Every state runs its car accident claims through one of two basic legal systems: tort, or no-fault. Which one your state uses affects who pays first after an accident, and whether you can sue for pain and suffering.
Under a tort system, the driver found at fault in an accident (through their insurer) is responsible for the other party's medical bills, property damage, lost wages, and pain and suffering. Most states use this system. A handful of states — Kentucky, New Jersey and Pennsylvania — let drivers choose between full-tort and limited-tort coverage: limited tort gives up the right to sue for pain and suffering in exchange for a lower premium, while full tort keeps that right at a higher cost. Check your state's current default and options directly with your insurer, since these choice rules can change.
A no-fault system requires your own insurer to pay your medical bills after an accident regardless of who caused it, so injured drivers get treatment without waiting on a fault determination or a lawsuit. In practice, U.S. no-fault systems are really a hybrid with limited-tort rules layered on top — you still may be able to sue the at-fault driver for serious injuries, just not for the smaller claims your no-fault coverage already handles. The core no-fault benefit is usually personal injury protection (PIP), which covers medical costs for you and your passengers no matter who was at fault. A few states layer additional no-fault benefits on top — for example, New York offers an optional extra benefit (Optional Basic Economic Loss, or OBEL) covering further lost income and related costs beyond the standard PIP amount.
Twelve states have no-fault auto insurance laws, and every driver in them must carry personal injury protection. They differ in when you can step outside no-fault and sue the other driver (Insurance Information Institute, “Background on: No-fault auto insurance”):
The other states and D.C. use the tort system, where the at-fault driver's liability insurance pays the other side's losses.
New Jersey, Pennsylvania and Kentucky have “choice” no-fault laws: when you buy a policy, you decide whether to accept the lawsuit threshold or reject it and keep the right to sue for any auto-related injury (Insurance Information Institute). The two options go by different names in each state — Pennsylvania calls them limited tort and full tort; New Jersey calls them “limitation on lawsuit” and “no limitation on lawsuit.”
The choice applies to you and usually to relatives in your household, including when you're a passenger or pedestrian, so it's worth making deliberately rather than accepting whichever option the form defaults to. Ask your insurer for the price difference: it varies by state and insurer, and for some households full tort costs less extra than people expect.
Many accidents aren't 100% one driver's fault, which is where comparative negligence comes in. It lets each side recover a share of their losses reduced by their own percentage of fault, rather than an all-or-nothing outcome. There are two common versions:
Which version applies, and exactly where the threshold sits, is set state by state, so it's worth checking your own state's rule (or asking your insurer or an attorney) if you're ever in a shared-fault accident.
AutoInsuranceQuery editorial team. Last reviewed: September 29, 2026.