How to Complete the NYS NF-7 Verification of Self-Employment Income Form

The NYS NF-7 form is the Verification of Self-Employment Income that a self-employed person files with a no-fault auto insurer to claim lost earnings after a New York motor vehicle accident. It has to reach the insurer within 90 days of the first day you missed work, and it needs your business details, the disability dates, a net loss figure, and supporting income documents attached. You can download the PDF from the New York Department of Financial Services website or ask the carrier handling your claim to send you one.¹

What You Can Collect Before You Start

Knowing the caps changes how you fill out the form. New York Insurance Law Section 5102 defines “basic economic loss” as a combined pool of up to $50,000 per person covering medical expenses, lost earnings, and other costs. Lost earnings inside that pool are capped at $2,000 per month for up to three years from the accident date.² The statute then reduces the payout by 20 percent, so a documented monthly net loss of $2,000 or more pays out at $1,600 per month.³

If you expect medical bills plus lost earnings to break through $50,000, check your policy for optional additional coverage. New York permits insurers to offer an extra $25,000 that can go toward lost earnings or therapy once the initial $50,000 is used up.² Not every policy carries the rider, so confirm with your carrier early.

Filling Out the Form, Section by Section

The cover portion identifies the claim. Fill in the policyholder’s name, the policy number, the accident date, and your assigned claim number, then enter your own name and address as the applicant.⁴

Questions 1 Through 5: Business and Disability Dates

Questions 1 through 4 ask for your occupation, business address, business phone number, and the nature of your business. Be specific on question 4. “Consulting” is vague; “freelance electrical engineering consulting for commercial construction projects” tells the adjuster exactly what work you couldn’t perform. Question 5 asks for the dates you were unable to attend to your business because of the accident. These dates need to line up with your medical records, so confirm them with your treating physician before you write anything down.⁴

Questions 6 and 7: Substitute Services

Question 6 asks whether you hired someone to fill in for you while you were injured. If yes, provide the substitute’s daily, weekly, or monthly wage; the period they worked; the total gross amount you paid; and their name, address, and phone number. Question 7 is the follow-up: even after paying a substitute, did you still lose money? If so, enter the net loss for the disability period from question 5. This applies when a substitute can handle some of your work but not all of it, or when clients leave because you weren’t personally available.⁴

Question 8: Net Loss Without a Substitute

If you didn’t hire anyone, question 8 asks whether you suffered a net loss of earnings during the disability period and how much. The key word is “net.” The insurer wants the income you actually lost after accounting for business expenses that stopped while you weren’t working, such as supplies you didn’t buy or fuel you didn’t burn. Gross revenue before minus gross revenue during is the wrong number if your expenses also dropped.

Signature and Fraud Warning

Sign and date the form. You are affirming everything on it under penalty of perjury. Directly above the signature line, the form prints a fraud warning: anyone who knowingly files a claim containing materially false information commits a fraudulent insurance act and faces a civil penalty of up to $5,000 plus the value of the claim for each violation.⁴

Documents to Attach

The form tells you what to include: federal income tax returns for the last two years, plus documents proving your income for the current year. If you haven’t filed one or both returns, submit whatever proof of earnings you have for those years.⁴ Strong packages typically include:

Schedule C (Form 1040), which sole proprietors use to report profit or loss and which shows net business income after deductions.
Monthly profit-and-loss statements covering at least six months before the accident, useful when your income fluctuates seasonally.
Business bank statements showing regular client deposits that corroborate the income figures on your tax returns.
Signed contracts or outstanding invoices for specific jobs the accident kept you from completing.
1099 forms issued by clients for the tax years in question.

The insurer is comparing what you earned before against what you earned or couldn’t earn after. Gaps in the paper trail are the most common reason adjusters send claims back for more information, and a complete set up front saves weeks of back-and-forth.

Deadlines That Control the Claim

Three deadlines run the timeline, and missing any of them can end the claim:

Written notice of the accident must reach the no-fault insurer within 30 days, with enough detail to identify you and the collision. Late notice is excusable only with written proof of a clear and reasonable justification.⁵
The completed NF-7 and supporting documents must reach the insurer within 90 days of the date you first lost work due to the accident. The form itself states this deadline.⁴
Once the insurer has complete proof of claim, meaning all verification forms and any additional documents it requested, it must pay or deny within 30 calendar days. Benefits not paid within that window are legally overdue.⁶

Where and How to Send It

Send the completed NF-7 and all supporting documents to the claims office of the no-fault carrier named on your policy. Use certified mail with return receipt or keep a fax confirmation. Every deadline above runs from the insurer’s receipt date, not your mailing date, so you need proof of when the package landed.

Address matters. If you submit to the wrong office within the insurance company, the 15-business-day clock for the insurer to request additional verification doesn’t start until the paperwork reaches the correct claims processing office, and that internal transfer can take up to 10 business days.⁷ Verify the mailing address with your adjuster before sending anything.

What Happens After You Submit

Once your NF-7 and documents arrive, the insurer has 15 business days to request additional verification.⁸ These requests don’t have to use a specific form; a letter or a phone call asking for clarification counts. Respond promptly, because the 30-day pay-or-deny clock doesn’t start until the insurer has everything it asked for.

The insurer may also require an Examination Under Oath, where you testify about your business operations and income. The request must be based on objective standards and can’t be a routine fishing expedition.⁸ If you’re called for one, the carrier must reimburse your lost earnings and reasonable transportation costs for attending. Failing to appear can result in a denial, so treat the scheduling seriously.

If the Insurer Denies the Claim

A denial arrives on a prescribed form explaining the reason. You can file for arbitration through the American Arbitration Association’s New York No-Fault Conciliation Center, mailing a copy of the denial, supporting documents, and a $40 filing fee. If the arbitrator awards you any portion of the claim, the fee is refunded. You can also bring a lawsuit instead.⁹

One timing detail catches people off guard. If you don’t request arbitration or file a lawsuit within 30 days of receiving the denial, interest stops accruing on the disputed amount until you take action.⁹ The claim itself doesn’t expire at 30 days, but the financial pressure on the insurer to settle shrinks the longer you wait.

Mistakes That Delay Payment

Adjusters who process these claims see the same errors. Disability dates on the NF-7 don’t match the treating physician’s records, so the insurer sends a verification request and the 30-day clock resets. The claimant reports gross revenue instead of net income, inflating the loss figure and triggering a deeper review. Tax returns are missing or cover only one year instead of two. The form lands at a regional office instead of the claims processing center, burning 10 business days in an internal transfer.

Fill out the form with your tax preparer’s records open in front of you, confirm your disability dates with your doctor’s office before writing them down, and call the adjuster to verify the correct mailing address. An hour of preparation on the front end avoids weeks of delay on the back end.

1
New York State Department of Financial Services. No-Fault Information for Insurers
2
New York State Senate. New York Insurance Law Section 5102 – Definitions
3
New York State Department of Financial Services. Re: No-Fault Insurance; Coordination with Workers’ Compensation
4
New York State Department of Financial Services. New York Motor Vehicle No-Fault Insurance Law Verification of Self-Employment Income
5
New York State Department of Financial Services. Consumer FAQs About No-Fault Insurance
6
New York Codes, Rules and Regulations. 11 CRR-NY 65-3.8 – Payment or Denial of Claim
7
New York Codes, Rules and Regulations. 11 CRR-NY 65-3.5 – Claim Procedure
8
Cornell Law Institute. 11 NYCRR 65-3.5 – Claim Procedure
9
New York State Department of Financial Services. Regulation No. 68 – 11 NYCRR 65