What is Personal Injury Protection Insurance? Do I Need It?

By Personal Injury

Personal Injury Protection (PIP) provides medical related benefits for injuries that drivers and passengers receive as a result of a car accident, regardless of who is at fault.  New York is a no-fault insurance state, so all motorists are legally required to carry Personal Injury Protection.   

What does personal injury protection cover? 

Personal Injury covers three main things

  • Medical costs
  • Financial losses
  • Death

Personal Injury Protection will cover all most injuries that are sustained in a car accident including:

  • Emergency Room visits
  • Doctors visits
  • Surgeries
  • Medical supplies (wheelchairs, walkers, crutches, canes, etc.)
  • Diagnostic testing (CT Scans, MRI, Xrays)
  • Ambulance transfers
  • Physical therapy
  • Dental treatments

If a driver or passenger of the vehicle is unable to work as a result of the injuries that occurred in the collision, PIP will cover economic losses.  It will cover 80% off the monthly earnings that are lost or up to $2,000 per month which ever amount calculates out to less.  The total amount will be paid for a period of three years or less after the accident happened. 

You will also receive $25 a day if you are unable to attend to daily chores as a result of the injuries that were sustained in an accident (unable to do laundry, clean the house, grocery shopping) and have to pay someone else to do these for you, you will receive compensation under PIP.  If a driver or passenger ends up passing away during the accident, PIP will issue up to $2,000 to assist with the cost of a funeral and burial.  If you wish to have financial protection, you can purchase additional Personal Injury Protection.  This will increase your limits but also increase your premiums.

The cost of Personal Injury Protection varies in the state of New York similar to your type of insurance coverage.  The cost of PIP is determined by your age, driving record, type of vehicle and where you reside. 

New York State provides some of the highest minimum limits on PIP in the country.  But should you purchase additional coverage? The cost of medical expenses that are associated with a motor vehicle accident may be greater than the limits under Personal Injury Protection.  If you have good health insurance coverage, additional PIP may not be necessary to purchase but if your health insurance is not great, additional PIP may be worth the investment.  There is also the option of purchasing Optional Basic Economic Loss coverage (OBEL).  This provides you will an extra $25,000 in benefits that can be put towards lost wages and medical expenses.  Depending on the extent of your injuries and how long you will be out of work as a result of these injuries, OBEL might be something you should consider.  Since your wages lost benefits are only covered up to $50,000, if you will be disabled longer or experience a sizable reduction in your monthly wages with basic PIP coverage it would be beneficial to purchase OBEL coverage. 

In New York State, you will have 45 days after the date of the start of your medical treatment to file for repayment.  You will need to show proof of your treatment from the medical doctors who are treating you and be submitted by your insurance company.  It should be documented that the injuries were caused by an accident, the extent of the injuries and the type of treatment you are receiving.  You will have 90 days to file a claim in New York State for lost wages and submit written proof of your lost wages.  Once you file a claim, your insurance company will have 30 days to reimburse you from the date your forms were received. 

The attorneys at Losi & Gangi want to ensure that all drivers are protected by insurance and stay safe while they are on the road.  If you are interested in learning more about Personal Injury Protection or have recently been involved in an auto accident call us today at 716-854-1446 and one of our attorneys can explain what your insurance will cover.

Article adapted from: https://www.newyorkmotorinsurance.com/blog/personal-injury-protection-in-new-york-state/

What is Workers’ Compensation Fraud?

By Workers Compensation

Workers’ compensation fraud occurs when someone willfully makes a false statement or conceals information in order to receive workers’ compensation benefits or prevents someone from receiving benefits to which they might be entitled.  The people who may be committing this fraud can be employers, employees, providers or anyone else involved in the system. Unfortunately, the people that commit workers’ compensation fraud are making your premiums higher, higher prices on goods and services and lost pay due to draining business profits. 

When employers commit workers’ compensation fraud, they are usually doing this to avoid paying workers’ compensation premiums.  Employers can use a variety of tricks to accomplish this goal such as using shell companies.  Shell companies are inactive companies without significant assets that can be used to disguise business ownership from law enforcement or the public. 

