There are two basic types of personal injury claims you can file against insurance companies in New York. For example, if you meet with a car accident and you’re not at fault, you may file a claim with your own insurance company or the other driver’s insurance company. However, both may deny your claims for different reasons. As a result, it’s best to understand when a personal injury claim can be rejected and how to deal with rejected personal injury claims.
When Can a Personal Injury Claim Be Rejected?
Insurance companies cite different reasons when they deny personal injury claims, and looking at the reason behind your claim’s denial can serve as the basis for filing an appeal or taking your case to court. The most common reasons why a personal injury claim can be rejected include:
- Coverage problem. If an insurance company can show that your injury is the result of a pre-existing condition and out of coverage parameters, it can deny your claim. In addition, it might also point out that the injuries you’ve suffered fall outside of the coverage provided by the policy in question. This can be possible given that insurance policies come with different coverage levels, but it requires a close look to assert if the insurance company is right.
- Inadequate evidence. An insurance company may reject a personal injury claim if it feels there’s inadequate evidence to support the claim. In this case, you need to provide enough evidence to substantiate your claim. For example, if your claim mentions you needed surgery for an injury you suffered in an accident, you should have medical records that prove the same.
- Missed deadlines. Insurance companies and other entities typically have deadlines in place when it comes to how much time you get to file a personal injury claim. For example, if you wish to file a no-fault car accident claim, you need to do so within 30 days of the accident. Since the deadlines vary and there are exceptions, it’s best to consult a lawyer who handles personal injury lawsuits.
- Unpaid premiums. An insurance company may deny your personal injury claim if the policy’s premiums were unpaid when the accident occurred, saying coverage did not exist at that point in time.
- Liability. If you file a personal injury claim with someone else’s insurance company, like the driver of another car, it might reject your claim if it feels that the injuries are a result of your own fault. However, even partially at-fault drivers in New York can seek damages because of the state’s comparative fault law. Besides, you might not be at fault at all.
- Breaking the law. It’s common for insurance companies to have very specific wordage in their policies to highlight that the coverage does not apply if injuries occur when a claimant is breaking the law. This could include getting involved in a high-speed car chase and crashing or meeting with an accident because you’re intoxicated. However, if you can dispute any of the supposed facts that support the rejection, you stand a chance to file an appeal.
- Did not mitigate damages. As a claimant, it’s your duty to take effective measures to alleviate your damages. This could be getting medical treatment as soon as possible or returning to work once you’re fit and able.
What Are the Limitations on Personal Injury Claims?
The statute of limitations for filing personal injury claims in New York depends on the type of case in question. For example, a three-year statute of limitations applies on claims that arise owing to automobile accidents, premises liability accidents, and general negligence that results in injury. It stands at one year from the date of the incident for intentional emotional distress, and three years from the date of the incident for negligent emotional distress.
If you plan to file a case against New York City or New York State, you have to file a notice of claim within 90 days of the accident. You get one year and 90 days from the date of the accident to file a lawsuit. In cases of wrongful death, you get two years from the date of the death to initiate proceedings.
If a missed deadline is the cause of your claim denial, you might be unable to file an appeal or take your case to court. However, since a few exceptions apply in different cases, seeking advice from a personal injury lawyer is ideal.
How Do You Handle a Rejected Personal Injury Claim?
If you’re wondering how to deal with rejected personal injury claims, know that no single approach works equally well for all and you need to consider the specifics of your case. Keep in mind that insurance companies can deny claims for the wrong reasons or based on their own interpretation of the law or the facts of a case.
So, how do you handle a rejected personal injury claim from an insurance company? Ideally, by partnering with an experienced personal injury lawyer who can then help you choose the best course of action, which might come in different forms.
File an Appeal
If you feel that an insurance company has rejected your personal injury claim erroneously, you hold the right to appeal the decision. For example, the insurer may question the extent of your injuries because of inadequate evidence, which you may address by providing all the required evidence.
Initiate Legal Proceedings
If you feel that an insurance company did not act in good faith, as required by the law, when processing your claim, you have the right to sue the company in question. According to Section 2601, under Article 26, Chapter 28, of the Consolidated Laws of New York, unfair claim settlement practices include:
- Intentionally misrepresenting policy provisions or facts related to the coverage.
- Not acknowledging communication related to a claim with promptness.
- Not adopting and implementing reasonable standards for the timely investigation of a claim.
- Not acting in good faith to settle a claim promptly and in a fair manner.
- Forcing a claimant to file a court case by offering a substantially low settlement amount.
- Not having a rational reason to reject your claim.
Conclusion
Now that you know what happens if a personal injury claim is rejected, keep in mind that you don’t have to take the insurance company’s word that the reason for denial is valid. Ideally, you should seek advice from a personal injury lawyer who specializes in dealing with denied claims to determine if you can file an appeal. This is because the best way to deal with a rejected personal injury claim is to take a close look at the legalities that surround your case.