Insurance Claims in Rochester, NY

What Are Insurance Claims?

Filing an insurance claim in Rochester, New York can be a stressful process. Every policy is different, and insurance companies may not pay you what you deserve. In some cases, hiring an insurance claim attorney is necessary. This page breaks down the nuances of  different types of insurance claims.

What Is a Property Insurance Claim?

A homeowner’s insurance policy is an agreement to protect the home from damage under specific occurrences. When you as a policyholder suffer a loss, you should find a dedicated Rochester, New York property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your property.

If the insurer denies coverage or delays, policyholders should consult a property insurance attorney about a bad faith claim. If your claim goes to court and you win, you can often recover your court costs, attorney fees, and coverage benefits. There is also the possibility of recovering more money depending on the state laws under which you file your claim.

What Types Of Damage Claims Apply to Property Insurance?

Specific geographic regions impact the design of insurance policies. For example, Florida property insurance policies have more provisions for hurricanes versus earthquakes.

According to, Rochester property owners face a lower risk of damage from earthquakes and tornadoes than the state average. However, Rochester does experience extreme weather events including thunderstorm winds, flooding, hail, and winter storms. Moreover, FloodFactor reports that Rochester has a moderate risk of flooding over the next 30 years. This means flooding is likely to impact day-to-day life within the city. Be aware, standard homeowner policies do not cover flooding. However, Rochester homeowners can purchase coverage through the National Flood Insurance Program.

How to File a Property Insurance Claim in Rochester, New York

After you suffer a loss, you must contact your insurer as soon as possible. Taking this step begins the insurance claim process and gets things moving along. You need to notify your insurance company in writing or over the phone. From there, your insurer appoints a claim representative.

What to Expect Afterwards

When you submit a claim in Rochester, you must prepare as much detailed information as possible for the insurance adjuster. To speed up the process, it may be advisable to have an independent evaluation done by a neutral third party as well. Under New York State law, your insurer must make payment on an accepted claim within 30 days after you supply proof-of-loss. In fact, these payments are subject to interest if they take more than 30 days. Specifically, New York State imposes a 2% fine each month the payment is outstanding.

Additionally, New York State law governs unfair claim settlement practices in Rochester. Some of the practices deemed unfair include:

  • Failing to acknowledge with reasonable promptness pertinent communications regarding claims
  • Failing to adopt and implement reasonable standards for the prompt investigation of claims
  • Not attempting in good faith to execute prompt, fair and equitable settlements of claims in which liability has become reasonably clear

What Is an Auto Insurance Claim?

Auto insurance claims involve requesting compensation from an auto insurer after an accident. Car accidents are incredibly stressful, especially if there are uncooperative responsible parties. However, your insurer’s job is to work on your behalf to secure compensation for repairs, injuries and other expenses.

What Do You Do After a Car Accident?

Rochester drivers involved in a crash should always call 911 for emergency medical assistance. Remember to move out of the way of traffic safely, and put your car into park. According to the New York State DMV, you must notify the Rochester Police immediately if there are injuries, or fatalities. If the accident caused property damage only, you must exchange license, insurance, and registration information with the other drivers. Furthermore, you must file your own accident report within 10 days if the crash involved injuries, death, or property damage of at least $1,000.

Your next step is to call your insurance company. According to WalletHub, New York State is an at-fault state for car insurance. This means that the at-fault driver’s insurance covers the other driver’s damages. In addition, you can sue the at-fault driver for lost wages, emotional distress, and even hospital bills that exceed coverage. Consulting with an experienced Rochester attorney can help determine the best way to obtain the right amount of compensation.

Auto Claims Adjuster

Your auto insurance company will assign a claims adjuster to your claim report. Your adjuster acts as your representation in any mediation between you and all other involved parties. This insurance representative bears responsibility for investigating the claim and seeing that you receive compensation for any repairs or injuries.

Whether there are repair claims, personal injury claims, or you are dealing with someone who does not have insurance, your auto insurance adjuster should see you through the process. Your claims adjuster may recommend a garage to handle your vehicle repairs. They may also make arrangements for a rental vehicle if required. The most important thing to note is that your auto claim adjuster is your primary point of contact regarding the status of your claim in Rochester.

Health Insurance Claims

Rochester, New York policyholders file health insurance claims when they seek reimbursement for medical services or treatments. When you obtain a medical service from a provider, your health insurance carrier should become notified directly. If there are any discrepancies in your claim, consider hiring a health insurance claim specialist attorney.

How Do You File a Health Claim in Rochester, New York?

There are two ways to file a health insurance claim on your behalf. The first is the medical facility notifies your insurer for you. You may be able to walk out of the facility without spending anything, but that depends on your policy. The other way is to file a health insurance claim yourself. Taking this route can occur when a health provider you use is not in your provider network. The facility may still file the claim on your behalf, but you may need to file it yourself.

Hopefully, your health insurance claim is accepted, and your prescribed treatment is fully covered. However, if your claim is denied in Rochester, it is important to know your rights. According to Coverage Rights, New York State residents have the right to an internal appeal with your insurer. Specifically, you can request that your insurer conduct a full and fair review of the denial. Be aware, your health insurer may offer a second level of internal appeal. You are not required to participate in the second level under state law. Instead, you can request an external review with the New York Department of Financial Services (DOFS). Additionally, if you believe your insurer did something illegal or unethical, you can file a complaint with the DOFS.

Work with an Experienced Local Insurance Lawyer in Rochester, New York.

If your health insurance provider refuses to honor a claim, seek out a qualified Rochester insurance claim attorney’s help. An insurance claim attorney can help if you have been improperly denied coverage or sent a bill for a service you never received. We can even help you connect with an attorney across New York state lines.

Submit a request online or call us today at (866) 345-6784 to get in touch with an experienced lawyer in your area!

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