New York no-fault (auto accident)
No-fault DME in New York, explained
How no-fault covers durable medical equipment after a car accident — the payment clock, assignment of benefits, and who pays — in plain language, from a Brooklyn desk that handles these claims daily.
The short answer
Does New York no-fault cover DME after a car accident?
Yes. New York’s no-fault rules (Regulation 68) cover durable medical equipment prescribed after a covered auto accident. With an assignment of benefits, the supplier bills the insurer directly, so you aren’t billed where your claim applies. A prescription is required, and eligible patients pay $0 out of pocket where your claim applies and documentation is complete.
Does New York no-fault cover medical equipment?
Yes — durable medical equipment prescribed for injuries from a covered auto accident is part of the medical benefits under New York’s no-fault rules (Regulation 68, found at 11 NYCRR Part 65). That spans the recovery equipment an auto injury calls for — from back braces and CPM rentals to cold therapy units, compression devices, and ankle-foot supports. A prescription from your treating provider is always required before equipment is supplied.
No-fault DME is priced using the same fee schedules New York uses for workers’ comp: under the no-fault rules (11 NYCRR 65-3.16 and 68.1), medical expenses are measured against those adopted schedules. That is what sets the reimbursement the insurer pays the supplier.
This is general information about the New York process, not legal advice.
- Reg 68
New York no-fault rules, 11 NYCRR Part 65
- 30 days
Payment clock after the insurer receives proof of claim
- AOB
Assignment of benefits — the bill goes to the carrier
How no-fault DME payment works
The facts that shape a New York no-fault DME claim, and how the desk keeps a referral moving.
- 30 days
No-fault payment clock after proof of claim
- Reg 68
New York no-fault rules (11 NYCRR Part 65)
- AOB
Supplier billed directly via assignment of benefits
- 5
Boroughs served from Brooklyn
How fast does no-fault have to pay? The 30-day clock
Under New York’s no-fault rules (11 NYCRR 65-3.8), no-fault benefits are overdue if the insurer does not pay within 30 calendar days after it receives your proof of claim — which is why we confirm the prescription and claim details before fulfillment.
Proof of claim received
The insurer receives your proof of claim, and the 30-calendar-day payment clock starts running.
A verification request pauses the clock
If the insurer asks for additional records or information, the clock stops until the requested material is received — then resumes.
Payment due when the clock runs out
Benefits are overdue if the insurer has not paid within the 30 days. Complete, prompt documentation is what keeps the clock running.
Will I be billed? Assignment of benefits
Where your claim applies, you generally are not billed. With a signed assignment of benefits (an NF-AOB), the DME supplier is paid directly by the no-fault insurer instead of billing you for the equipment. That is how eligible patients pay $0 out of pocket where your claim applies and documentation is complete.
If there is a coverage or documentation problem, we explain the issue before fulfillment rather than leaving you to sort out a bill later.
With an assignment of benefits, the bill routes to the carrier — not to you.
What if the same accident is also a workers’ comp claim?
Sometimes one accident triggers both no-fault and workers’ compensation — for example, a crash while you were working. When that happens, the paths don’t stack; one carrier owns the medical expenses.
When the accident is also a workers’ comp claim
New York’s no-fault rules (11 NYCRR 65-3.16) make the workers’ comp carrier the source of medical-expense reimbursement instead of the no-fault insurer.
What we confirm first
We help confirm which claim path applies before equipment is supplied, so the right carrier is billed the first time.
Send a no-fault DME referral
Patients, attorneys, providers, and adjusters can start one here. Send the patient’s details, the prescription, and the claim information, and the Brooklyn desk reviews it the next business day.