Car accident claims: how they work

Fault states and no-fault states#

Most states use a fault system. The driver who caused the crash is legally responsible for the losses, and their liability insurance pays your medical bills, lost income, vehicle damage and pain and suffering, up to the policy limits. Your own policy may pay some bills sooner, but the at-fault driver's insurer is the main source of money.

No-fault laws apply in 12 states: Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah. In these states your own personal injury protection (PIP) pays your medical bills and some lost income, whoever caused the crash. In exchange, your right to sue the other driver for pain and suffering is limited by a serious injury thresholdSerious injury threshold. A rule in some no-fault states that lets you sue the at-fault driver for pain and suffering only if your injury meets a legal definition of serious, or a dollar level of medical bills. Glossary:

• Verbal threshold. The injury must fit a legal description. In Michigan, for example, a suit for pain and suffering needs death, serious impairment of body function, or permanent serious disfigurement.
• Monetary threshold. Medical bills must pass a dollar level, or the injury must be of a listed type. In Utah, one route is medical expenses above $3,000.

In Kentucky, New Jersey and Pennsylvania, drivers choose on their policy whether to accept the lawsuit limit or keep the full right to sue. If you live in one of these states, your policy's declarations page shows which option applies to you.

Some fault states add PIP to every policy without limiting lawsuits. Texas, for example, includes at least $2,500 of PIP unless the policyholder rejects it in writing, and you can still claim against the driver who caused the crash. The Texas guide has the details.

What a negligence claim must prove#

Most car accident claims are negligenceNegligence. Failing to use the care a reasonable person would use in the same situation, such as running a red light or texting while driving. Glossary claims. To recover, the injured person generally has to show four things:

• Duty. Every driver owes others on the road a duty to drive with reasonable careDuty of care. The legal obligation to act with reasonable care toward others. Every driver owes it to everyone else on the road. Glossary.
• Breach. The driver fell short of that care, for example by speeding, running a light, following too closely, texting or driving impaired.
• Causation. That carelessness caused the crash and your injuries. This link is called causationCausation. The link between someone's careless act and your injury. You must show the crash caused the harm you are claiming. Glossary.
• Damages. You suffered real losses: medical bills, lost income, vehicle damage, pain and suffering.

Breaking a traffic law is strong evidence of carelessness, and any ticket the officer wrote will appear in the police report. A ticket is not the final word on fault, though: insurers and courts look at all the evidence, including your own account and what witnesses saw.

Insurers rarely argue about duty. Most disputes are about breach (who had the green light) and causation (whether the injuries came from this crash). That is why evidence matters so much.

Evidence that counts#

The strongest claims are built from records made close to the time of the crash. These are the pieces adjusters look at first:

Camera footage from nearby shops, homes and buses may be recorded over, so many people ask for it in the first days. In disputed cases, lawyers may also seek phone records or the data stored in a car's crash recorder. Our guide to the first 72 hours after a car accident lists what to collect at the scene.

How shared fault changes a claim#

Many crashes involve some blame on both sides. Most states use comparative negligenceComparative negligence. A rule that splits blame between the people involved and cuts your recovery by your own share of fault. Glossary: your recovery is cut by your own share of fault. The states differ on where the cut-off falls:

• 51% bar: 26 jurisdictions, including Texas and Florida, bar recovery once you are more than 50% at fault.
• 50% bar: 10 jurisdictions bar recovery at 50% or more.
• Pure comparative fault: 9 jurisdictions let you recover something even if you were mostly at fault.
• Contributory negligence: 5 jurisdictions can bar recovery for almost any fault of your own.
• Slight versus gross negligence: South Dakota uses its own test.

These rules change. In New York, for example: Since May 26, 2026, a car-crash injury plaintiff more at fault than the defendant(s) recovers nothing; wrongful death and property damage claims stay pure comparative, and suits filed before that date follow the old pure rule. Try the fault-rule explainer to see how your state treats a given share of blame.

Policy limits and where the money comes from#

The other driver's policy limitsPolicy limits. The most an insurance policy will pay for one claim or one accident, no matter how large the losses are. Glossary usually cap what their insurer will pay, however large the losses. Each state sets a minimum. Texas requires $30,000 per person and $60,000 per crash for injuries; Pennsylvania requires $15,000 and $30,000; Maine requires $50,000 and $100,000. Drivers can buy more, but the law requires only the minimum.

When your losses are larger than the other driver's coverage, there may be other sources:

• Your own underinsured motorist coverage, which can pay the difference up to your limits. Our guide to uninsured driver accidents explains how it works.
• Another responsible party, such as an employer whose worker was driving for the job; see company vehicle accidents.
• The driver personally. A court judgment above the policy limits is the driver's own debt, but collecting it from an individual can be hard.

If the other driver had no insurance at all, your uninsured motorist coverage is often the main source. The Insurance Information Institute estimates that 14.5% of Texas drivers were uninsured in 2023.

Steps in a typical car accident claim#

1. Get medical care and report the crash. Call 911 if anyone is hurt, make sure a police report is made, and get checked the same day.
2. Tell your own insurer. Most policies require prompt notice. Reporting a crash is not an admission of fault.
3. Open a claim with the other driver's insurer. Give basic facts. You generally do not have to give that insurer a recorded statement.
4. Use your own coverage for early bills. PIP, medical payments coverage or health insurance can pay while fault is sorted out.
5. Build your claim file. Keep the report, photos, witness details, records, bills and proof of lost pay in one place.
6. Finish treatment or reach a stable point. Claims are usually valued once doctors can say what the injury has cost and will cost.
7. Send a demand and negotiate. The insurer answers with an offer, and most claims settle with a signed release.
8. File a lawsuit before the deadline if needed. Talks with an insurer do not pause your state's filing deadline.

Our claim process guide walks through each stage in detail.

Deadlines for car accident claims#

Every state sets its own deadline for car-crash lawsuits. For an adult's injury claim it is 2 years in Texas, 2 years in California, 3 years in New York and only 1 year in Tennessee. A claim against a city or state agency may need a written notice much sooner; in Texas it is due within 6 months.

PIP claims on your own policy have separate deadlines, set by state law and the policy, and they can be very short. Look up your state's rules in our state-by-state guides.