The insurance company denies my no fault claim!?

Asked about 1 year ago - Flushing, NY

I got into a car accident while i was on a bike 2 months ago (4/28/13). While riding my bike on a side-walk (slowly), a car runs into me hitting me sideways (He tried to get into a parking lot). Ambulance came, was rushed to the ER for a minor ankle injury. I filed and submitted a claim with the other parties insurance company within 2 weeks. After waiting a month, i was scheduled to meet with one of their health examiners to follow up on my injury. A week later i get a mail from the insurance company, them denying ALL of my no-fault claims.

Attorney answers (8)

  1. Matthew C Simon

    Pro

    Contributor Level 18

    10

    Lawyers agree

    Answered . I dont know all of the details, but it sounds like its time to get a lawyer. Many personal injury attorneys, such as myself, work on a contingency basis (you dont pay unless you win or settle) and offer free 30 minute consultations. Dont try handling this yourself without an attorney as the insurance company is likely trying to gather evidence to use against you. Do not delay.

    The above is general information only and is not legal advice. The information provided does not form an attorney-... more
  2. Eric Edward Rothstein

    Contributor Level 20

    10

    Lawyers agree

    Answered . Did you see the insurance company doctor? You should have received a denial form explaining the reason for the denial and you are entitled to get a copy of the doctor's report. These exams are generally a scam as the doctors usually say the claimant is fine whether it's true or not.

    I am a former federal and State prosecutor and have been doing criminal defense work for over 16 years. I was... more
  3. David Ian Schoen

    Pro

    Contributor Level 20

    9

    Lawyers agree

    Answered . What reason did they give you for the denial. This sounds fishy

  4. Michael Evan Greenspan

    Contributor Level 16

    9

    Lawyers agree

    Answered . It appears that you notified the vehicle's insurer of your accident, but did you provide the carrier with a fully signed and completed application for no fault benefits within 30 days of the collision?

    Assuming that you did submit the no fault application, the carrier may well have denied the claim, but in doing so, has to explain to you in writing what the basis is for the denial. It could be that you filed with the wrong insurance company. It could be that the policy was cancelled prior to the collision. In any event, you really need to contact an experienced personal injury lawyer in your community and have that attorney review the correspondence from the carrier. Only then can you determine what happened and why the carrier is denying your claim

    Good Luck

    Answering this question does not create an attorney-client relationship between us. The answer given is for... more
  5. Joseph Nicholas Armao

    Contributor Level 6

    8

    Lawyers agree

    Answered . Unfortunately, the insurer has the right to have you examined to determine if you still require treatment. Even more unfortunately, a no-fault Independent Medical Examination ("IME") is rarely a fair assessment of your condition, and the doctors will perform a cursory examination, tell you you're fine, and then recommend the insurer deny any future benefits.

    If you want to continue treatment, you will either have to pay out of pocket and then sue the insurance company for breach of contract in order to get reimbursed, or (a much better idea and the way this is commonly done) find health care providers who will allow you to assign them your no-fault benefits, and let them fight with the insurance company instead of you.

  6. Jayson Lutzky

    Pro

    Contributor Level 20

    6

    Lawyers agree

    Answered . Time for you to retain a personal injury lawyer to assist you. No fault procedures are technical and if. You make a mistake, then the insurance company will deny payment.

    If this answer is helpful, then please mark the helpful button. If this is the best answer, then please indicate... more
  7. Christian K. Lassen II

    Pro

    Contributor Level 20

    5

    Lawyers agree

    Answered . Bottom line is a local lawyer needs to review the correspondence.

  8. Andrew Lawrence Weitz

    Pro

    Contributor Level 17

    2

    Lawyers agree

    Answered . First of all, if your injury required surgery it is not a "minor ankle injury." You need to speak to a NYC attorney with experience in automobile accidents. Most attorneys who practice in auto liability offer free consultations. Your injury is serious and you stand to collect a substantial award by starting a lawsuit. Your no fault situation is merely a small part of the equation. Further, if your health care providers "accepted assignment if benefits," they are the ones who have to fight with no fault, not you. Look up some profiles of personal injury lawyers on Avvo. You need to bring a suit against the hitter and hope there is adequate insurance coverage. Your lawyer will determine the answer to this question.

    I may be contacted at 212-553-9300.
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