What Should You Do When Your Insurance Denies a Brain Injury Claim?
When an insurance company denies your brain injury claim in New York, you have specific legal rights and remedies available. According to the New York Department of Financial Services, you can request an external appeal within four months of receiving a final adverse determination. Brain injury victims often face denials based on claims that treatment is not medically necessary, experimental, or related to pre-existing conditions.
Insurance denials for brain injuries are common, but they are not final. Understanding your appeal rights, documenting your injuries thoroughly, and seeking experienced legal representation can make the difference between a denied claim and full compensation for your injuries.
Key Takeaways: Insurance Denied Brain Injury Claims in NY
- External appeals: New York law grants you the right to appeal insurance denials to the Department of Financial Services within four months
- High success rate: Up to 75% of insurance appeals succeed when pursued, though less than 1% of denied claimants actually file appeals
- No-Fault coverage: New York’s No-Fault system provides up to $50,000 in Personal Injury Protection for medical expenses and lost wages, regardless of fault
- Common denial reasons: Insurers frequently deny TBI claims citing pre-existing conditions, lack of medical necessity, or disputes over causation
- Filing deadlines: You must file external appeals within 4 months and internal appeals typically within 180 days of denial
- Legal representation matters: An experienced brain injury attorney can challenge bad faith denials and maximize your recovery
Why Do Insurance Companies Deny Brain Injury Claims in New York?
Insurance companies deny brain injury claims for various reasons, many of which are rooted in profit motives rather than legitimate policy concerns. Understanding these denial tactics helps you prepare a stronger appeal.
Pre-Existing Condition Arguments
According to research on TBI insurance coverage exclusions, insurers commonly argue that your brain injury resulted from or was exacerbated by a pre-existing condition. If you have a history of concussions, migraines, or prior brain injuries, insurance companies will scrutinize your medical records to attribute your current symptoms to previous conditions.
However, New York law recognizes that defendants remain liable for aggravating pre-existing conditions. If an accident worsened your condition or made you more susceptible to severe injury, you can still recover full compensation for the extent of harm caused.
Medical Necessity Disputes
Insurers frequently deny coverage for brain injury treatment by claiming services are not medically necessary. This is particularly common for:
- Cognitive rehabilitation: Extended therapy sessions for memory, attention, and executive function deficits
- Neuropsychological evaluations: Comprehensive testing to document cognitive impairments
- Long-term care: Ongoing rehabilitation beyond initial recovery periods
- Specialized imaging: Advanced MRI or PET scans to document subtle brain damage
- Mental health services: Treatment for depression, anxiety, or personality changes following TBI
Out-of-Network Provider Denials
A recent case highlighted by The Hill involved an insurance company denying coverage for an infant’s life-saving brain surgery because providers were out-of-network. The insurer reversed the denial only after public pressure and media coverage. This illustrates how insurers use network restrictions to deny legitimate claims, even in life-threatening situations.
Causation Challenges
Insurance companies often dispute the causal link between an accident and your brain injury. As noted by New York brain injury attorneys, insurers exploit the fact that cognitive symptoms may appear or intensify weeks or months after the initial incident. They argue that only immediately documented symptoms are accident-related, attempting to exclude delayed manifestations of brain trauma.
Warning: Insurance companies have a financial incentive to deny or minimize brain injury claims. TBIs are among the most expensive injuries to treat, with lifetime costs ranging from $85,000 to over $3 million according to medical cost research. Insurers save money by denying coverage, even when their policyholders have legitimate claims.
Understanding New York’s No-Fault Insurance and Brain Injuries
New York operates under a No-Fault insurance system that significantly impacts how brain injury claims are handled. According to the New York Department of Financial Services, all drivers must carry Personal Injury Protection (PIP) coverage, also called No-Fault benefits.
No-Fault Coverage Basics
No-Fault insurance in New York provides:
- Medical expenses: Up to $50,000 per person for reasonable and necessary accident-related medical and rehabilitation expenses
- Lost earnings: 80% of lost earnings from work, up to a maximum of $2,000 per month for up to three years from the accident date
- Other expenses: Up to $25 per day, for up to one year, to reimburse reasonable and necessary expenses such as household help and transportation to medical treatment
The No-Fault system is designed to pay benefits promptly, regardless of who caused the accident or whether any negligence occurred. This helps brain injury victims access immediate medical care without waiting for fault determinations.