Here are a few examples of Workers’ Compensation Fraud

Claimant Fraud

  • Malingering or exaggeration of symptoms
  • Working while allegedly disabled and not reporting income
  • Claiming a job-related injury that never occurred
  • Claiming a non-work related injury as a work-related injury
  • Falsifying mileage reports

Employer Fraud

  • Underreporting payroll or misclassifying employees for lower insurance premiums
  • Deducting premium dollars from employee’s wages
  • Employer knowingly fails to have necessary workers’ compensation coverage

Medical or Health Care Provider Fraud

  • Providing unnecessary testing or treatment of injured workers to reap financial benefit
  • Billing for services or treatment never performed
  • Billing the workers’ compensation insurer and the workers’ health insurer for the same services

Workers compensation is a benefit to all employees.  The Office of Workers’ Compensation is there to protect injured workers and if you need help understanding your workers’ compensation rights call the attorneys at Losi & Gangi at 716-854-1446 to help give you all of the information you may need. 

Article adapted from: https://www.thebalancesmb.com/workers-compensation-fraud-examples-4101604

What Does No-Fault Insurance Mean?

By Personal Injury

No-Fault Auto Insurance laws require every driver to file a claim with their own insurance company after an accident regardless of who was at fault.  In states with no-fault laws, like New York, all drivers are required to purchase Personal Injury Protection (PIP) as part of their auto insurance policies. 

No-Fault applies only to state laws that both provide for the payment of no-fault first party benefits and restrict the right to sue (limited tort).  Under no fault- laws, motorists may sue for severe injuries and pain and suffering only if the case meets certain thresholds.  These thresholds relate to the severity of injury and may be expressed in verbal terms or monetary threshold, which are dollar amounts of medical bills. 

Some laws also include minimum requirements for the delays of disability incurred as a result of the accident.  Because high threshold no-fault systems restrict litigation, they tend to reduce costs and delays in paying claims.  Verbal thresholds eliminate the incentive to inflate claims that may exist when there is a dollar “target” for medical expenses.  In some states, verbal threshold has faded over time due to the broad judicial interpretation of the verbal threshold language and PIP coverage has become the target of abuse and fraud by dishonest doctors and clinics that bill for unnecessary and expensive medical procedures. 

New York State is one of 12 states that have no fault auto insurance laws and has verbal threshold.  State auto liability insurance laws fall into four categories: no-fault, choice no-fault, tort liability and add-on.  The major differences between the four are whether there are restrictions on the right to sue and whether the policyholders own insurer pays first-party benefits, up to the state maximum amount, regardless of who is at fault in the accident. 

In the 1970s many states for the first time allowed accident victims to recover financial losses from medical and hospital expenses and lost income from their own insurance companies.  Twenty-four states now have laws that allow policyholders to obtain compensation for auto accidents from their own insurers.  Out of the 24 states, 12 have placed restrictions on the right to sue through a monetary threshold, which allows a suit to be filed for pain and suffering when medical expenses reach a certain stipulated amount or through a descriptive or verbal threshold, which allows suits only when the injury incurred meets the criteria for a serious injury as defined by state statute.

In the early 1990s, pure no-fault which prohibits most lawsuits for bodily injury, began to gain support.  Pure no-fault addresses the waste of resources and the inequities in the liability system and the need to affordable coverage for medical care and rehab costs.  The first attempt at a pure no-fault system was a plan to pay for no-fault auto insurance through a fee collected on gasoline sales.  This failed in all states due to opposition to the gasoline usage based fee but the pure no-fault idea was incorporated into a variety of legislative proposals in various states. 


The No-fault system is intended to lower the cost of auto insurance by taking small claims out of the courts.  Each insurance company compensates its own policyholders for the cost of minor injuries, regardless of who was at fault in the accident.  No-fault can often be used to denote any auto insurance system in which each driver’s own insurance company pays for certain fosses regardless of fault.  No-fault applies only in states where insurance companies pay first-party benefits and where there are restrictions on the right to sue. 

The first-party benefits known as Personal Injury Protection (PIP) are a mandatory coverage in true no-fault states.  Since New York is a no-fault state,  drivers may sue for severe injuries if the case meets certain conditions known as the tort liability threshold. 

Choice no-fault

In choice no-fault states, drivers may select one of two options: a no-fault auto insurance policy or a traditional tort liability policy.

