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The insurance company denies my no fault claim!?

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.

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Attorney answers 8


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-client relationship, and should not be relied upon to take or refrain from taking any action. I am not your attorney until we sign a retainer agreement.


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


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 named to the Super Lawyers list as one of the top attorneys in New York for 2012 and 2013. No more than 5 percent of the lawyers in the state are selected by Super Lawyers. Martindale-Hubbell has given me its highest rating - AV Preeminent - in the areas of Criminal Law, Personal Injury, and Litigation. According to Martindale-Hubbell”AV Preeminent is a significant rating accomplishment - a testament to the fact that a lawyer's peers rank him or her at the highest level of professional excellence." Fewer than 8% of attorneys achieve an AV Preeminent rating. I also have the highest ranking – “superb” – on Avvo. The above answer, and any follow up comments or emails is for informational purposes only and not meant as legal advice.


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 informational purposes only and is not a substitute for contacting an attorney licensed to practice in your jurisdiction and obtaining legal advice from such an attorney.


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.


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 it. Thanks. For further information you should see an attorney and discuss the matter completely. If you are in the New York City area, then you can reach me during normal business hours at 718 329 9500 or


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


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.

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