What To Do When Your Insurance Claim Is Denied

court house in New York

Consumers in the state of New York have substantial legal protection. For example, consumers can hold insurance companies liable for bad faith – that is, for unfair insurance practices. This is where an injury attorney can help.

If you’re injured in a car wreck or any other accident, or if your vehicle or other property – your home or business, for example – is damaged in an accident, your insurance company should compensate you quickly. Unfortunately, many consumers have to fight for their reimbursement.

Even accident victims who have been severely injured may have to deal with excuses, brush-offs, unreasonable delays, and other obstacles to acquiring the insurance settlement they need, deserve, and are entitled to under the law.

WHO CAN BE A VICTIM OF INSURANCE BAD FAITH?

Keep reading. Anyone can be injured or sustain property damage unexpectedly. You are going to learn exactly what insurance “bad faith” is, and you’ll also learn what your rights are if you become a victim of insurance bad faith here in New York.

Anyone who files a property or injury claim can potentially end up in a dispute with an insurance company. In Western New York, if you can’t get an insurance company to meet its obligation to you, an experienced Rochester personal injury attorney can take legal action on your behalf.

WHAT IS THE DEFINITION OF INSURANCE BAD FAITH?

Bad faith is the legal term that describes what happens whenever insurance companies handle a property claim or an injury claim negligently or unfairly.

instances of bad faith

Insurance company practices that are particular instances of bad faith include:

1. persistent efforts to settle your claim for less than its actual worth
2. unwarranted delays in handling your claim
3. giving you false or disingenuous reasons for denying your claim
4. threatening to cancel coverage unless you agree to an insufficient settlement amount
5. persistently requesting more details as a stalling tactic

WHAT ARE THE RIGHTS OF INSURANCE BAD FAITH VICTIMS?

In some cases, merely hiring a good injury attorney will be sufficient to make an insurance company fulfill its obligation to you. Sometimes, a letter from your attorney will be all it takes.

Consumers in New York pay a great deal for insurance, so an insurance company’s bad faith is not acceptable.

bad faith insurance practices

If you file a claim for insurance bad faith, you may be awarded the settlement you were denied along with any additional damages that a court may order. However, you must be represented by a lawyer who has substantial experience advocating for victims of bad faith insurance practices.

By itself, the denial of an insurance claim is not necessarily an act of insurance bad faith. Bad faith claims must be based on an insurance company’s specific acts or failures to act.

WHAT’S THE BEST WAY TO COUNTER INSURANCE BAD FAITH?

What is the best way to take effective action if an insurance company operates in bad faith in New York?

You can and probably should formally file a complaint with the New York Department of Financial Services, but the Department’s own website warns, “We cannot attempt to resolve or otherwise handle every individual complaint.”

WHY WILL YOU NEED A PERSONAL INJURY LAW FIRM’S HELP?

However, you should also obtain an attorney’s help for these reasons when you are dealing with insurance bad faith:

1. Only a NY personal injury lawyer can help you to determine if an insurance company is, in fact, operating in bad faith and if you qualify to file a lawsuit.

2. If your case goes to court, and if your claim prevails, the court will compel the insurance company to compensate you adequately.

insurance bad faith claim

3. If your insurance bad faith claim prevails, you may also be able to have your legal fees paid by the insurance company.

An insurance company owes good faith to every consumer who files a property or injury claim, whether the consumer is a policyholder or a third party. If you are victimized by bad faith insurance practices, have a reliable insurance attorney handle your case.

HOW WILL YOU AND YOUR ATTORNEY PROVE YOUR BAD FAITH CLAIM?

How will an accident attorney prove that you are a victim of insurance bad faith? As mentioned previously, a bad faith claim must be based on an insurance company’s specific acts or failures to act.

Here is how you can help your own bad faith insurance case:

1. When an accident happens that will generate an insurance claim, make and securely store copies of the relevant insurance documents as well as any correspondence that you have with the insurance company.

2. Make notes of every conversation with an insurance company representative and include the time, date, and name of the representative.

WHAT DOES IT TAKE FOR AN INSURANCE BAD FAITH CLAIM TO PREVAIL?

For your insurance bad faith claim to prevail, you and your attorney will have to prove that an insurance company’s denial of benefits was more than a mere mistake. Instead, you’ll have to prove that it was intentional or negligent behavior.

Your lawyer will study the details of your property or injury claim and your subsequent bad faith claim. Your lawyer may also request from the insurance company the documents related to your claim as well as documents describing the company’s procedures and policies.

bad faith cases

Representatives of the insurance company may be required to provide depositions or courtroom testimony. In some bad faith cases, your attorney may ask an authority in the insurance industry to testify as an expert witness about the industry’s practices and procedures.

Particularly when an insurance company has failed to follow its own procedures and policies – and when your attorney can prove it – an insurance bad faith lawsuit will very probably prevail.

