A lot of people hurt in Buffalo crashes are surprised to learn they can’t simply sue the driver who hit them for pain and suffering. New York’s no-fault system trades that right away for benefits that pay regardless of fault, unless the injury crosses a line the law calls “serious injury.” Since May 2026, that line has moved.
Why does the threshold exist?
No-fault pays your medical bills and lost wages up to $50,000 regardless of fault. In exchange, Insurance Law 5104 limits lawsuits between people covered by the system. You can sue for non-economic loss, meaning physical pain, emotional distress and lost enjoyment, only if you have a serious injury. Economic losses above the basic $50,000 aren’t limited by the threshold.
What counts as a serious injury now?
Under Insurance Law 5102(d), as amended in 2026, a serious injury is one that results in any of the following.
- 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.
The old ninth category, an injury that kept you from substantially all of your usual activities for at least 90 of the first 180 days, was deleted for actions commenced on or after May 26, 2026. The DFS circular letter explains the change. Read our guide to the 2026 reform for the rest of it.
Which categories are easy to prove?
Some are fairly clear-cut. A fracture shows up on an X-ray or CT scan, and even a small one counts. Death and dismemberment speak for themselves. Significant disfigurement usually means scarring a reasonable person would find unattractive or objectionable, and photos taken over time help show it.
Which categories get fought over?
The two limitation categories cause most of the litigation, especially in neck, back and shoulder cases.
- Permanent consequential limitation means a lasting limitation that’s more than minor.
- Significant limitation doesn’t have to be permanent but must be more than slight, and it usually needs to last a meaningful time.
Courts generally want objective medical evidence, such as range-of-motion measurements compared to normal values, MRI findings or nerve studies, along with a doctor’s explanation of how the crash caused the limitation. Your own description of pain matters, but it isn’t enough on its own.
What do insurers argue?
- Pre-existing conditions. An MRI showing degeneration lets the defense say the problem was there before. Your doctors need to address whether the crash caused or worsened it.
- Gaps in treatment. Stopping care for months, without explanation, suggests you got better. If no-fault cut you off or you ran out of benefits, make sure that’s documented.
- Minor findings. A small loss of motion may be called insignificant.
How is the threshold decided?
Often, the defense files a motion for summary judgment, arguing you can’t meet the threshold as a matter of law. Both sides submit medical reports. If the judge finds a real factual dispute, the case goes forward. At trial, the 2026 amendments require the jury to decide fault first, and only then decide whether there’s a serious injury.
Who isn’t bound by the threshold?
Motorcycle operators and passengers aren’t covered by no-fault, so they generally don’t face the threshold when suing. People hurt by a vehicle that isn’t covered by the system, and some out-of-state situations, may also fall outside it. Ask about your own facts.
What helps your claim?
- See a doctor promptly and describe every symptom, not just the worst one.
- Follow the treatment plan and keep appointments.
- Ask your doctor to measure and document your limitations.
- Keep a simple journal of what you can’t do, like lifting your kids, shoveling snow or sitting through a shift.
- Photograph scars and visible injuries regularly.
The short version
- Pain and suffering claims after a New York crash require a serious injury.
- Fractures, disfigurement, permanent limitations and significant limitations still qualify.
- The 90/180 category is gone for suits filed on or after May 26, 2026.
- Objective medical proof decides most limitation cases.
No-fault bills still have to be sent on time
Winning or losing the serious-injury argument does not change the first no-fault deadlines. The DFS filing FAQ still generally requires notice of the claim within 30 days and medical bills within 45 days. Those bills, and the treatment notes behind them, are often the same bills and treatment notes a court later uses to decide whether an injury is a fracture, a significant limitation or another statutory category. A gap in treatment that starts because a bill was never submitted can hurt both the no-fault claim and the threshold showing.
Motorcyclists are generally outside no-fault and do not have to cross the threshold to sue, which the DFS no-fault FAQ explains. Pedestrians and cyclists usually do have to cross it if they want pain-and-suffering damages from a covered person, unless a 2026-reform exception applies to the case.
The 2026 reform also added a $100,000 cap on non-economic damages in some cases involving certain at-fault drivers, as the DFS Circular Letter No. 3 (2026) explains. That cap, where it applies, is a damages issue, not a reason to miss the 30-day no-fault notice. Our 2026 reform guide covers when the new rules apply to a case commenced on or after May 26, 2026.
This is general information. A lawyer can review your medical picture against the categories. You can browse attorneys around Buffalo.