Can Insurance Companies Deny Your Injury Claim in New York? Here’s the Catch
You got hit. You filed your claim. And then, instead of a check, you got a letter explaining, in the friendliest possible corporate tone, why the insurance company isn’t paying you what you expected. Sound familiar? If so, you’re not alone, and you’re not imagining things. Insurance companies can and do deny injury claims in New York, sometimes for legitimate reasons and sometimes for reasons that exist mainly to protect their bottom line.
So can they actually say no? Yes. Should they be allowed to say no for just any reason? That’s a different question entirely.
Why Would an Insurer Deny a Perfectly Good Claim?
Insurance companies are businesses, and businesses like to keep money rather than pay it out. That doesn’t mean every denial is unfair, but it does mean every denial deserves a second look. Common reasons claims get denied or undervalued include disputes over who caused the accident, questions about whether an injury meets New York’s “serious injury” threshold under the No-Fault Law, gaps in medical treatment that insurers use to argue an injury wasn’t that serious after all, missed filing deadlines, or simply a low first offer designed to see if you’ll take the bait before you understand what your claim is worth.
Here’s where it gets interesting: New York actually regulates how insurers are allowed to behave when handling claims. Under New York Insurance Law § 2601, insurers are prohibited from engaging in unfair claim settlement practices, which includes misrepresenting policy terms, failing to investigate claims with reasonable promptness, and refusing to attempt good faith settlements once liability is reasonably clear. In other words, an insurance company can deny a claim, but it can’t just make things up or drag its feet for no reason.
What Tends to Trigger a Denial or Lowball Offer
A few patterns show up again and again in claim denials, and it helps to know what they look like before you’re staring at one in your inbox:
- Claiming your injuries don’t meet the legal threshold for a lawsuit
- Arguing the accident was partially or entirely your fault
- Pointing to gaps between your accident date and your first doctor’s visit
- Disputing the necessity of ongoing treatment, therapy, or surgery
- Suggesting your injuries existed before the accident occurred
None of these arguments are automatically true just because an insurer raises them. They’re positions, not facts, and positions can be challenged.
What Should You Do When a Claim Gets Denied?
Take a breath first. A denial letter is not a final verdict; it’s an opening move. Insurance adjusters are trained to manage costs, and a denial or lowball offer is often simply the starting point of a negotiation they’re hoping you won’t push back on. Keep every piece of paperwork you receive, including the denial letter itself, your medical records, and any correspondence with the adjuster. Avoid giving recorded statements without understanding what you’re agreeing to, and resist the urge to accept a quick settlement just to make the headache go away.
Don’t Let a Denial Be the Final Word
A denied or undervalued injury claim can feel like the system is rigged against you, but New York law gives injured people real tools to push back. If your claim has been denied, delayed, or lowballed, our New York personal injury attorneys at Jaroslawicz & Jaros, PLLC have protected the rights of the injured across New York for more than 45 years. We’re based right here in New York City, and we know how insurance companies operate because we’ve spent decades going up against them. Contact Jaroslawicz & Jaros, PLLC today for a free consultation, and let’s talk about what your claim is really worth.
Source:
nysenate.gov/legislation/laws/ISC/2601