WHAT ELSE DO YOU NEED TO KNOW?

Here is one last thing you must know. In Western New York, if you are injured in a traffic crash because another driver was negligent, you should take your case directly to a personal injury attorney, and then refer all inquiries from the insurance company to that law firm.

Property can be replaced, and in most cases, it is actually more practical to handle a property damage claim on your own. You, however, cannot be replaced. If you have been injured, let an experienced Rochester personal injury lawyer handle your injury claim from the very beginning.

And if you become a victim of bad faith insurance practices regarding any insurance claim, discuss your rights and options promptly with a reliable New York injury attorney. Any time you deal with an insurance company, having the help of a good injury lawyer is your right.

Can You Borrow Money From A Lawsuit?

If you’re injured by someone else’s careless negligence in the state of New York – by a distracted driver, a negligent healthcare provider, or even by a defective consumer product – you are entitled by law to full compensation for your medical expenses and other losses. You need the help of a Rochester personal injury attorney at once.

However, it may take a considerable amount of time for an injured victim of negligence to receive that full compensation. If an injury claim cannot be settled out of court, a personal injury trial is necessary and the case then may not be resolved for a least a year – and even longer when a case is complicated.

And while a personal injury claim is pending, the bills are piling up. If you are recovering from injuries and you’re unable to work, you could very quickly find yourself facing temporary – but nevertheless quite serious – financial hardship.

Let’s be frank. If you’re filing a personal injury claim that could take months to resolve, and if you’re injured and away from work, unless your savings are considerable, you are very quickly going to need some cash until you can return to work or until your claim is resolved.

WHAT ARE LAWSUIT LOANS?

One option to consider – but consider it very carefully – is what’s called a lawsuit loan. A lawsuit loan is a cash loan against a future out-of-court settlement or jury verdict. Lawsuit loans are also called “litigation financing,” lawsuit funding, and “lawsuit advances.”

However, and as you might imagine, you have to be quite careful about applying for and accepting a lawsuit loan. Borrowing against your personal injury award is a way to deal with short-term financial obligations, but the long-term cost may be too much to bear.

If you apply for a lawsuit loan, it’s imperative to do your research and understand the real cost.

Lenders who offer lawsuit loans sell the product primarily to injured victims of negligence in personal injury cases – cases arising from traffic accidents, slip-and-fall injuries, defective consumer products, and incidents of medical malpractice.

Here in New York, if you sustain a personal injury or injuries in a traffic collision or any other accident caused by someone else’s negligence, after you have been treated by a healthcare professional, discuss your case at once with an experienced Rochester personal injury attorney.

WHAT WILL A PERSONAL INJURY LAW FIRM DO?

If you’ve been injured by another person’s negligence, and if you choose to pursue a personal injury claim, your personal injury lawyer will:

1. investigate the accident and your injury
2. examine the applicable insurance policies
3. review the evidence and question the pertinent witnesses
4. determine precisely who has legal liability
5. hold the liable party or parties accountable
6. negotiate aggressively for the compensation you need and deserve

Most personal injury claims – about ninety percent – are settled privately when attorneys for both sides meet and negotiate away from the courtroom. However, if your case cannot be settled out of court, you may have to go to trial to obtain the compensation that is rightfully yours.

And that can take months. A complicated, disputed case can sometimes stretch out for more than a year. With your medical bills mounting and no income from your job, a lawsuit loan might look quite tempting. But is a lawsuit loan really a wise option?

HOW DO LAWSUIT LOANS WORK?

After you’ve filed a personal injury claim, you apply for the loan from a lawsuit loan lender. The lender evaluates your claim to determine how much you should receive if you negotiate a settlement or prevail in a personal injury trial.

If your loan is approved, you’ll receive it right away. You agree to repay the loan (the principal) along with a “funding fee” or interest on the loan from your compensation when you receive it.

WHAT’S THE CATCH?

You’ll usually be told that the interest or “funding fee” is from two percent to four percent per month. Sounds reasonable, right? But do the math.

The actual annual interest on a lawsuit loan can run as high as sixty percent. If a complicated personal injury lawsuit and trial takes place over two years, you could be obligated to pay back twice what you borrowed – or more.

WHAT ARE THE COSTS IN A PERSONAL INJURY CASE?

When you and your attorney reach a personal injury settlement or prevail at trial, some of your costs must be paid at that time. These costs can include:

1. The attorney’s fee: For most personal injury cases, the attorney’s fee is usually from thirty-three to forty percent of the full, final compensation amount.

2. Routine lawsuit expenses: Expenses can include expenditures ranging from copy machine costs to paying for an expert witness and his or her time and expenses.

3. Medical liens: If you obtain medical services from hospitals, doctors, or other healthcare providers on the basis of a medical lien, that lien must be paid from the compensation amount – before you personally receive any compensation.