Tort Liability

In traditional tort liability states, there are no restrictions on lawsuits.  A policyholder at fault in a car crash can be sued by the other driver and by the other driver’s passengers for the pain and suffering the accident caused as well as for out-of-pocket expenses such as medical costs.


In add-on states, drivers receive compensation from their own insurance company, similar to no-fault states but there are no restrictions on lawsuits.  The word add-on is used because in these states, first party benefits have been added on to the traditional tort liability system.  In add-on states, first party coverage may not be mandatory and the benefits may be lower than in no-fault states.

Effectiveness of No-Fault Auto Insurance

Insurers general favor laws that provide for verbal thresholds on suits instead of dollar thresholds.  One of the disadvantages of having a dollar target for medical expenses is that it may lead fraudulent claims.  Unless the law includes a provision that enables the threshold to be adjusted to keep pace with inflation, its effectiveness in curbing litigation wears down.  In states with higher than average PIP benefits is that dishonest providers of professional service have found ways to cheat the system increasing the cost of auto insurance.

In many no-fault states, PIP coverage is being exploited by fraud rings that include corrupt doctors and chiropractors, lawyers and pain clinics.  These groups have created “medical mills” or phony clinics that file fraudulent auto insurance medical claims.  New York State modified regulation 68, a reform adopted in 2002 that substantially shortened the time period for reporting auto accident injuries and submitting medical bills.  This reduced notification time allows insurers to look at the treatment plan sooner to there are fewer opportunities for unnecessary medical tests and treatments. 

If you have recently been in an auto accident contact Lost & Gangi today at 716-854-1446 to help guide you towards the next steps.  Let us help you get the compensation you deserve. 

Article adapted from https://www.iii.org/article/background-on-no-fault-auto-insurance

What If My Employer Doesn’t Have Workers Comp Insurance?

By Workers Compensation

Most employers offer their employees numerous benefits including health and dental insurance, 401K and more. When employees are injured at work, they usually have to go though New York State’s workers’ compensation system to get reimbursed for medical treatment and to receive other benefits.

New York State Employers must carry workers’ compensation insurance through a third party insurance carrier or through a self-insured program set up by the employer. In most cases, employers must get workers’ comp insurance when just one person is hired. Large employers may insure themselves but need to apply with the state and meet very stringent self-insurance requirements. Even if they aren’t required to buy workers’ comp insurance, many employers choose to have it for their employees.

But what happens if your employer doesn’t have workers’ comp insurance? You may sue the employer in a civil court by filing a personal injury claim. In this case you can seek the full amount of your losses without being subject to an arbitrary cap set by law. Most states only pay around two-thirds of the worker’s wage loss for temporary disability benefits only up to a certain amount for a limited period of time. You can also collect money damages for emotional distress caused by your injuries otherwise known as “pain and suffering” and may be able to collect punitive damages which are intended to punish the employer if its bad misconduct caused your injuries. Neither of these can be rewarded through workers’ comp.

If you sue in court it can be a much slower process. It can be months or even years before you see any money through a lawsuit rather than a few weeks with workers’ comp. Since workers’ comp is a no-fault system you will need to prove that your employer was at fault for the personal injury accident. Talk to a lawyer immediately so that you can start the process and make sure your suit is filed in a timely matter.

Many states have special funds reserved for people who are injured while working for an uninsured employer otherwise known as “Uninsured Employers’ Funds”. Under these funds you may be able to get your medical bills covered or receive payments for a portion of your wage loss from it. Check with New York State’s workers’ compensation office for more information on how to file a claim or call the Workers Compensation Attorneys at Losi & Gangi today at 716-854-1446 and we can get you the proper representation you will need in your case.

Traumatic Brain Injuries in Construction Workers

By Personal Injury

A traumatic brain injury (TBI) is a type of injury that damages the brain itself and causes it to malfunction. It usually results from a blow to the head or a jolt to the head and body. An object penetrating the skull can also cause a TBI.

Construction workers sustain more traumatic brain injuries than employees at any other type of workplace in the United States.  That is because construction sites are much more dangerous than other places of employment. There is typically heavy machinery, constant motion, and high work surfaces involved in construction and the risks become greater when using this equipment.

