New York law gives injured people the right to pursue claims against anyone who negligently or intentionally contributed to their injuries. But most accident victims have no idea how to obtain injury compensation.

How Injury Claims Work in New York

The process of filing a personal injury claim in New York depends on how your injuries occurred.

Car Accident Injury Claims

Since New York uses no-fault auto insurance, you might have an extra step if your injuries happened in a car accident. Under New York law, you cannot pursue a legal claim against an at-fault driver unless your losses exceed $50,000 or you suffered a serious injury.

Serious injuries include:

• Death
• Dismemberment
• Significant disfigurement
• Fracture
• Loss of a fetus
• Permanent loss or limited use of an organ, body member, function, or system
• An injury that totally disables you for 90 of the 180 days following the injury

New York’s no-fault system was designed to free insurers and courts from battles over minor injuries. If you suffer an injury that does not fall on this list, you will file a claim with your auto insurer for any medical costs and wage losses you incurred. This no-fault claim gets paid regardless of who caused the crash.

If your injury is on this list, you can go straight to a liability claim against the at-fault driver.

Non-Auto Accident Injuries

Injuries resulting from accidents other than auto crashes will also typically fall under an insurance policy. Some examples include:

• Homeowner’s insurance may cover guests who slip and fall or suffer dog bites
• Business liability insurance covers slip and fall accidents on company property
• Malpractice insurance covers medical malpractice

These policies are fault-based rather than no-fault. As a result, you will file a third-party claim against the at-fault party’s insurance policy.

Process for Handling Third-Party Liability Claims

Once you get to the third-party liability claim stage, all claims get handled in the same manner. You and your lawyer will file a claim with the at-fault party’s insurer that describes your accident, injuries, and the losses you incurred as a result.

You need to include proof of your claim. This will typically entail:

• Crash reports or other official reports
• Witness statements
• Medical records
• Receipts and other financial records

The insurer assigns a claims adjuster to investigate. The adjuster’s job is to protect the insurer from paying invalid claims. They also protect their employer from overpaying for valid claims. Adjusters review each claim and the supporting documents. They can deny the claim for many reasons, including that:

• The policyholder did not cause your injury
• The policyholder was not negligent
• You did not suffer any injuries
• You received unreasonable or unnecessary treatment

You can respond to any claim denials from the adjuster by submitting additional evidence. Your lawyer can also respond with legal arguments.

If the adjuster accepts your claim, they will make a settlement offer. The initial offer will likely undervalue your claim. Adjusters make low offers for two reasons:

1. You might accept the low offer
2. A low offer leaves them room to negotiate with your lawyer

Hopefully, your lawyer will be able to negotiate a fair settlement with the adjuster. This settlement should cover your past and future losses.

Filing a Lawsuit

You can file a lawsuit against the at-fault party when the insurer persists in denying your claim. You can also go to court when the adjuster refuses to make a fair offer to settle.

Your lawsuit starts with a complaint against the at-fault party. Their insurer will join the claim as an essential party since it will be responsible for paying your damages if the court finds their policyholder liable.

To win your claim, you must prove the other party acted negligently or intentionally in causing your injuries. Most claims are based on negligence. This means the other party failed to exercise reasonable care, which caused you to suffer an injury.

You will exchange information with the other party and gather evidence in a process called discovery. The other party will look for evidence that you contributed to the cause of your injuries or that your injuries are not as serious as you claim.

Only 3% of personal injury cases reach trial. Most will settle before a jury ever sees them. If the insurer refuses to settle your case, your lawyer will present evidence at trial to prove your claims and your losses.

Talk to an Experienced Personal Injury Lawyer

When you suffer an injury due to someone else’s actions, you should not have to carry the financial burden your injuries caused. An experienced injury attorney can guide you through a personal injury claim to get fair compensation based on your injuries. Contact Silberstein, Awad & Miklos for a free consultation to discuss your personal injury claim.