When No-Fault Coverage Falls Short
For traumatic brain injuries, the $50,000 No-Fault limit often proves inadequate. Research from New York brain injury cost analysis shows that Manhattan therapy sessions typically cost between $300 and $700 per visit. Patients needing therapy twice weekly for a year face annual costs of $30,000 to $70,000 just for outpatient therapy.
When your brain injury treatment exceeds No-Fault limits, you may pursue additional compensation through:
- Liability claims against at-fault parties
- Underinsured motorist coverage
- Health insurance policies
- Personal injury lawsuits for economic losses exceeding No-Fault benefits
The Serious Injury Threshold
New York law restricts lawsuits for non-economic damages (pain and suffering) to cases involving a “serious injury” as defined in Insurance Law Section 5102(d). According to New York’s serious injury threshold, traumatic brain injuries qualify as serious injuries because they involve “significant limitation of use of a body function or system.”
This threshold allows brain injury victims to pursue compensation beyond No-Fault benefits, including damages for pain, suffering, loss of enjoyment of life, and other non-economic harms.
New York’s Insurance Appeal Process: Internal and External Reviews
New York provides a structured appeals process when insurers deny brain injury claims. Understanding both internal and external appeal rights is essential to overturning denials.
Internal Appeals: Your First Line of Defense
Before pursuing an external appeal, you typically must exhaust your insurance company’s internal appeals process. Internal appeals involve:
- Review request: Submit a written request for reconsideration of the denial within the timeframe specified in your denial letter (typically 30-180 days)
- Supporting documentation: Provide additional medical records, physician statements, treatment notes, and expert opinions supporting medical necessity
- Insurance review: The insurer reviews your appeal, often with a different claims adjuster or medical reviewer
- Second-level review: Many insurers offer a second level of internal appeal if the first level denial is upheld
The internal appeal process can take 30 to 60 days, depending on whether you request expedited review for urgent medical situations.
External Appeals Through New York DFS
If your insurer denies your internal appeal, you have the right to request an external appeal through the New York Department of Financial Services. This independent review is available when insurers deny coverage based on:
- Medical necessity
- Experimental or investigational treatment
- Out-of-network care
- Level of care or treatment setting appropriateness
External Appeal Timeline and Requirements
According to New York Insurance Law Section 4914, the external appeal process follows these parameters:
| Requirement | Details |
|---|---|
| Filing deadline | Within 4 months from the date of the final adverse determination letter |
| Filing fee | $25 payable to your insurer (waived for Medicaid, Child Health Plus, or financial hardship) |
| Review timeline | External appeal agent must decide within 30 days of receiving the request (expedited reviews decided within 72 hours) |
| Required documents | Completed application, physician attestation form, denial letters, supporting medical records |
| Independent reviewer | DFS assigns an independent external appeal agent with no conflict of interest |
Expedited External Appeals
You can request expedited external review if:
- The denial concerns admission, continued stay, or emergency services where you have not yet been discharged
- Waiting 30 days for standard review would seriously jeopardize your life, health, or ability to regain function
- A delay in treatment would pose an imminent threat to your health
For brain injury victims requiring immediate rehabilitation, surgical intervention, or intensive care, expedited appeals can be critical.
Appeal Success Statistics: According to insurance denial research, up to 75% of insurance appeals succeed when pursued. However, less than 1% of denied claimants actually file appeals, meaning millions of Americans pay out-of-pocket for care their insurance should cover. Don’t let insurers discourage you from exercising your appeal rights.
How Do You Document a Brain Injury to Overcome Insurance Denials?
Comprehensive medical documentation is your strongest weapon against insurance denials. Brain injuries present unique documentation challenges because symptoms may not appear on standard tests and can develop over time.