Safety interventions must be emphasized in the construction industry.  More than 2,200 workers died of a traumatic brain injury from 2003 to 2010. Traumatic brain injuries represented one-quarter of all construction fatalities during the eight-year period.  More than half of fatal work-related traumatic injuries were a result of falls from roofs, ladders, cranes, and scaffolds.

How a TBI affects a person depends on its severity, and on where it occurs. There are various stages of severity. For example, a concussion is classified as a mild TBI. Some consequences of a TBI may include amnesia, coma, and even death. 

A TBI is very difficult to treat because of the wide range of symptoms and complications it presents. Each injury affects a person differently, both physically and emotionally.  Sometimes symptoms may not show up for days or even weeks after the injury has occurred. Confusion, persistent headaches, slow thinking or speaking, sleep changes, increased sensitivity to light and sound, tinnitus, and moodiness are all possible symptoms after a TBI.  The more quickly a diagnosis can be made, the sooner treatment can begin.

In order to prevent a TBI, a construction worker must wear a hardhat and adhere to the safety precautions on their job site.  Sometimes accidents do happen and Losi & Gangi will be there to represent you in your case. If you are currently experiencing a TBI from a construction accident and have any questions, please call us today at 716-854-1446 to speak to one of our attorneys. 

For more information on traumatic brain injuries in construction workers, please see the below links:



How to Prevent Injury When Working in a Factory

By Workplace Safety

As an employee you have the right to a safe working environment, no matter the nature of your job. Most of our clients at Losi & Gangi have been personally injured as a result of construction accidents, slip and fall accidents, motor vehicle accidents or other job-related injuries. Here are some tips on how to prevent injury when working in a factory:

– Keep Workspaces Clean
A cluttered, unclean work area makes it difficult to maneuver around and workers are more prone to hazards when it is messy in the workspace.  Keep shared areas clean and tidy to prevent any accidents.

– Proper Signage
There should be proper signs around work areas in noticeable places and in spaces where specific procedures should be practiced.

– Report Dangers and Accidents
It is important that employees report dangers and accidents that they come in contact with so that others do not come across the same issues.

– Provide Proper Training
Make sure all staff are properly trained for their jobs including how to use equipment and follow safety procedures.

– Provide Proper Equipment
Employees must have on proper safety equipment for the job at all times.

– Avoid Shortcuts
A lot of people take shortcuts when they’re familiar with their job or are in a hurry. Even though some safety precautions may be time consuming, they can be the difference of a life or death situation.

– Get the rest you need
Drowsiness and overworked employees contribute to a lot of the accidents that happen in factories. Be sure to get as much rest as possible to perform the job tasks to your full capability.

We don’t want to see you get hurt, but if it happens on the job, our workers’ compensation attorneys at Losi & Gangi are here to represent you fairly and accurately. Get in touch with us today at 716-854-1446

More information is available at the following website:

Should You Hire a Lawyer For Your Case?

By Uncategorized

Not every case requires a lawyer. However, in most situations, you are much better off with one. At Losi & Gangi, the attorneys are there to represent you fairly and accurately. Below are the reasons you should and should not hire an attorney.

Reasons to hire a lawyer:

– The Law is Complicated: A solid case can quickly change its course without the help of a trained and emotionally detached attorney.

– Not Having a Lawyer May Cost You More: Depending on the case, you can spend time behind bars or get hurt financially. Hiring a lawyer could save you time and money in the long run.

– Lawyers Know How to Challenge Evidence: If you do not have the correct legal training, you will not know what is key evidence and whether or not it was properly obtained or even if the testimony of a witness contradicts an earlier statement. Also, did the crime lab properly handle all of the evidence throughout every step of the case?

– Filing the Wrong Document or Following the Wrong Procedure Could Ruin Your Case: You may struggle with deadlines and protocols when filling out legal documents if you are not an attorney. If one document is late or filled out incorrectly, you could delay or even have your case thrown out.

– They Have Access to the Witnesses and Experts You’ll Need on Your Side: Attorneys network with other professionals to help their clients.

If you are not and attorney, how will you know who can efficiently help your case?

– A Lawyer Can Present Your Strongest Case: Hiring a lawyer allows them to explain to you your options, which can help you avoid penalties from the beginning.