When these costs are paid, if you took out a lawsuit loan, the lender is paid from what remains.

WHAT ARE YOUR ALTERNATIVES?

If you need cash while your personal injury case is pending, consider all of your alternatives and discuss the matter with your personal injury lawyer. You may have other options:

1. Is there any insurance coverage that might provide quick cash?
2. Do you qualify for any state or federal disability benefits?
3. Could a loan from your bank or credit union provide better terms than a lawsuit loan?
4. What about a personal loan from a friend or a family member?

Yes, a lawsuit loan can cover immediate financial obligations, and if for any reason a jury decides against you in a personal injury trial, you do not have to repay the lender. It’s the risk the lender takes, and it’s the main reason that interest rates on lawsuit loans are so outrageously high.

WHAT DOES IT COST TO BEGIN PURSUING JUSTICE?

You, however, don’t have to take any risks in order to pursue the justice you deserve. A Rochester personal injury lawyer will provide a free first legal consultation to an injured victim of negligence.

You’ll learn how the law applies to your own case and whether you should take legal action. If you and your attorney agree to pursue compensation, you’ll pay no attorney’s fee until and unless compensation is recovered on your behalf.

If you are injured by another person’s negligence, you have two immediate priorities. Get medical attention at once – that’s first. Then get the legal advice and representation you need from an experienced Rochester personal injury attorney. That is your right.

How To Respond To A Low Settlement Offer For Your Personal Injury Claim

If you are injured by another person’s negligence here in the state of New York – in a traffic crash or any other accident scenario – you may seek the help of a Rochester personal injury attorney to file a claim and seek compensation for your medical expenditures, your lost wages, and your personal pain and suffering.

If your injuries are sustained in a traffic collision, New York is a “no-fault” auto insurance state, so your own auto insurance company should pay for at least the first part of your compensation.

When you’ve collected your medical bills and the other pertinent documents, you will probably fill out some paperwork to submit your injury claim to the appropriate insurance company.

WHAT SHOULD YOU DO IF YOU ARE INJURED BY NEGLIGENCE?

If you are injured by negligence in western New York, the wisest move is taking your case directly to a personal injury lawyer – one who routinely handles injury claims and negotiates with insurance companies on behalf of injury victims.

But if you decide to go it alone, before you file an injury claim and negotiate for your compensation, be prepared. Determine what you think is a fair settlement figure, and then decide on the lowest amount that you can accept.

Expect the first settlement offer from an insurance company to be almost unreasonably low. People sometimes take those offers. Don’t. Your response to – and your rejection of – that first settlement offer should be made in writing.

HOW SHOULD YOU HANDLE A LOW-BALL FIRST SETTLEMENT OFFER?

Ask the insurance company why the offer is so low, and refer to any evidence you have that supports your claim.

Be patient. If you’ve heard nothing from the insurance company after about fourteen days, call the adjuster and ask when you can expect a response. When you have that response, address in writing every point that the insurance company raises, and then make your counteroffer.

The more documentation you can present to an insurance company, the stronger your claim will be. A company’s low settlement offer for an injury claim may be based on insufficient evidence regarding the severity and extent of your personal injury or injuries.

Rochester personal injury attorney Donald A. White says, “I believe that the best defense to a low settlement offer is a good offense … if I am faced with a low settlement offer and the case is not on the court’s trial calendar, I would push the case to get it on a trial calendar.”

Attorney White suggests responding to a low offer by completing the discovery process and telling the judge that you are ready for trial.

He explains, “The trial judge could then assist in trying to get a reasonable settlement offer from the defendant or, perhaps, send the case to mediation to try to achieve a settlement.”

WHEN YOU FILE YOUR CLAIM, WHAT WILL AN INSURANCE COMPANY NEED?

Thus, it is imperative to make sure that the insurance company has up-to-date copies of all of your medical bills, pharmacy receipts, tests results, and any other documents that support your claim.

You may speak several times back-and-forth with the insurance company’s claims adjuster before you reach a final settlement agreement. Don’t feel pressured, intimidated, or hurried.

When you negotiate with an insurance adjuster, after you have set forth the basics of your claim, if the negotiations continue, emphasize the strongest parts of the claim.

WHAT MIGHT BE THE “STRONG POINTS” OF A PERSONAL INJURY CLAIM?

Stress any long-term injury or disability and any basic daily activities that you cannot perform. If you will be out of work for months, if the other driver was intoxicated well above the legal limit, if you will need to hire someone to care for your kids or household – emphasize that.

When you negotiate a personal injury claim, these are the kinds of “strong points” that may help you prevail.

When a final agreement is reached, confirm it immediately in writing. Send a letter to the insurance company confirming the amount and the expected payment date. Once an agreement has been reached, you should expect to be paid promptly.

