gaps in treatment and pre-existing conditions

Defendants look closely at the treatment timeline. In Pommells v. Perez, the Court of Appeals held that a plaintiff who stops treatment after the accident while claiming serious injury “must offer some reasonable explanation for having done so.”⁷

The Court also explained that “even where there is objective medical proof, when additional contributory factors interrupt the chain of causation between the accident and claimed injury, such as a gap in treatment, an intervening medical problem or a preexisting condition, summary dismissal of the complaint may be appropriate.”⁷

How defendants test your injury

Defense medical examinations

Once you sue and your physical condition is in controversy, the defendant can require you to be examined by a doctor it chooses.¹⁰ Many people call this an IME, short for independent medical examination, although the doctor is hired by the defense. Defense doctors often report normal range of motion, a “resolved” sprain, or degeneration that existed before the crash.

Summary judgment on the threshold

The most common defense move is a motion for summary judgment, which asks the judge to dismiss the case before trial on the ground that there is no serious injury. The defense usually supports it with the examining doctor’s report and record reviews. If the defense makes that initial showing, you must answer with objective medical proof of a serious injury caused by the accident.⁷

The Court of Appeals has acknowledged that no-fault abuse remains a concern, but it has also recognized that in some cases “the role of skeptic is properly reserved for the finder of fact.”⁸ Strong treating-doctor documentation, measured findings and a clear explanation of any gap give a case the best footing at this stage.

Who is outside the threshold

The threshold in § 5104(a) applies to suits between covered persons.¹ A covered person includes a pedestrian injured through the use or operation of an insured motor vehicle and the owner, operator or occupant of an insured motor vehicle.² A pedestrian hit by an insured car is a covered person, so the threshold generally applies to the pedestrian’s claim against the driver.

Motorcyclists are treated differently. The no-fault definition of “motor vehicle” excludes motorcycles, and motorcycle occupants do not receive no-fault benefits under these rules.²¹¹ Because of that, an injured motorcyclist is generally not a covered person and is not limited by the serious injury threshold when suing a car driver. The reverse is not true. A covered person suing a motorcyclist still has to meet the threshold.¹ Our motorcycle accident page covers these claims in more detail.

Whether your injury meets the threshold depends on your medical records, the timing of your treatment and when your case is filed. A lawyer can review those facts with you.