– It’s Always Better to Avoid Problems Rather Than Fix Them Later: If you don’t really understand the fine print of contracts you are signing, hiring a lawyer can help to avoid headaches.

– Lawyers Know How to Negotiate Settlements and Plea Bargains: Chances are the experienced lawyer that you hire will have seen cases like yours in the past and know how to deal with them in court a lot better than you ever would.

– The Other Party Probably Has Legal Representation: If you are going against a party with a lawyer and you do not have one, chances are the attorney representing them will take advantage of the fact that you are not a legal counsel.

– Lawyers Often Provide a Free Consultation: There is no harm in talking to an attorney that does a free face-to-face consultation.

Reasons to not hire a lawyer:

– Some legal proceedings, such as small claims court, require parties to represent themselves, so lawyers are not allowed.

– Many small disputes can also be handled through alternative dispute resolution programs, such as mediation, in order to avoid the expense and stress of hiring an attorney and going to court.

At Losi & Gangi, we always put our clients best interest first.  Call Losi & Gangi at 716-854-1446 to see if hiring a lawyer is the right choice for you.

More information is available at the following websites:


2019 Tailgate Concert Series Acts Announced

By Uncategorized

Originally Published on http://www.ubbulls.com/sports/fball/2018-19/releases/20190604o1itw5
June 4, 2019

BUFFALO, NY – The University at Buffalo’s popular Tailgate Concert Series returns for a seventh season this fall and the school has announced the acts coming to Stampede Square beginning in August. Presented by Losi and Gangi, fans will once again enjoy live music by national recording artists as well as popular local talent just 100 yards away from the south gate of the stadium two hours prior to kickoff.

Country artist and former Voice contestant RaeLynn will be performing at the season opener on August 29 against Robert Morris. RaeLynn’s songs include “God Made Girls” which reached number seven on the US Country charts. She was a contestant on the 2012 season of NBC’s The Voice.

Another country artist, Granger Smith, will take the stage on September 21, prior to UB’s game against Temple. Smith is known for such hits as “Backroad Song” which appeared on his EP “4×4”, an album that debuted at number six on the Top Country Albums chart.

Local favorites Nerds Gone Wild, an award-winning ’80s party band will perform at homecoming, prior to Buffalo’s game against Ohio on October 5. Never Ben, East Aurora’s premier party band specializing in pop, rock and blues will play prior to the October 26th game against Central Michigan.

The Tailgate Concerts take place inside Stampede Square which opens three hours prior to kick-off. Fans are encouraged to arrive early to cheer on the team during the Walk to Victory, enjoy family friendly activities and listen to live music all before kick-off.

Season tickets are only $125 and are on sale now for the 2019 season. Fans who cannot commit to a full season package should check out the MoBULL Pass, the most flexible ticket option for any UB fan. For just $100 get 10 flexible tickets to be used at football, men or women’s basketball or wrestling. For our fans eighth grade and younger, be sure to join the Jr. Bulls Kids Club. For complete ticket information click here

Date Opponent Performer
Aug. 29 Robert Morris RaeLynn
Sept. 21 Temple Granger Smith
Oct. 5 Ohio Nerds Gone Wild
Oct. 26 Central Michigan Never Ben

Finding a Treating Doctor In Your Workers’ Compensation Case

By Workers Compensation

Workers’ compensation covers all reasonable and necessary medical treatment for an injury or illness that happens at work.  This includes doctors’ appointment, surgeries, Physical Therapy, medications and other treatments.  The doctor who treats your work injury will play a key role in your case by being the one who oversees all of your medical care and giving you opinions that will affect how much you receive in workers’ compensation benefits.  It is very important to find a treating doctor that you can trust.

In 2010, New York State promulgated medical treatment guidelines which provide detailed criteria doctors must follow in order to obtain treatment.  The attorneys and staff at Losi & Gangi are very well versed in working with your doctor to help Injured Workers obtain medical treatment in the most efficient matter.

Being able to choose a doctor usually falls under one of these categories (1) choosing a doctor from a list or medical Network provided by your employer, (2) you choose any authorized doctor or (3) your employer chooses the treating doctor for you.  Losi and Gangi can help you find a doctor who provides treatment under the New York state workers’ compensation law.