Essential Medical Documentation
- Emergency room records: Initial assessment, Glasgow Coma Scale scores, and treatment provided immediately after the injury
- Diagnostic imaging: CT scans, MRIs, PET scans, and functional imaging showing structural or metabolic brain abnormalities
- Neurological evaluations: Examinations by neurologists or neurosurgeons documenting cognitive, motor, and sensory deficits
- Neuropsychological testing: Comprehensive cognitive assessments measuring memory, attention, processing speed, executive function, and emotional regulation
- Treatment notes: Ongoing documentation from physical therapists, occupational therapists, speech therapists, and cognitive rehabilitation specialists
- Physician statements: Letters from treating physicians explaining the medical necessity of recommended treatment and the causal relationship between the accident and your injuries
Documenting Cognitive and Behavioral Changes
Many brain injury symptoms are invisible on standard imaging but profoundly impact daily functioning. Comprehensive documentation should include:
- Baseline comparison: Pre-injury cognitive testing, work performance reviews, or academic records establishing your pre-injury functioning level
- Functional assessments: Documentation of how brain injury symptoms affect activities of daily living, work capacity, and social relationships
- Witness statements: Statements from family members, coworkers, or friends describing observed changes in personality, behavior, memory, or cognitive abilities
- Daily symptom logs: Tracking of headaches, dizziness, confusion, memory lapses, mood changes, and other symptoms
- Vocational assessments: Evaluations by vocational experts documenting reduced earning capacity or inability to return to previous employment
The Importance of Immediate Medical Attention
Seeking immediate medical care after any head trauma is critical for both your health and your insurance claim. As noted by New York brain injury attorneys, insurance companies argue that only symptoms documented immediately after an accident are related to the injury. Any gap in treatment or delayed medical care gives insurers ammunition to deny your claim.
Even if you feel fine after a head injury, obtain medical evaluation. Many serious brain injuries do not produce immediate symptoms, yet early documentation of the traumatic event establishes the foundation for your claim.
What Are Common Bad Faith Insurance Tactics for Brain Injury Claims?
While New York does not have a specific bad faith insurance statute, insurers owe policyholders an implied covenant of good faith and fair dealing. According to New York bad faith law, you can take legal action against insurance companies for dishonest or negligent conduct in handling your claim.
Unreasonable Delays
Insurance companies may drag out claims processing, hoping you’ll accept a lowball settlement or abandon your claim. Common delay tactics include:
- Repeatedly requesting the same documentation
- Failing to schedule independent medical examinations promptly
- Delaying claims adjuster assignment
- Missing response deadlines without explanation
- Slow-walking the appeals process
New York Insurance Law Section 3224-A requires insurers to acknowledge claims within 30 business days and pay or deny claims within 30 days of receiving proof of loss. Violations of these standards may constitute bad faith.
Inadequate Investigation
Insurers have a duty to thoroughly investigate claims before denying coverage. Bad faith investigation tactics include:
- Failing to review all submitted medical records
- Relying solely on in-house medical reviewers without considering treating physician opinions
- Ignoring expert medical opinions that support coverage
- Failing to request necessary information before issuing a denial
- Conducting biased independent medical examinations with doctors known to favor insurers
Lowball Settlement Offers
According to bad faith insurance research, “lowballing” settlement offers constitutes abuse of a dominant bargaining position. Insurers may offer settlements far below the actual value of brain injury claims, particularly when they know victims face financial pressure from mounting medical bills and lost income.
Misrepresenting Policy Terms
Some insurers deny claims based on policy exclusions or limitations that don’t actually apply. Common misrepresentations include:
- Claiming treatment is not covered when policy language is ambiguous
- Applying exclusions more broadly than policy language supports
- Failing to explain coverage options or additional benefits available
- Mischaracterizing medical necessity standards
- Incorrectly applying coordination of benefits provisions to reduce payouts
Signs of Bad Faith Denial
- Denial without adequate explanation
- Refusal to communicate in writing
- Pressure to settle quickly for low amounts
- Contradictory reasons for denial
- Ignoring treating physician opinions
- Unreasonable documentation demands
Your Rights Against Bad Faith
- File complaints with NY Department of Financial Services
- Pursue breach of contract claims
- Seek damages for insurer’s bad faith conduct
- Recover additional damages beyond original claim
- Hold insurers accountable for regulatory violations
- Request punitive damages in egregious cases
What Damages Can You Recover When Insurance Denies Your Brain Injury Claim?
When you successfully appeal a denial or pursue legal action against an insurer, you may recover various categories of damages.
