What to Do if Your Personal Injury Claim is Denied in New York

If you receive serious injuries, the first thing you may look to do is contact your insurance company to see if they will help you out. After all, the point of insurance in the first place is to have a sort of safety net if something bad happens. Unfortunately, many people are dismayed when their insurance company says that they are not going to cover you for one reason or another. What certainly seems like a betrayal can leave people shocked, upset, and angry, but most of all, wondering what they should do next.

The first step after an insurance company denies your personal injury claim is to inquire as to why. This can help form the foundation for whether you are going to appeal your claim or take the insurance company to court and argue that they should be covering your injuries.

If you need help with a denied personal injury claim, call our Mount Vernon, NY personal injury lawyers with The Martello Law Firm at the number (914) 685-6950 for a free review of your situation.

Reasons Insurance Companies Deny Personal Injury Claims in New York

There are many reasons why an insurance company might deny your claim that they should cover your injuries. Understanding exactly why your claim was denied is important to our Westchester, NY personal injury lawyers because it can help form the basis of an argument that it was incorrect to deny your claim. This will be helpful whether the dispute is resolved with a negotiation between you and the insurance company or if it turns into a court case.

Injury Not Covered

One of the most common reasons that an insurance company will assert that they do not cover your injuries is that they are not included in your insurance policy. Each policy will have different levels of coverage, so some types of injuries will, in fact, not be covered. However, insurance policies can be worded in strange ways, to the point where whoever is evaluating your claim may think that something is not covered at first glance when it actually is.

Lack of Evidence

Another reason that insurance claims are denied is a lack of evidence. Just like in court, you need to show evidence that you were injured and the extent of your injuries. If, for example, you claim that you were in a car accident and needed surgery on your leg, but there are no medical records showing a hospital stay and no record of a damaged car taken into a repair shop, an insurance company may be hesitant to provide coverage under their policy. Frequently, obtaining evidence and showing it to an insurance company is one way to get a claim that was initially denied to be approved later.


Insurance providers often have deadlines in place for when someone needs to file a claim for coverage. The deadlines will vary from company to company, so make sure that you bring your insurance claim within the deadline so that it is not initially denied.

Liability Disputes

Many insurance policies will not provide coverage if they determine that an injury was your fault. Generally, in New York, the insurance of the individual who caused someone else’s injuries is the insurance that pays for the injuries. If you are dealing with someone else’s insurance company, they may try and defend their client and come to the conclusion that the injuries were your fault. In order to get coverage, you would need to dispute that assertion.

What to Do after Insurance Denies Coverage for Personal Injury Claims

You have two main options after an insurance company denies coverage for your personal injury claim. First, you can appeal the denial through the insurance company. Alternatively, you can sue the company. In both cases, it is a good idea to have a personal injury attorney in your corner to handle the legal side of things.

Appealing a Denied Claim

It is generally a good idea to try and appeal a claim before suing an insurance company in court. This can be beneficial if you do take the claim to court because it shows that you tried to exhaust all your options before turning to a more adversarial solution.

One of the ways you can appeal is if you believe that your claim was denied in error. Hiring a lawyer is still a good idea in these instances because insurance companies may be more willing to play ball with an attorney than a frustrated customer.

Another reason that claims are often appealed is that you have new information that changes their evaluation of your situation. If you found any new evidence about your case that the insurance company did not know about, knowledge of that information may turn a situation they believe would not trigger coverage into one where they are willing to provide it.

File a Lawsuit

If, after trying to appeal your case to your insurance company, they still do not want to provide coverage, you should consider filing a lawsuit against your insurance company to compel them to provide coverage.

There are a number of reasons why you might choose to file a lawsuit against an insurance company that is acting obstinately. If your insurance company is asking for an excessive amount of evidence to support your claim, reading your policy in an extremely narrow way to deny coverage, or incorrectly blaming you for your injuries, your only recourse may be to file a lawsuit against them.

Call Our New York Personal Injury Lawyers Today

Have a chat with our Ossining, NY personal injury lawyers by calling The Martello Law Firm at (914) 685-6950.

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