Was Your New York Injury Claim DENIED? Here’s How to Fight Back & WIN!

Summary

This source outlines how to contest a denied insurance claim following an injury in New York. Attorney Brett Harrison explains that denials often stem from missed deadlines, disputed liability, or insufficient evidence, rather than a lack of merit. The text emphasizes understanding state-specific rules, such as the 30-day no-fault filing window and comparative negligence law, which allows victims to recover partial damages even if they are somewhat at fault. To overturn a rejection, the guide advises claimants to meticulously review denial letters, preserve medical records, and seek legal counsel to navigate appeals or litigation. Ultimately, the material encourages persistence against insurance companies to ensure victims receive the financial compensation they are legally entitled to.

FAQs:

What should I do immediately if my New York injury claim is denied?

You should carefully review the denial letter to identify the specific reasons cited for the rejection and note any internal appeal deadlines, which often fall between 30 and 60 days. Gathering all relevant documentation, such as accident reports, medical records, and photos of the scene is also critical to building a case for a reversal of the decision.

How long do I have to file a no-fault insurance claim in New York?

New York State law requires you to file a no-fault (Personal Injury Protection) claim within 30 days of the accident. Missing this deadline can result in the insurance provider denying coverage for medical bills and lost earnings, regardless of who was at fault for the incident.

Can I still recover damages if I was partially at fault for the accident?

Yes, New York follows a pure comparative negligence rule that allows you to recover a portion of your damages as long as another party shared some responsibility. Your total compensation is reduced by your percentage of fault; for instance, being 20% responsible would allow for the recovery of 80% of the total damages.

What is the statute of limitations for a personal injury lawsuit in New York?

The general deadline to file a personal injury lawsuit in New York is three years from the date of the accident. However, claims against municipalities or government entities often have shorter windows, such as a 90-day notice-of-claim requirement followed by a lawsuit filed within 1 year and 90 days.

What qualifies as a “serious injury” under New York law?

A serious injury is legally defined to include conditions such as broken bones, significant disfigurement, loss of a limb or organ, or any injury that limits normal daily activities for at least 90 days. Meeting this threshold is required to pursue a liability claim or lawsuit against an at-fault driver for non-economic damages like pain and suffering.

Transcription of the Video

If you’re injured in New York and just received a denial letter from the insurance company what do you do next this could mean the difference between walking away with nothing and your head and your tail between your legs or recovering the compensation you are entitled to because here’s the real truth a denial is not the end of the road it’s where a lot of the people want to give up but this is where the rubber meets the road this is where the real smart ones fight back and win i’m Brett Harrison New York State injury attorney and today I’ll walk you through exactly what an insurance denial means why claims get denied and a step-by-step guide of what you can do if your claim was denied. First let’s take a deep breath okay ready and let’s read that denial carefully it will state the reason your claim was denied and there might be multiple reasons why you’re denied knowing the why is crucial because it guides your very next steps.

Here are four common reasons insurance companies deny claims in New York State: one missed deadlines if you waited too long to notify the insurer or file the claim they might deny it for lateness in New York State you must file a no-fault claim within 30 days of the accident. Two disputed liability the insurer may argue about who caused the accident if there is any doubt the insurance company might deny or delay your claim while also attempting to blame you for the accident and number three insufficient evidence the insurance company they may deny your claim because they say you haven’t proven their driver was at fault for the accident or that you weren’t really injured enough in this accident. Now let’s go to number four policy exclusions or limits sometimes accidents can fall outside coverage due to an excluded driver or the associated costs exceeding the policies limits in New York State basic no-fault PIP or personal injury protection coverage tops out at 50,000 per person if your expenses go beyond that often times the insurer won’t pay more without further legal action.

Now it’s frustrating I know but a denial doesn’t mean the end of your claim it just means we got to work a little harder the insurance company isn’t voluntarily paying up quite yet that’s not a surprise by the way. To make this real let me share a real scenario I had with a client imagine you’re in a car accident over in Brooklyn could be in Brooklyn could be in any of our five boroughs of Long Island. Another driver runs a red light and hits you in your car you file a claim with their insurance company expecting personal injury compensation and car damage to be covered but then you get the denial letter. The insurer says “You were partly at fault because they claim you were speeding.”