Economic Damages
Economic damages compensate for measurable financial losses resulting from your brain injury:
- Past medical expenses: All treatment costs incurred from the date of injury through settlement or trial
- Future medical expenses: Projected lifetime costs of ongoing care, rehabilitation, medication, and medical equipment
- Lost wages: Income lost due to time away from work during treatment and recovery
- Lost earning capacity: Reduction in future earning potential due to permanent cognitive impairments
- Household services: Cost of hiring help for tasks you can no longer perform independently
- Modification expenses: Home or vehicle modifications to accommodate your disabilities
For severe brain injuries in New York, lifetime costs can be substantial. According to Manhattan TBI cost analysis, lifetime expenses range from $1 million for mild injuries with some long-term effects to over $10 million for severe cases requiring extensive care.
Non-Economic Damages
Non-economic damages compensate for intangible losses that don’t have a specific dollar value:
- Pain and suffering: Physical pain and emotional distress caused by your injuries
- Loss of enjoyment of life: Inability to participate in activities and hobbies you enjoyed before the injury
- Loss of consortium: Impact on your relationship with your spouse
- Disfigurement: Permanent scarring or physical changes
- Mental anguish: Anxiety, depression, PTSD, or other psychological impacts
In New York, you can pursue non-economic damages only if your brain injury meets the serious injury threshold under Insurance Law Section 5102(d).
Bad Faith Damages
If you can prove the insurance company acted in bad faith, you may recover additional damages beyond your original claim. According to New York bad faith damages law, potential recovery includes:
- Consequential damages resulting from the insurer’s bad faith conduct
- Interest on delayed payments
- Attorney’s fees and costs in some circumstances
- Punitive damages in cases involving gross negligence or intentional misconduct
How Can a Brain Injury Lawyer Help When Insurance Denies Your Claim?
Experienced legal representation dramatically increases your chances of overturning an insurance denial and securing fair compensation for your brain injury.
Navigating the Appeals Process
Brain injury attorneys understand the technical requirements of both internal and external appeals. They ensure:
- All deadlines are met
- Required documentation is complete and properly formatted
- Medical evidence is presented persuasively
- Physician attestations clearly explain medical necessity
- Legal arguments are properly framed
Missing a single deadline or failing to submit required documentation can result in denial of your appeal rights. Legal representation protects against these procedural pitfalls.
Building a Compelling Medical Case
Attorneys work with medical experts to document the full extent of your brain injury and establish medical necessity for recommended treatment. This includes:
- Retaining independent medical experts to review your case
- Obtaining comprehensive neuropsychological evaluations
- Coordinating with treating physicians to obtain detailed reports
- Commissioning life care plans that project future treatment needs and costs
- Presenting vocational evidence of lost earning capacity
Challenging Bad Faith Denials
When insurers act in bad faith, experienced attorneys can:
- Document patterns of unreasonable conduct
- File complaints with the New York Department of Financial Services
- Pursue breach of contract and bad faith claims in court
- Seek damages beyond the original claim value
- Hold insurers accountable through litigation
Maximizing Your Recovery
Brain injury lawyers ensure you pursue all available sources of compensation, including:
- No-Fault benefits up to policy limits
- Health insurance coverage
- Liability claims against at-fault parties
- Underinsured motorist coverage
- Uninsured motorist coverage
- Workers’ compensation (for work-related injuries)
- Third-party liability claims
Insurance Denied Your Brain Injury Claim?
Don’t let insurance companies minimize your brain injury or deny you the compensation you deserve. Our experienced New York brain injury attorneys fight bad faith denials and pursue maximum recovery for TBI victims. Contact us today for a free consultation.
What Are the Time Limits for Appealing Insurance Denials in New York?
Strict deadlines govern insurance appeals and legal claims in New York. Missing these deadlines can permanently bar your right to appeal or pursue compensation.