In many states, employers have the option of Contracting with a preferred-provider plan, not work, or Managed Care Organization to treat their employees work injuries.  This is a way for employers and insurance companies to reduce costs and control the medical care for workers’ compensation cases.  If your employer has a similar plan to this, you must use a treating doctor for their Network and follow their rules for getting care.  In New York State such a plan only lasts for a short period of time.

In New York you have the right to choose your own treating doctor as long as your employer doesn’t have her provider plan or Managed Care arrangement.  You will need to choose from a list of healthcare providers that the state is approved for treating workers’ comp injuries.  Your employer’s insurance company may limit your options if they have a preferred provider organization (PPO).  If this is the case, you must see a network physician for the first 30 days and may have a specific Pharmacy you have to use.  If you happen to change your treating doctor, the new doctor must be in the workers’ compensation boards list of authorized medical providers.  Your employer may transfer your medical care to a different doctor if the initial physician you choose isn’t authorized by the WCB to treat any workers comp injuries.

In other states, you first have to go to a treating doctor picked by your employer.  Some of these states only require you to see the company doctor for your initial visit or for a certain length of time.  Some workers worried that a company selected doctor may have a conflict of interest and might minimize the extent of their injuries.  If this is true, you may be able to switch doctors if you believe you aren’t getting an adequate care but must follow the rules in your state for changing workers’ compensation doctors.

Here are some tips you should consider while finding the right treating doctor:

  1. Consider their experience and understanding of your medical condition
  2. Willingness to accept the workers’ comp medical fee schedule
  3. Have knowledge of the workers’ comp claim process
  4. Willingness to support your workers’ comp claim with detailed reports and
  5. Availability for medical appointments

Losi & Gangi can help you with all considerations necessary to find the right treating doctor.

Bottom line – you should choose a doctor you can trust and feel comfortable around.  If you have questions call us today at 716-854-1446 and one of your experienced workers’ comp lawyers can explain the rules in New York state covering workers’ compensation and Medical Care.

How Filing For a Workers’ Comp Case Will Affect An Employer

By Workers Compensation

Workers’ compensation is insurance that provides cash or medical care benefits for workers who are injured or become ill as a direct result of their job. Employers must pay for this insurance, and may not require the employee to contribute to any cost necessary for  compensation. Weekly benefits such as monetary payments and medical care are given by the employer’s insurance carrier, as directed by the Workers’ Compensation Board, a state agency that processes the claims.

It is not enough to just have insurance as an employer. It is the employer’s responsibility to also provide immediate emergency medical treatment for employees who are injured on the job. They must complete a full report of the injury, with the injured worker’s review and mail it to the nearest workers’ compensation board office within a timely manner.

A claim is paid if the employer or insurance carrier agrees that the injury or illness is work-related. If the employer or insurance carrier disputes the claim, no cash benefits are paid until the workers’ compensation law judge decides who is right. If a worker is not receiving benefits because the employer or insurance carrier is arguing that the injury is not job-related, he or she may be eligible for disability benefits in the meantime. Any payments made under the Disability Program, however, will be deducted from future workers’ compensation awards.

In a workers’ compensation case, neither party is determined to be “at fault”. The amount that a worker receives is not decreased by perceived carelessness, nor increased by an employer’s fault. Although workers’ compensation laws provide treatment to injured employees, they are also meant to protect employers, as they are designed to be the only remedy that injured employees may seek from their employers. One may find that an employer frowns upon employees who file workers’ compensation benefit claims, and some blatantly discriminate against such employees.

Most states prohibit employers from punishing, discriminating against, or discharging employees who exercise their rights under workers’ compensation laws, and allow employees to bring civil actions against their employers for the tort of “retaliatory discharge.”

It is of the business owners best interest to comply with the rules and regulations set forth by the Workers’ Compensation Board. Failure to do so could easily result in further fees, punishments or even lawsuits.

If you or someone you know has been injured at work or is dealing with a workers’ compensation case, call Losi & Gangi at 716-854-1446 and speak with one of our experienced attorneys.

This article has been adapted from information gathered from other sources including http://www.wcb.ny.gov/.