New York No-Fault Insurance, under 11 NYCRR 65 (also known as “Regulation 68”), provides coverage after a car accident for medical expenses, lost wages, and other reasonable and necessary expenses. Although Regulation 68 doesn’t explicitly mention mileage reimbursement, travel expenses are generally considered “reasonable and necessary” when related to receiving medical treatments.

How Do I Get My Mileage Reimbursed By No-Fault Insurance?Under No-Fault?

Reimbursement for your mileage under No-Fault insurance applies to travel to and from medically necessary appointments. No-Fault insurance companies will reimburse that mileage in accordance with IRS standard mileage rates. To get your No-Fault mileage paid, you first need to send the No-Fault insurance company proper proof of claim, i.e., documentation that details each trip, within 90 days of the trip itself.

Although 11 NYCRR 65 doesn’t have a specific section on mileage, under 11 NYCRR 65-3.16(a), the mileage traveled to access medically necessary treatment is covered, so trips to doctors, diagnostic imaging, physical therapy, chiropractic, and surgeries are all eligible.

How Do You Calculate No-Fault Mileage Reimbursement Rate?

The majority of No-Fault insurance companies use the IRS mileage rate as the benchmark to reimburse mileage. The IRS sets a medical mileage rate each year, and for 2023, the rate is 22 cents per mile under IRS Publication 463 and IRC § 162(a). To calculate your No-Fault mileage reimbursement:

1. Record your round-trip mileage from your home to the medical provider.
2. Multiply by the IRS rate: For instance, a 20-mile round trip would be reimbursed at $4.40 (20 miles x $0.22).

How Do You Document Your No-Fault Mileage for Reimbursement?

Having accurate records will make the difference in whether you get your No-Fault mileage reimbursed or not under 11 NYCRR 65-3.16 for “necessary expenses.” Documenting as much detail about your No-Fault mileage as possible will help speed up the claims process.

1. Create a mileage log: Record specifics of each trip’s date, destination, purpose, and round-trip mileage.
2. Keep appointment confirmations: Collect receipts or confirmations from your provider to verify the visit in case the No-Fault insurance company requests verification.
3. Submit mileage logs monthly: Although under the No-Fault regulations you have 90 days to submit reimbursement for other expenses, it’s much easier to submit it on a monthly basis to process claims more efficiently.

How Do I File a No-Fault Mileage Reimbursement Claim

Because 11 NYCRR 65 doesn’t specify a standard form to be submitted for mileage reimbursement, No-Fault insurance companies typically accept a detailed mileage log and, if necessary, an appointment ledger or treatment records from the visits traveled to for reimbursement.

• Contact your insurer for submission guidelines: Some insurers have specific forms or submission methods, so make sure they don’t have a required form to be used.
• Attach your mileage log and supporting documents: Include all relevant appointment confirmations to substantiate each trip. Make sure you calculate all the mileage to and from and provide a total for each trip as well as for all trips taken during that time period.
• Submit within recommended timeframes: 11 NYCRR 65 requires specific deadlines to submit your No-Fault mileage within, i.e., no later than 90 days following the specific trip that is sought to be reimbursed. No-Fault insurance also only reimburses mileage for up to one year after the accident, so submitted claims thereafter unfortunately won’t be paid.

How Can You Send Your No-Fault Mileage Claim to the No-Fault Insurance Company?

Making sure your No-Fault insurance company receives your mileage reimbursement claim is extremely important to avoid your claim getting delayed or even denied. Here are some options to make sure that when you send your claim, you have safeguards in place to confirm it was sent timely.

• Send by Fax with Confirmation: Faxing your No-Fault mileage claim provides an immediate paper trail, as almost all fax machines generate a confirmation sheet showing the date, time, and successful delivery. Keep the confirmation as proof that the insurance company received your documents.
• Send by Certified Mail with Return Receipt: Mailing the No-Fault mileage claim by certified mail with a return receipt guarantees that the insurance company receives it. The postal service will provide a tracking number and notify you when the documents are delivered and signed for.
• Use Secure Email with Read Receipts: If your insurer accepts email submissions, send the claim using secure email and request a read receipt to confirm it was opened by the recipient. Be sure to encrypt any sensitive data to protect personal information.
• Upload to the Insurer’s Online Portal: Many No-Fault insurance companies have online portals for document submissions. Uploading documents directly can be one of the most secure and immediate ways to submit your claim. Look for an upload confirmation page and save a screenshot or download the receipt as evidence.
• Follow Up by Phone: After submission, call your adjuster at the No-Fault insurance company to confirm they received your claim and have all necessary documents. Ask for a reference number or the representative’s name to record the conversation.
• Keep Copies of All Submitted Documents: Always retain a copy of your mileage log, appointment confirmations, and any additional correspondence. If disputes arise, having organized records will support your case.

What to Do After Your No-Fault Mileage Claim is Denied

If a mileage claim is denied, it’s often due to incomplete documentation or disputes over the medical necessity of trips.

• Request a written explanation of denial: 11 NYCRR 65-3.8 requires insurers to provide reasons for claim denials, which can highlight any gaps in documentation.
• Submit additional evidence as needed: Include any additional medical notes or appointment confirmations to verify necessity.
• Consider No-Fault arbitration: 11 NYCRR 65-4.2 provides for arbitration, allowing a neutral arbitration party to review unresolved claims.

If an insurer denies payment:

• Consult a No-Fault attorney: An attorney from Horn Wright, LLP, with expertise in 11 NYCRR 65 can help you understand your rights and represent you in disputes.
• Request an internal review: Formal appeals may prompt the insurer to reconsider the claim.
• File a complaint with the Department of Financial Services: If you suspect unfair practices, DFS can investigate and take action if necessary.

Call Horn Wright, LLP, Today for All No-Fault Matters

While New York’s No-Fault regulations under 11 NYCRR Part 65 do not directly address mileage reimbursement, medical transportation is covered as a necessary expense. Following IRS mileage rates, keeping organized records, and sending claims securely will help ensure reimbursement. With a thorough understanding of No-Fault Insurance procedures and the appropriate safeguards, you can effectively recover transportation costs while focusing on your recovery.