If you are handling your own personal injury claim without a lawyer, you must be fully prepared. Fair compensation for the most serious long-term and permanent injuries will be something that no insurance company wants to pay.

WHEN SHOULD YOU SEEK AN ACCIDENT ATTORNEY’S ADVICE?

If, at any time in your negotiations, you believe that the insurance company is being negligent, dismissive, or disingenuous with you – or just plain lying to you – seek advice from an experienced Rochester personal injury attorney.

In fact, if you are seriously injured in western New York by a negligent driver, you really should have a Rochester accident attorney handle your injury claim from the very beginning.

A good injury lawyer will launch an immediate and independent investigation of the accident, determine exactly how you were injured and who was at fault, and examine the evidence and witnesses on your behalf.

Personal injury lawyers are skilled negotiators who know how the insurance companies work and what it takes to win the compensation you need.

You’ll be able to refer all inquiries about the case to your attorney, while you focus on regaining your health and recovering from your injuries.

WHAT IF YOU THINK THAT YOU CAN’T AFFORD A LAWYER?

When people handle their own personal injury claim, it is often because they believe that they cannot afford to hire an attorney, but that’s a myth. In New York, a personal injury lawyer will provide an injured victim of negligence a free first legal consultation with no obligation.

Every case is different, so a free consultation allows injury victims to learn more about their rights, where they stand legally, and how New York’s personal injury law applies to the specific case.

Accident attorneys work on a contingent fee basis, so if you and your attorney decide to move forward with legal action, you will pay your attorney nothing until a settlement or a verdict is obtained on your behalf.

HOW MUCH TIME DOES AN INJURY VICTIM HAVE TO TAKE LEGAL ACTION?

Here in New York, the statute of limitations gives an injured victim of negligence three years – from the injury date – to file a personal injury lawsuit. Do not wait three years and then scramble at the last minute to file a lawsuit. The sooner your attorney is on the case, the better.

Sometimes it really is possible to negotiate successfully your own personal injury claim with an insurance company – but frankly speaking, that’s rare. Those who try often end up frustrated and eventually retain an attorney out of exasperation.

In the greater Rochester area, if you suffer injury because someone else was negligent, you need to put a qualified accident lawyer on the case – at once.

Don’t take any chances if your health and your future are in the balance. Having an attorney’s advice and representation is your right.

What Is the Role of a Rochester Personal Injury Lawyer?

What Is a Personal Injury Lawyer?

When you think of the terms “personal injury” or even “wrongful death,” you are referring to legal terms that describe an injury that is a result of the negligence of another person. In the state of New York, personal injury or wrongful death may result from a range of causes including:

  • Automobile accidents (cars, trucks, and/or motorcycles)
  • Cycling accidents
  • Toxic exposures
  • Swimming pool accidents
  • Unsafe work environments
  • Liability cases
  • Construction accidents
  • Medical malpractice

These unfortunate cases can happen because of someone’s negligent acts regarding “due care,” also known as their duty to society or the public to act in a certain manner. Your personal injury lawyer is the attorney that would defend you in the event of an injury, meaning that they would be able to represent you in the case that an act of harm occurs, even if it’s not necessarily a crime.

Defining Personal Injury Cases

By law, the definition of personal injury as any injury to the body, mind, or emotions. As mentioned briefly above, personal injury cases fall underneath civil and tort guidelines, meaning that you can still be compensated for cases concerning:

  • Harm from medical malpractice
  • Cases of assault and battery
  • Refusal of coverage from insurance companies
  • Defamation, libel, and/or slander
  • Liability cases
  • Product fault
  • Injuries that may have occurred while on the land or premise of the accused party

What Should You Look for in Your Personal Injury Lawyer?

A legitimate personal injury lawyer should have a bachelor’s degree and a Juris Doctor Law degree to practice legally.  Besides passing the state bar exam, your lawyer should have also continued their education on several fronts and ideally currently participate in professional affiliations to stay up to date with the most modern practices in civil law.

For instance, our skilled Rochester personal injury lawyers hold affiliations with Monroe County Bar Association and New York State Bar Association. Attorney Don White is even the Deputy Leader of the Western Republican Committee among many more!

What Can a Personal Injury Lawyer Do for You?

When handling sensitive cases like personal injury lawsuits, you need someone that is going to fight in your best interest. A personal injury lawyer does just that by representing you and what you stand for by filing legal complaints, offering only the soundest legal advice, and prepares legal documents to adequately represent you in court. After all, the compensation for your injury is ultimately our firm’s success, so we do our best to get you what you deserve.

However, there are many times that clients decide to settle out of court with the opposing party. Your retained personal injury lawyer will still represent your behalf to make sure your settlement is legitimate and fits your needs, especially if you have lost wages, a large amount of medical bills, and more. Contact us today!Our team of attorneys is here to make sure that the case runs smoothly, correctly, and that you are compensated for your injuries accordingly.