Skip to main content
Map Location Offices in Roseland, Hoboken, West Orange Phone 24/7 Call Answering: 888.329.0805
David A. DiBrigida

When a Policy Option Limits Your Recovery

Posted in Personal Injury

People hurt in a New Jersey crash can be surprised to learn that pain and suffering is not always available. Auto policies in the state can carry an option that restricts recovery for those losses unless the injury meets a defined standard. These answers explain how the standard works and what evidence supports it.

Does New Jersey Limit Recovery for Pain and Suffering After a Crash?

It can. Under N.J.S.A. 39:6A-8, a policy written with the limitation option restricts recovery of noneconomic loss, such as pain and suffering, unless the injury falls into one of the categories the statute lists. Whether the limit applies depends on the option selected on the policy, so the policy language is the first thing to review.

Which Injuries Qualify Despite the Limit?

The statute allows recovery of noneconomic loss when the bodily injury results in one of the following:

  • Death
  • Dismemberment
  • Significant disfigurement or significant scarring
  • Displaced fractures
  • Loss of a fetus
  • A permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement

What Does Permanent Injury Mean Under the Statute?

The statute treats an injury as permanent when the body part or organ has not healed to function normally and will not heal to function normally with further medical treatment. The finding must rest on objective clinical evidence, and a certification from a treating physician or a board-certified physician is required.

Knowing what to expect from a personal injury lawyer helps when medical evidence is the central issue.

What Evidence Supports a Permanent Injury?

Because the standard depends on objective findings, the strongest records are specific and consistent. Useful items include:

  • Narrative reports from the treating physician
  • Imaging results such as X-rays and MRI scans
  • Records of therapy and follow-up visits over time
  • Notes on limits at work and in daily activities

Gaps in treatment can weaken the picture, so follow-up appointments should not be skipped. An East Orange personal injury lawyer can help organize these records before they are sent to an insurer.

Do Medical Bills Fall Under the Same Limit?

No. The limitation option concerns non-economic loss, not treatment costs. Medical bills are handled differently, through personal injury protection coverage on an automobile policy, and a separate set of rules governs that coverage.

This is why an injured person can have a straightforward path for bills and a more demanding standard for pain and suffering in the same claim.

Does the Type of Crash Change the Evidence?

The kind of vehicle changes who is involved and which records exist. An East Orange car accident claim can involve two private policies and a police report.

Crashes with commercial vehicles add more parties. An East Orange truck accident claim may involve the driver, the carrier, and several insurers.

Passengers in ride-hailing vehicles face their own questions about which policy applies, and an East Orange Uber accident claim can involve both a personal policy and a company policy.

Can the Value of a Claim Be Estimated Early?

A rough estimate is possible once the injury and its treatment are clear, but it can change. The factors that determine value include the type of injury, the length of recovery, and the proof of lost income.

Whether the injury meets the permanent-injury standard can be a major factor in the value of the non-economic portion.

What Should Someone Do First After a Crash?

Early steps protect both health and the claim. An injured person should:

  • Seek medical care promptly and follow the treatment plan
  • Photograph the vehicles, the scene, and visible injuries
  • Gather the other driver’s insurance information
  • Review the declarations page of the personal auto policy
  • Keep a record of symptoms and missed work

The declarations page shows which option applies, and an East Orange personal injury lawyer can explain how that option affects the claim.

Who Handles Accident Questions at the Firm?

Law Offices of David A. DiBrigida works with accident victims across New Jersey who need to recover money from insurance companies. Attorney David DiBrigida has handled personal injury matters for more than 30 years, and the firm has assisted people since 1992.

The threshold question turns on the policy and the medical records, so anyone in East Orange hurt in a crash can reach out to the firm with both to review the coverage and the evidence.

It doesn’t matter how good an attorney is if they don’t pay close attention to the wants & needs of the client.

We want to make sure that each of our clients is as happy with the experience they have with our firm as they are with the ultimate result in his or her case.