5 Things to Know About New York's Serious Injury Threshold
1. What Qualifies as a Serious Injury?
Under New York Insurance Law § 5102(d), a serious injury includes:
- Death
- Dismemberment
- Significant disfigurement
- 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 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
2. Treatment Gaps Matter
Courts require explanation for gaps in medical treatment. A plaintiff who terminates therapeutic measures or fails to pursue further treatment must offer some reasonable explanation for their actions. Unexplained gaps in treatment can undermine your serious injury claim.
3. Pre-Existing Injuries Require Careful Proof
When pre-existing conditions are present, plaintiffs must demonstrate that their current symptoms were actually caused by the accident, not the prior condition. This requires detailed medical evidence showing how the accident exacerbated or caused new injuries distinct from pre-existing conditions.
4. Deficiencies Must Be Quantified
Medical evidence must provide objective, quantitative evidence of limitations, comparing the plaintiff's condition to normal function. Vague or subjective descriptions of pain or limitations are insufficient. Your medical records must include specific measurements, range of motion tests, and objective findings.
5. Medical Records Must Be Properly Certified
Proof submitted must be in admissible form. Unsworn medical records are generally insufficient for summary judgment. Your attorney must ensure all medical documentation is properly certified and meets evidentiary requirements for court proceedings.
