Insurance can help people cover unexpected expenses when things go wrong. In many circumstances, insurance is required by law, and insurance companies must adhere to strict and complex laws surrounding the entire insurance industry.
Insurance companies deny claims for various reasons. The denial might be wrongful if there is no solid reasoning. Some denials are due to errors, and you should take steps to fix these errors before pursuing legal action. Many cases are based on bad faith dealings where the insurance company knows they are wrong but would rather save money by denying claims. The evidence you need depends on the reasons for the denial. The terms of your policy are crucial as the policy is the contract between you and the insurance company. You can claim damages for the expenses that should have been covered in the first place.
The insurance process is complicated, and insurance companies rely on claimants giving up after being denied. Our New York personal injury lawyers can help you sue the insurance company for wrongfully denying your claims. For a free case evaluation, call The Carrion Law Firm at (718) 841-0083.
Filing a Lawsuit Against My Insurance Company for Denying My Claim in New York
Denied insurance claims are nothing new. Insurance companies routinely deny claims they believe are not covered by the claimant’s policy. Although having a claim denied is hard, it is not necessarily the end of the road. Insurance companies sometimes wrongfully deny claims. In some cases, the denial is wrongful because it was made in error. In other cases, the insurance company is dealing in bad faith and should have approved the claim. Talk to our Queens personal injury attorneys about your denied claim, and we can help you sue the insurance company.
You should consider filing a lawsuit if you believe your claim was wrongfully denied. The insurance process is so complicated that many people feel they cannot stand up to their insurance company. However, a denied claim might mean you cannot cover your expenses, pay rent, or put food on the table. Filing a lawsuit might be the difference between keeping a roof over your head and being out on the street.
An attorney with experience with suing insurance companies can help you determine whether your claim was wrongfully denied and what you can do about it. Often, insurance companies back down and are more willing to reevaluate your claim once they know you have hired legal representation. Even if they do not, a lawyer can help you prove the claim was wrongfully denied and get you the necessary coverage.
Why Would My Insurance Company Deny My Claim in New York?
There are various reasons that insurance companies often claim when denying claims. While these reasons are sometimes true or at least reasonably believed by the insurance company, they are sometimes false or fabricated. You should speak to our Syracuse personal injury attorneys about any denied insurance claim, and we can help you determine if it is legitimate or wrongful.
Insurance companies commonly deny claims based on a lack of coverage. Whether or not your claims are covered depends on the terms of your insurance policy. These terms might mention specific instances that are included and excluded from coverage. If your claim is not covered under the policy, the insurance company may deny it. However, insurance policies are often confusingly worded, and the insurance company might incorrectly deny a claim that is actually covered by your policy.
Insurance companies also deny many claims based on fraud. If the insurance company suspects your claims are fraudulent, they will not hesitate to deny them. Fraud is taken incredibly seriously by insurance companies. Small mistakes might give a false impression of fraud, and your claim might be wrongfully denied.
Even if the insurance company knows your claim is not fraudulent, there might not be enough evidence to convince them that your claim should be approved. For example, you might file an insurance claim after a car accident to get coverage for vehicle damages and medical bills. However, the insurance company might deny your claim if you forget to provide evidence of your medical costs.
Steps to Take Before Suing Your Insurance Company in New York
While you should certainly consider suing the insurance company for wrongfully denying your claim, you should also consider some preliminary steps to take with your attorney. It is not unusual for wrongfully denied claims to result from mistakes or errors. Our Brooklyn personal injury lawyers can help you identify possible errors in your insurance claim and work to correct them so your claim can be approved. If this tactic does not work, we can help you file a lawsuit.
If your claim was denied in error, we should bring the error to the insurance company’s attention and allow them to correct it. Often, insurance companies will quickly correct mistakes once they realize them. Even so, hiring an attorney is important, as it might take some convincing from a skilled legal professional to get the insurance company to reevaluate your claim and address the error.
If a lawsuit becomes necessary, we have to make sure process is served on the correct entity. Insurance companies can be huge, and we are usually suing the organization as a whole rather than a few individuals. According to I.S.C. Law § 1212(b), we must serve process on a superintendent of the insurance company. The superintendent has power of attorney and handles various legal aspects of the insurance company. Insurance companies are required by law to appoint a superintendent.
Common Reasons to Sue Your Insurance Company for Denying your Claims in New York
There are many possible reasons behind a wrongfully denied insurance claim. You should discuss your circumstances with our New York personal injury lawyers to determine if your claims were indeed wrongfully denied.
Problems with Policy Coverage
Insurance claims are often denied because insurance companies do not believe the claimant’s policy covers the claims. Policies are agreements between insurance companies and customers. Under the policy, the customer pays the required fees for coverage, and the insurance company will cover damages under specific conditions. If the conditions for coverage are not present, the insurance company can deny the claim.
