Who needs the NYS FORM NF-2?
Under the New York No-Fault Law, victims of motor vehicle accidents are entitled to benefits or reimbursement of their basic economic loss. The NYS FORM NF-2 is an application for motor vehicle no-fault benefits.
What is the purpose of the NYS FORM NF-2?
The purpose of this form is to apply for benefits. Based on the NYS FORM NF-2, the Motor Vehicle Accident Indemnification Corporation determines whether the applicant is entitled to benefits.
When is the NYS FORM NF-2 due?
The applicant should complete and return the form as soon as possible.
What information should be provided?
The applicant should provide the following information:
- (a) personal information: name, phone numbers, address, date of birth, social security number;
- (b) information about the accident: date and time, place of the accident, brief description of the accident;
- (c) information about injury;
- (d) information about the vehicle at the time of accident: owner’s name, make, year, type of vehicle (truck, motorcycle, bus or school bus, automobile).
The applicant has to indicate whether he was the driver of the vehicle, a passenger in the motor vehicle, a pedestrian, a member of policyholder’s household, and whether he or the relative with whom he resides owns a motor vehicle.
The applicant must provide the name and address of the doctors or persons who furnished him health services.
If the applicant was treated at a hospital he should indicate the hospital’s name and address and the date of admission.
Furthermore, the applicant specifies the amount of health bills and answers whether:
- he would have more health treatments.
- he was at the time of accident in the course of his employment.
- he lost time from work, specifying the date absence from work began.
- he has returned to work, specifying the date when he returned to work and amount of time lost from work.
The following information should also be provided:
- average weekly earnings;
- number of working days per week;
- number of working hours per day;
- names and addresses of the current employer and other employers for one year preceding the accident, and dates of employment;
- other expenses resulting from his injury;
Finally, the applicant should indicate whether his injury resulted in any other expenses, and if yes, he should attach explanation and amounts of such expenses.
- If the applicant has received or is eligible for payment under New York State Disability or workers’ compensation, he should indicate this
Where do I send the NYS FORM NF-2?
The applicant must send the form as soon as possible to the Motor Vehicle Accident Indemnification Corporation with its address at 110 William Street, New York, N.Y. 10038.
