If you are one of many car accident victims who have an insurance claim denied by the carrier the first time around, do not give up. Insurance rejections are common and do not necessarily mean the end of your claim. There are steps you can take to appeal the insurance company’s decision and pursue fair financial compensation for your losses.
Determine the Reason for the Denial
First, learn the reason why the automobile insurance company rejected or denied your claim. Insurance carriers in New York are required to issue rejections in writing, along with explanations as to why the claim was not accepted.
Read your denial letter carefully. Compare what it says to the language on the insurance policy. If something doesn’t add up, like a valid claim getting rejected for an invalid reason, take steps to try to reverse the decision. You may also be able to bring a claim against the insurance company for bad faith.
Request an Internal Review
The first step is requesting an internal review by the insurance company. You have 60 calendar days to send in a written request for an internal appeal. An internal review is performed by someone else within the company; a representative who is not the original insurance adjuster who was assigned to your claim. The insurance company will review your case and determine whether the initial denial was valid. If not, they may reverse the decision.
File an Official Complaint
If an internal review does not lead to a positive car accident case outcome, you can start an external appeal by filing an official complaint against the car insurance company with the New York State Department of Financial Services (DFS). The DFS will investigate your complaint and coordinate a review of the denial by an external agent. They may impose penalties on the insurer if a wrongful claim denial is discovered.
Collect Evidence
While the DFS is handling an external appeal, it can benefit you to gather information and evidence pertaining to your car accident claim and rejection. You should start building a case in preparation for a potential insurance bad faith claim.
Evidence for your case may include all correspondence and communication from the insurance company (including the rejection letter), police accident reports, medical records, witness statements, photographs, videos, and a copy of the insurance policy used.
Contact an Attorney
Next, bring your case to a free consultation with a car accident attorney for professional assistance. An attorney will work for you – not the car insurance company. You can trust your lawyer to help you achieve the best possible outcome for your car accident claim, even if you initially received a negative response from the insurance company.
After reviewing your car accident case, your attorney may determine that you have grounds for an insurance bad faith claim. Bad faith means an insurer has not treated your case with an honest and “good faith” attempt to resolve it according to New York’s insurance laws and the terms of the policy.
A wrongful claim denial is a type of insurance bad faith that occurs if there was not a valid reason to reject the car accident claim. Proof of insurance bad faith could lead to an additional settlement or judgment award from the insurance company on top of compensation for your original car accident claim.