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Fault vs. No Fault in a Personal Injury Case

Whether your state is considered fault or no fault can have a great impact on your case.

What the concept of fault may mean for your accident or injury case

“Fault” means something different based on where you live. Although you might be clear about who was at fault for your injury, how it’s handled by insurance varies based on whether you live in a fault or no-fault state.

If you’ve been injured and are considering pursuing a legal claim, the first question you need to answer is who’s at fault. After all, in order to make a successful claim for damages, you have to know who you’re making a claim against and what makes that person or company liable.

First, it’s important to establish that an at-fault defendant can be a person or an entity, like a government agency (school, municipality, etc.) or a company. For the purposes of this article, we’ll refer to the at-fault defendant as a person. But in reality, any entity that has legal status can be a defendant in a civil lawsuit.

Next, what does it mean to be at fault?

Fault is a type of liability. In order to recover damages, you must be able to prove that the defendant was at fault for the injury.

Elements to establishing negligence

Negligence is the failure to take reasonable care in situations where a person would expect that they would come into contact with another person or property. Negligence as a legal standard is when a person acts carelessly, not intentionally.

There are 4 legal elements to establishing negligence:

  1. Duty of care. Every person owes a duty of care to various other people at different times. For example, a driver owes a duty of care to other drivers, pedestrians, bicyclists, and any road users or property owners that they’ll exercise caution and drive in a way that won’t harm another person or property. Likewise, a pedestrian owes a duty of care to other pedestrians, bicyclists, and anyone else they encounter to look where they’re going and try to avoid collisions or other harm. A shop owner owes a duty of care to customers (or any member of the public) to maintain premises that are reasonably safe and free from harm.
  2. Duty of care is breached. A breach is the defendant’s failure to take appropriate care to avoid the plaintiff’s being injured. For example, if the store owner mopped the floor and failed to put up a warning sign that it was wet, that could be a breach of their duty to keep the premises free from hazardous conditions.
  3. The breach causes injury. People breach their duties all the time, and many times no one is hurt. You could be walking down the sidewalk and texting, which would be breaching a duty to other pedestrians because you’re not looking where you’re going. But if you don’t actually bump into anyone, there’s no injury. It only becomes legal negligence or fault if your behavior causes someone to be injured.
  4. The injury results in financial loss. Back to the sidewalk example... you’re walking and texting. You bump into someone hard enough for them to stumble, but they don’t fall or suffer any bruises or other injuries. Maybe they’re having a bad day, though, and they get angry and threaten to sue you for not watching where you were going.

    It doesn’t work that way. For someone to claim negligence, they have to prove that you weren’t looking where you were going and that failure caused them injury — not being annoyed, but an injury that required medical treatment. The resulting medical treatment, or other financial losses like lost wages, would be calculated to determine what you’re responsible for in damages.

While each of these examples seems pretty straightforward with respect to who’s at fault, that’s not always the case. In more complicated cases, there could be multiple defendants, and it can be difficult to establish who is at fault and for what.

Finding fault after a car accident

A car accident is a personal injury claim where there’s almost always an insurance company involved. If you’re in an accident with 2 drivers, each of whom has motor vehicle insurance, the driver who’s not liable for the accident will likely file a claim against the insurance of the driver who is liable. If liability isn’t disputed and the insurance company offers a settlement that covers the driver’s expenses, the claim closes there.

However, some states have no-fault laws.

In a no-fault state, each party in a car accident makes a claim against their own insurance policy regardless of which party was at fault for the accident.

Which states have no-fault auto insurance laws?

States with no-fault laws include Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania, and Utah. Puerto Rico also has no-fault laws.

which states have no-fault auto insurance laws?

These states also require that automobile insurance policies include personal injury protection (PIP).

Essentially, the no-fault system takes small claims from car accidents out of the courts and limits the ability to sue by adding an insurance-based way for an injured person to recover costs.

