Why Insurance Companies Deny Injury Claims
December 19, 2025
Insurance claims are intended to provide financial recovery after an accident or injury. However, many claimants in New York experience denials from insurance companies, leaving them frustrated and uncertain. Understanding the common reasons behind these denials can help you avoid mistakes and improve your chances of a successful claim.
Common Reasons Insurance Companies Deny Claims in New York
Insurance claims may be denied for several reasons, including insufficient evidence or documentation to support the injury and its connection to the accident. Late filing beyond policy deadlines or legal time limits can also result in denial. Additionally, certain claims fall under policy exclusions, such as pre-existing conditions or injuries sustained during non-covered activities.
Disputes over fault may lead insurers to deny claims, particularly if the injured party is believed to be partially or fully responsible. Inconsistent statements can raise credibility concerns, while suspected fraud or misrepresentation may prompt denial and further investigation.
How to Prevent Your Claim from Being Denied
- Document everything: Medical records, accident reports, photos, and receipts
- File promptly: Submit claims as soon as possible within policy deadlines
- Be honest and consistent: Ensure all statements match supporting evidence
- Understand your policy: Review exclusions and coverage limits
- Consult an attorney early: Legal guidance can help prevent technical mistakes and strengthen your claim
Steps if Your Claim Is Denied
- Request a written explanation from the insurance company
- Review your policy for coverage and deadlines
- Gather additional evidence supporting your claim
- Negotiate or appeal the denial with the insurer
- Consider filing a lawsuit if negotiations fail
Taking prompt and organized action increases your chances of a successful claim resolution.
Key Takeaways
- Claim denials are common, often due to documentation, timing, policy limits, or disputes over fault
- Acting promptly, maintaining evidence, and consulting a lawyer improves your chances of success
- Understanding your policy and your rights in New York is critical
Frequenlty Asked Questions
Why was my personal injury claim denied? Common reasons include lack of evidence, late filing, policy exclusions, disputes over fault, inconsistent statements, or suspected fraud.
Can I appeal a denied claim? Yes. You can request a written explanation, provide additional evidence, negotiate, or file a lawsuit if necessary.
Does New York law protect me from claim denials? New York law regulates claim timelines, notices, and insurance practices, but insurers still have significant discretion. Consulting an attorney can help protect your rights.
How long do I have to appeal a denial? Appeal timelines vary by insurance policy and type of claim. Review your policy and act promptly.
Should I hire a lawyer after a denial? Yes. Legal counsel can help negotiate with insurers, ensure compliance with deadlines, and file a lawsuit if needed.
Bottom Line
Insurance companies in New York have numerous reasons to deny claims, but being prepared, thorough, and proactive can prevent many denials. Legal guidance and careful documentation are key to protecting your right to compensation.
References
- New York Insurance Law § 3420. (2024). Property and casualty insurance; claim handling and bad faith. New York State Senate. https://www.nysenate.gov/legislation/laws/INS/3420
- New York Department of Financial Services. (2023). Handling of insurance claims. https://www.dfs.ny.gov/consumers/insurance/claims
- New York Unified Court System. (2023). Personal injury claims overview. https://nycourts.gov/courthelp/GoingToCourt/PersonalInjury.shtml
- American Bar Association. (2023). Dealing with denied insurance claims. https://www.americanbar.org/groups/public_education/resources/law_related_education_network/insurance_denials/
- National Association of Insurance Commissioners. (2023). Tips for filing claims and avoiding denials. https://www.naic.org/cipr_topics/topic_insurance_claims.htm