Insurance Appeal Deadlines
| Appeal Type | Deadline | Notes |
|---|---|---|
| Internal appeal (first level) | 30-180 days from denial | Varies by insurance policy; check your denial letter |
| Internal appeal (second level) | Per policy terms | Not all policies offer second-level internal appeals |
| External appeal to DFS | 4 months from final adverse determination | May file simultaneously with second-level internal appeal |
| No-Fault arbitration | Within applicable statute of limitations | For disputes over No-Fault benefit denials |
Statute of Limitations for Legal Claims
New York imposes time limits for filing lawsuits related to brain injuries:
- Personal injury claims: Three years from the date of injury under CPLR Section 214
- Medical malpractice: Two and a half years from the date of malpractice or the end of continuous treatment
- Breach of contract claims: Six years from the breach
- No-Fault benefits: Varies depending on specific benefit type and policy terms
While these deadlines may seem generous, building a strong brain injury case requires extensive investigation, medical evaluation, and expert analysis. Starting early gives your attorney time to develop comprehensive evidence supporting your claim.
Discovery Rule Exceptions
In some brain injury cases, symptoms may not manifest immediately or may worsen over time. New York applies a discovery rule in limited circumstances, starting the statute of limitations when the injury was or reasonably should have been discovered. However, courts narrowly interpret this exception, making it critical to consult an attorney as soon as you suspect your brain injury resulted from another party’s negligence or an insurer’s bad faith denial.
Can Pre-Existing Conditions Affect Your Brain Injury Insurance Claim?
Pre-existing conditions are one of the most common reasons insurers cite when denying brain injury claims, but having previous medical issues does not automatically disqualify you from coverage.
What Qualifies as a Pre-Existing Condition?
According to research on pre-existing conditions and TBI claims, a pre-existing condition is any health issue that existed before the traumatic event causing your current brain injury. Common pre-existing conditions relevant to TBI claims include:
- Prior concussions or traumatic brain injuries
- Chronic migraines or headaches
- Epilepsy or seizure disorders
- Cognitive impairments or learning disabilities
- Mental health conditions (depression, anxiety, PTSD)
- Degenerative neurological conditions
The Eggshell Plaintiff Rule
New York law recognizes the “eggshell plaintiff” rule, which holds defendants liable for the full extent of injuries they cause, even if the victim’s pre-existing condition made them more susceptible to severe harm. If you had a history of concussions and suffered a more severe brain injury in an accident, you can still claim full compensation for the current injury, as long as you can demonstrate the accident caused or aggravated your condition.
This principle also applies to insurance coverage disputes. Insurers cannot deny coverage solely because you have a pre-existing condition if the current injury represents new trauma or aggravation requiring treatment.
How Insurers Use Pre-Existing Conditions to Deny Claims
Insurance companies thoroughly review medical histories looking for any brain or neurological conditions. Common tactics include:
- Attribution arguments: Claiming current symptoms result from pre-existing conditions rather than the recent accident
- Exacerbation disputes: Arguing the accident had minimal effect on a pre-existing condition
- Medical records mining: Requesting authorization to access all medical records, then using unrelated past issues to deny coverage
- Causation challenges: Exploiting gaps in medical documentation to question whether the accident caused current symptoms
Protecting Your Claim Despite Pre-Existing Conditions
You can overcome pre-existing condition defenses by:
- Obtaining baseline medical records documenting your condition before the accident
- Working with treating physicians to clearly differentiate new injuries from pre-existing conditions
- Securing expert medical opinions explaining how the accident caused or aggravated your condition
- Documenting functional improvements between previous injuries and the current accident
- Maintaining consistent medical treatment showing progression of new symptoms
What Role Does No-Fault Arbitration Play in Brain Injury Claims?
When disputes arise over No-Fault insurance benefits in New York, arbitration provides an alternative to court litigation.
When No-Fault Arbitration Applies
No-Fault arbitration resolves disputes between insureds and insurers regarding:
- Denial of medical expense reimbursement
- Disputes over medical necessity of treatment
- Lost wage benefit calculations
- Other reasonable and necessary expense claims
- Coverage determination issues
Arbitration is binding, meaning both parties must accept the arbitrator’s decision unless they appeal to court under limited circumstances.
