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New York is one of a few states in the country that requires drivers to carry a no-fault auto insurance policy. One of the purported benefits of these policies is that they allow you to obtain compensation quickly for any injuries and lost wages you experience after a wreck. A no-fault policy makes these benefits available regardless of who was at fault. 

In theory, no-fault claims are simple for the average driver to file and collect. In practice, however, insurance companies can delay or deny them. More than being frustrating, this situation can threaten your ability to receive the care you need and cover your expenses. 

When your insurance carrier refuses to pay your claim, filing a lawsuit against the insurer may be the only path to receiving compensation. While you do not legally need an attorney to do this, having a lawyer’s assistance can prove extremely valuable. 

Why Insurers Deny No-Fault Claims 

No-fault insurance policies are meant to provide benefits no matter who is responsible for the crash. Even if the policyholder is completely at fault for the accident, their no-fault insurance company should pay them benefits according to the policy’s terms.  

However, this doesn’t always happen. Your no-fault claim could be denied for several reasons, including the following: 

Untimely Claims 

You have 30 days from the date of your accident to file your claim with your insurer. Your carrier can deny the claim if it believes you exceeded this time period. If you submit a partial or incomplete claim form, the insurer may not accept this submission as enough to toll the 30-day period. 

Refusal to Cooperate With the Claims Process 

In processing your no-fault claim, the insurance company may try to reach you for additional information. If it cannot reach you, it could use this as a reason to deny your claim. For example, your insurance company might deny your claim if it sends forms for you to sign or asks for medical records but does not receive them in a timely manner. 

Exhaustion of Benefits 

If you have already exhausted your policy’s benefits, the carrier will deny any new claims. For instance, suppose that you are involved in a series of traffic wrecks that collectively exhaust your $50,000 policy limit. Any additional claims may be denied, no matter how serious your injuries are. 

What a New York Injury Lawyer Can Do When Your Claim Is Denied 

Retaining an attorney immediately after a New York car accident can decrease the likelihood that your no-fault claim is denied. Your lawyer can ensure your claim is filed in time, respond to requests for additional documentation, and check for coverage and benefits. 

Whether represented by a lawyer or not, an attorney can continue advocating for you after your claim is denied by taking actions such as: 

Appealing the Denial 

Your first course of action after a claim is denied is to appeal the denial using the carrier’s appeals process. These processes can be confusing to navigate and require that you take action by specific dates. Again, your attorney can see to it that the necessary appellate steps are taken at the right time. 

Filing a Lawsuit Against the Insurer 

Bringing legal action against your insurer for improperly denying your no-fault claim is more complicated than filing the claim itself or appealing its denial. There are procedural and technical requirements your lawsuit must satisfy before it will advance in the courts. Your lawyer will know these requirements and how to meet them. 

Gathering Evidence to Support Your Lawsuit 

It is one thing to allege your insurer wrongfully denied your claim. Proving that this allegation is more likely than not to be true is a more challenging hurdle. To meet this burden, you will need to obtain and produce evidence in court, such as: 

• Your claim and any supporting documentation you submitted with it 
• All communications from your insurance company 
• Internal notes, memos, or other communications about your claim the company made in reaching its decision 
• Sworn statements from individuals who participated in the decision to deny your claim 

None of these items of evidence are beyond the reach of a layperson suing their insurer on their own. However, a knowledgeable attorney will be more familiar with the processes for obtaining them and can do so faster. A lawyer also has the knowledge and skills needed to use this evidence in your lawsuit more effectively. 

Contact an Experienced New York Injury Lawyer Today 

Do not assume that New York’s auto insurance laws being “no-fault” means that they are “no-hassle” as well. There are plenty of ways your insurer can delay or deny your claim.  

At Silberstein & Miklos, we have a team of experienced attorneys who are here to help you get the compensation you deserve. Contact us to schedule your free consultation.