Here’s the thing New York State law is on your side even if you were slightly speeding that doesn’t bar from recovery New York is what we call a comparative fault state meaning even if you’re partly to blame you can still recover damages now they may be reduced based on your percentage of fault in the accident. In Sarah’s case we fought back and we fought back hard we gathered the traffic cam footage and witness information proving the other driver was primarily at fault and this is a significant part and even if Sarah was say 20% at fault she could still legally recover the 80% of her damages. Faced with this evidence the insurance company had no choice but to correct course and pay Sarah the fair settlement she was entitled to. Here’s the key lesson don’t let an insurer use blameshifting as an excuse even if they say you’re partially at fault you may still recover a substantial portion under New York’s comparative negligence rule.

Before we jump into action steps here are four critical New York State personal injury basics to understand: number one no-fault insurance PIP or personal injury protection New York is a no-fault state after a car accident your own insurance company pays for your medical bills and lost earnings up to 50,000 regardless of who is at fault. But you must file your no-fault claim within 30 days of the accident or the insurer can deny coverage. Number two serious injury threshold to go after the at-fault driver for your pain and suffering New York law says your injuries must be serious or your economic losses exceed $50,000. Serious injury includes things like broken bones fracture significant disfigurement like heavy scarring the loss of a limb or an organ it can be significant limitation or use of a body part function or system or it can be any injury that keeps you from your normal activities for 90 or more days. Please be sure to consult with a personal injury attorney for confirmation because this is what we do we know how to find these things and how to place you within these categories.

Number three comparative fault New York State uses pure comparative negligence this quite simply means you can recover damages even if you are partly at fault as long as someone else was also at fault. Number four filing deadlines or what we attorneys call the statute of limitations in New York State in general you have three years from the date of the accident to file a personal injury lawsuit. Missing that deadline you are barred from a complete recovery. Some situations have shorter deadlines for example if a city vehicle or a town or municipal vehicle was involved you might have to file what’s known as an initial notice of claim within 90 days of the accident and then you must have to file a lawsuit generally within a year to a year and 90 days.

Specific steps you should take immediately after an insurance claim denial: number one review the denial letter read it line by line identify exactly why the claim was denied. Make a note of any appeal deadlines mentioned in the letter some insurance companies give you a window often between 30 or 60 days to appeal internally. Number two gather and preserve evidence start collecting all relevant documents accident reports photos of the scene medical records and witness statements. Number three consult New York personal injury attorney retaining a seasoned personal injury attorney early can dramatically improve your odds. A personal injury attorney like myself will evaluate the denial reasons and quickly tell you if the insurance company is off base. Most personal injury attorneys in New York State offer free consultation so it doesn’t cost you anything to get a qualified opinion.

An attorney can also make sure you meet all legal thresholds like confirming your injury meets the serious injury criteria to sue. Number four appeal or challenge the denial almost every insurance company has an internal appeal process for denied claims this usually means you or ideally your attorney will write a formal appeal letter responding to each reason for their denial along with the supporting evidence. Number five file a lawsuit if necessary if the insurance company still refuses to do the right thing after your appeal or negotiations the next step is a lawsuit. In New York State you have up to three years to file a personal injury lawsuit as long as it’s not against a municipality. Number six stay on top of medical care and records continue your medical treatment and follow your doctor’s advice even if the insurance company isn’t paying right now. Number seven notify New York State authorities if bad faith is suspected you have the right to file a complaint with the New York State Department of Financial Services (DFS).

In conclusion fight back and protect your rights understand the denial, get evidence, call a lawyer, appeal and if needed sue. Very importantly act quickly and decisively every day after denial matters the sooner you push back the better chance of turning that denial into a payout. If you’re feeling overwhelmed reach out to a qualified New York personal injury attorney who can guide you through this process and fight for you you are entitled to it.