Types of auto insurance systems

There are 4 types of auto insurance systems:

  • No-fault: In a pure no-fault system, the insurance company pays for its own insured’s minor injuries, regardless of who was at fault for an accident. In some states, this includes medical costs, lost wages, and other out-of-pocket expenses resulting from an accident. In a no-fault state, the insurance company pays the driver’s own benefits but there are restrictions on whether you can file a lawsuit.
  • Choice no-fault: In a state that allows choice no-fault, a driver can choose a no-fault insurance policy or a regular insurance policy.
  • Tort liability: This is “traditional” insurance. The driver who caused the accident is responsible for paying the costs to the other drivers. If the insurance companies can’t reach agreement, the injured drivers may file a lawsuit against the liable driver.
  • Add-on: A state that allows add-ons allows a driver to receive compensation from their own insurance company (just like a no-fault state), but there’s no restriction on lawsuits.

How no-fault insurance works

In no-fault states, the laws were passed in order to take small claims out of the court system. As insurance companies (and others) discuss fault systems, they’ll use these terms:

First party
Second party
Third party

The insurance company’s own policyholder
Insurance company
Anyone else injured in the accident

The insurance company provides compensation to its own policyholder (the first party) after an accident, regardless of who was at fault.

A driver in a no-fault state is required to carry PIP coverage, though coverage varies by state. However, if the injuries are severe, sometimes a driver can sue, even in a no-fault state.

No-fault medical coverage

There’s also a no-fault way to be protected from liability for accidents other than car crashes.

Most standard homeowners insurance policies include no-fault medical coverage. If a visitor is injured on your property, they can submit medical bills to your homeowners insurance company for payment without a liability claim against you.

What if there are multiple defendants at fault?

Sometimes it’s not just one person’s fault. There’s also the possibility that the person who caused the injury isn’t the person who’s legally at fault.

Here’s why:

An employer could be responsible for the conduct of their employees

Here’s an example:

A busy medical practice is owned by a group of 4 physicians. One employee is an office assistant whose duties include moving supplies from the storage closet to the front office. The assistant was in the process of restocking some information pamphlets in patient examining rooms. He put down a small box of pamphlets outside a room while he arranged some items inside the room. Meanwhile, a patient walked by and tripped on the box in the hall that the assistant had left on the floor. The patient was injured and filed a lawsuit.

Although the employee was at fault, the employer can be held responsible for employees’ actions. In this case, it’s possible that the employee didn’t have proper training about where to leave boxes so they don’t become obstacles. Or, perhaps the employee wasn’t informed that there would be patients passing by at that time. There are a variety of scenarios in which the appropriate entity to be the defendant in this lawsuit would be the owners of the medical practice, and not the individual who caused the injury.

A parent might be liable for the actions of their child

Let’s go with the classic baseball-through-the-window example. A 10-year-old child is practicing baseball in his backyard and hits an “out of the park” homerun (!!). Unfortunately, the neighbor’s house was too close to the outfield and the baseball broke a window.

The neighbors can’t exactly hold a 10-year-old responsible for the cost of the broken window but they CAN hold the parents responsible. Most states allow for civil parental liability.

A property owner might be liable for injuries on the property

If a commercial building houses a variety of offices and businesses, an injury that happens on the property could be the fault of a particular business owner or the property owner, depending on the circumstances. And, in some cases, it could be both.

There can be more than one party at fault for an accident. Your lawyer can help advise you based on the facts of your case about who they might be.

Shared fault rules

As if legal standards weren’t complicated enough, here’s another wrinkle:

Each of the no-fault vs. fault situations we’ve discussed are with respect to making a claim against someone’s insurance policy (or your own). And, sometimes those claims do act as a barrier against filing a lawsuit.

However, if you do need to file a lawsuit, you need to understand how negligence and fault are handled in your state.

Here’s a look at how each state considers fault:

Fault Systems by State

These systems of fault determine when your case could be affected by how you might have been negligent and contributed to your own injury.

Enjuris tip: For more on fault systems, visit the Enjuris article: Comparative negligence, contributory negligence, and determining fault.

Regardless of how your injury happened, you might need some advice or a professional opinion. A lawyer’s the best person to help you to understand who could be at fault for your claim and what to do next. They can also tell you whether you’re eligible to file a lawsuit for any costs remaining after an insurance settlement (or whether the settlement you’re being offered is a fair one).

The Enjuris Personal Injury Law Firm Directory is a great place to begin finding a lawyer in your state who’s ready to help. Your lawyer will explain your options, navigate the law, and help you to reach the best possible outcome for your claim.

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