What do you do if you get into a car accident and have no insurance and your at fault?

Pray and Pay. You will be responsible for all costs associated with the accident. If you don't have the funds to pay the entire claim the more than likely the other party will file the claim on their uninsured motorist section of their auto policy. The UM will act as your insurance would have if you had insurance. They will then come after you for all amounts paid, plus interest, legal fees, and collection costs. In order to keep the legal and collection costs at a minimum you should try and work out a payment plan with the insurance company. Depending on the state you live in you will probably face severe penalties, fines, and loss of your license. Some states will take your license until the amount owed is paid in full. You may be able to get a limited permit to go back and forth to work only.