How Long Does an Insurance Company Have to Investigate a Claim in New York?

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    After filing an insurance claim, you might need to wait before you get payments.  Insurance companies always do their own due diligence and try to verify your claim.  If you are filing with your own insurance, they’ll want proof that the accident truly happened and copies of bills and other statements.  If the at-fault driver’s insurance is involved, they might want a lot more proof that their driver caused the crash.  But how long do they have to collect this proof?

    There are 15-day deadlines for the insurance company to respond to your claim and acknowledge receipt, as well as for when they need to make a decision on your claim after closing its investigation.  As far as how long that investigation can take, there is no hard and fast rule.  All in all, our lawyers can help you if you come up against unreasonable delays in your insurance claim.

    For a free review of your case, call the Huntington car accident lawyers at The Carrion Law Firm today at (718) 841-0083.

    What Deadlines Does Your Insurance Have to Follow in New York Car Accident Claims?

    Under I.S.C. Law § 2601, insurance companies are prohibited from engaging in unfair practices.  This law has vague requirements that the insurance company has to use “reasonable promptness” in its communications and otherwise uses the phrase “prompt” or “promptly” a few times.  However, this law does not contain actual deadlines given in a number of days.  For that, we’ll need to turn to New York State’s regulations, specifically the New York Codes, Rules and Regulations, Title 11, Chapter IX, which governs what is considered “fair” with insurance claims.

    Part 216.4 of this chapter gives insurers 15 business days from the receipt of a claim to acknowledge that they received the claim.  That is their first deadline to follow.  Under Part 216.5, they have the same 15-day deadline from receipt of the claim to start their investigation.

    Part 216.6 provides additional deadlines on when they must make their decision.  If there is no dispute as to whether the insurance company should cover the damage/injury or not and their investigation is closed, then the insurance company has 15 days from when they receive proof of loss to determine whether they’ll accept the claim or not.  If they need more time to make a determination, they have to tell you within 15 days, then again periodically.  Making sure that you provide them with all of the information they need (medical bills, proof of missed work, the police report for the crash, etc.) can help avoid delays.

    All in all, if the insurance company takes more than 30 days to resolve your claim, Part 216.7(d) says they have to explain themselves to you.  It also creates some fines and penalties that could apply to the insurance company for delays.

    There are some differences with a third-party insurance claim, however.

    How Long Can the Insurance Company Take to Investigate Your Claim in NY?

    Under these rules, you can see that the insurance company has to initiate an investigation quickly, but there is no requirement on how long it takes to investigate.  Most cases are straightforward, and after you supply them with proof of your injuries and damages, there might not be any question as to whether the injuries are covered or not.  Since we use a no-fault insurance system in New York, your insurance company should cover any injuries you faced in a crash regardless of fault, so unless they have a dispute with the amount or need more information from you, there should be nothing left to dispute.

    This often means that they must file the 15-day deadline to make a decision on coverage in your case.  If they cannot decide within 15 days, they also have to tell you that and explain why, then explain themselves again at certain intervals as long as the investigation is ongoing.

    If the insurance company continues to drag out its investigation, our Schenectady car accident lawyers can step in on your behalf.

    What to Do if the Insurance Company Delays Your Claim in NY?

    As mentioned, our attorneys can step in on your behalf and fight to get your claim addressed more quickly if the insurance company has issued notices of delays.  If their reasons for delay make no sense or seem like they could be fabricated excuses, the insurance company might be committing what is known as “bad faith insurance” violations.  Our attorneys might be able to file a lawsuit against them, pressuring them to resolve the case more quickly and accurately or else face potentially higher punitive damages if they continue to drag out the case.  This can help speed up investigations and get you the damages you need more quickly.

    Dealing with the Other Driver’s Insurance in a NY Car Accident Case

    If your claim is with the other driver’s insurance company, there are still rules and regulations that they need to follow, including deadlines to acknowledge claims and initiate investigations.  However, this is an adversarial situation where the insurance company represents the at-fault driver and might do whatever they can within their legal options to deny your claim, delay the decision, or reduce the amount they will pay you.

    In these cases, it is best to have your Albany personal injury lawyer work with you and negotiate with the insurance company to try to reach a reasonable settlement.  If we cannot, then we can sue the driver who hit you – if your case meets certain standards under NY’s no-fault laws – and then we can leave payment up to the courts.  In these lawsuits, we will sue the driver and their insurance company, and the insurance company will step in to provide the driver with a lawyer and to pay damages.  But otherwise, the case works like any other car accident lawsuit.

    Call Our Car Accident Lawyers in NY for Help with Your Case

    If you were hurt in an accident, call the Buffalo car accident attorneys at The Carrion Law Firm today at (718) 841-0083.