A denial in this situation becomes wrongful if the insurance company is wrong about the coverage permitted under the policy. For example, the insurance company might claim that the claimant’s policy does not cover their damages when in fact the policy mentions the claimant’s damages as being covered. In other cases, insurance companies will purposefully twist the policy’s wording to suit its needs and deny claims. If you know your claims are covered but the insurance company says otherwise, contact our Hempstead personal injury attorneys immediately.
No Explanation for the Denial
When insurance companies deny a claim, they are required to explain why. This is often done in writing, and claimants will receive a letter in the mail detailing why their claim was denied. The purpose of the explanation is to provide transparency and allow claimants to take further action to appeal the decision.
If the insurance company does not explain the denial, or the explanation is vague, you can sue them. Often, a lawsuit in this situation is necessary because the insurance company has not given you any other recourse.
Bad Faith Dealings
Perhaps the worst reason for a denied insurance claim is bad faith dealings on the part of the insurance company. Dealing in bad faith may be difficult to prove, but it is illegal and should not be tolerated. For example, the insurance company might offer you a great policy at first, but then they alter the terms so they will likely never have to pay.
Proving that the insurance company acted in bad faith can be challenging. In the 1993 case of Pavia v. State Farm, The Court of Appeals in New York established certain criteria that plaintiffs must show to prove a prima facie case of bad faith. You must show that the insurance company’s denial was a “gross disregard” of your interests. The Court further explained that a gross disregard would include deliberately or recklessly failing to hold your interests equal to those of the insurance company when making a settlement offer.
Currently, a new law is being considered in New York that would make it much easier for claimants to prove bad faith by insurance companies. The Act to Amend the Insurance Law, in Relation to Unfair Claim Settlement Practices, which has not yet passed, would provide a right of action to plaintiffs who can prove by a preponderance of the evidence that the insurance company’s denial of their claim is not reasonably justified.
Evidence You Need When Filing a Lawsuit Against Your Insurance Company in New York
The evidence you need depends on why the insurance company denied your claim. If the insurance company had a very specific reason behind the denial of your claim, we must present equally unique evidence that shows the denial was wrongful. Even so, certain pieces of evidence are common across many lawsuits, and our Bronx personal injury attorneys can help you.
First, we should try to find evidence of the injuries or damages you wanted to be covered in the first place. Suppose the insurance company wrongfully denied your claim because they do not believe your policy covers it. In that case, we must have evidence of your injuries and damages that prove your claims fit well within the terms of the policy. This might require police reports, photos of damages or accident scenes, and any bills you incurred because of the injuries or damages.
We should also have a copy of the original claim you submitted to the insurance company. While the insurance company likely has this on file, you should always keep your own copies of everything you submit to the insurance company. If they claim there was some error with your claim, or it was missing information, we can pull out the original claim to prove them wrong.
Your policy is perhaps the most important piece of evidence we have. The policy is a lot more than a description of your coverage. The policy is a contract between you and the insurance company and is binding on both parties. If the insurance company violated the terms of the policy by refusing to cover you, they are in breach of the contract.
Is There a Deadline to Sue My Insurance Company in New York?
Depending on your situation, the terms for when you can file a lawsuit are likely contained within the policy. Our New York personal injury attorneys can comb through your policy to determine if you still have time to file a lawsuit.
A wrongfully denied claim is often related to a breach of the policy and may fall under the statute of limitations for breaches of contract. According to C.V.P. Law § 213(2), you have 6 years from the time of the breach to file a lawsuit against the insurance company. However, as mentioned before, the terms of your insurance policy might impose a shorter deadline.
Failure to notify the claimant of the limitations period to commence a lawsuit does not stop the insurance company from relying on the limitations period. According to the New York Department of Financial Services, the insurance company must advise claimants of any deadlines to take legal action if they deny a claim. However, failing to notify claimants of the deadline does not void the deadline, and claimants are still restricted by the deadline.
Potential Damages in a Lawsuit Against Your Insurance Company in New York
The damages in a lawsuit against an insurance company for wrongfully denying your claims are somewhat complicated. First, most plaintiffs want the coverage their original claim should have received in the first place. Second, many plaintiffs encounter various other expenses because of the denied claim, and the defendant may cover these damages if your case is successful. Our Binghamton personal injury lawyers can help you accurately assess your damages to maximize your compensation.
Insurance policies often cover the economic damages related to accidents and injuries. For example, you can file an insurance claim with your insurance for economic damages like medical bills and the cost of replacing your totaled vehicle. If you sue your insurance company for wrongfully denying your claim, you can claim these damages as part of your lawsuit.
Call Our New York Personal Injury Attorneys for a Free Review of Your Case
If you filed an insurance claim only to have the insurance company deny your claim, you can take legal action to remedy the situation. Our Harlem personal injury attorneys can help you sue the insurance company for wrongfully denying your claims. For a free case evaluation, call The Carrion Law Firm at (718) 841-0083.