The No-Fault Arbitration Process
No-Fault arbitration in New York follows this general process:
- Filing: The claimant files a demand for arbitration with the organization specified in the insurance policy (typically the American Arbitration Association)
- Arbitrator selection: Parties select or are assigned a neutral arbitrator familiar with No-Fault insurance law
- Discovery: Limited exchange of medical records, billing statements, and other relevant documents
- Hearing: Presentation of evidence and arguments, typically less formal than court proceedings
- Decision: The arbitrator issues a written decision determining coverage and benefit amounts
Advantages and Disadvantages of Arbitration
Arbitration offers several advantages for brain injury claimants:
- Faster resolution than court litigation
- Lower costs than traditional lawsuits
- Arbitrators experienced in No-Fault disputes
- Less formal procedures
- Confidential proceedings
However, arbitration also has limitations:
- Limited appeal rights
- May not address bad faith claims
- Cannot recover damages beyond policy limits
- Does not establish legal precedent
How Do You File a Complaint Against an Insurance Company in New York?
When insurers engage in unfair practices, you can file formal complaints with regulatory authorities.
Filing with the New York Department of Financial Services
According to the DFS complaint process, you can file complaints online, by mail, or by phone regarding:
- Claim denials or delays
- Unfair settlement practices
- Policy cancellations or nonrenewals
- Premium disputes
- Bad faith conduct
- Regulatory violations
What Happens After Filing a Complaint?
The DFS investigates complaints and may:
- Contact the insurance company for explanation and documentation
- Mediate between you and the insurer
- Order corrective action if violations are found
- Impose fines or sanctions for regulatory violations
- Refer matters for enforcement action
While filing a complaint does not guarantee reversal of a denial, it creates a regulatory record of the insurer’s conduct and may pressure the company to reconsider its position.
DFS Contact Information
You can reach the New York Department of Financial Services:
- Phone: (800) 342-3736 (Monday-Friday, 8:30 AM to 4:30 PM)
- Online: DFS Consumer Complaint Form
- Mail: New York State Department of Financial Services, One State Street, New York, NY 10004-1511
Take Action Now: The combination of internal appeals, external DFS appeals, regulatory complaints, and legal representation gives you multiple pathways to challenge unfair insurance denials. Don’t accept a denial as final. Exercise your rights under New York law to pursue the benefits you paid for and deserve.
Frequently Asked Questions About Insurance Denied Brain Injury Claims in NY
Can I appeal an insurance denial for brain injury treatment in New York?
Yes. New York law provides both internal appeals through your insurance company and external appeals through the Department of Financial Services. You must file an external appeal within four months of receiving a final adverse determination. According to insurance research, up to 75% of appeals succeed when pursued, though less than 1% of denied claimants actually file appeals.
What should I do immediately after my brain injury claim is denied?
First, carefully review the denial letter to understand the stated reasons for denial and the appeal deadline. Request a complete copy of your claim file from the insurance company. Document all symptoms and treatment needs. Consult with a brain injury attorney experienced in insurance appeals before the deadline expires. Do not miss appeal deadlines, as this can permanently bar your rights.
How long does the New York external appeal process take?
The external appeal agent must make a determination within 30 days of receiving the appeal request. For expedited external reviews involving urgent medical situations, decisions are made within 72 hours. You must submit your external appeal application to DFS within 4 months from the date of the final adverse determination from your internal appeal.
Will my pre-existing condition prevent me from recovering for a new brain injury?
No. New York recognizes the “eggshell plaintiff” rule, which holds that defendants and insurers remain liable for the full extent of injuries they cause, even if pre-existing conditions made you more susceptible to harm. If an accident caused or aggravated your brain injury, you can recover compensation even with a history of previous concussions, migraines, or other neurological conditions.
What if my brain injury treatment exceeds New York’s $50,000 No-Fault limit?
When brain injury treatment exceeds No-Fault coverage limits, you can pursue additional compensation through liability claims against at-fault parties, your health insurance policy, underinsured motorist coverage, or personal injury lawsuits. Because brain injury lifetime costs often range from $1 million to over $10 million, exceeding No-Fault limits is common for moderate to severe TBIs.
Can I sue my insurance company for bad faith in New York?
Yes. While New York does not have a specific bad faith statute, all insurance contracts contain an implied covenant of good faith and fair dealing. You can take legal action if your insurer fails to properly investigate your claim, unreasonably delays processing, denies coverage without adequate explanation, or engages in other dishonest or negligent conduct. Successful bad faith claims may result in damages beyond your original claim value.
How much does it cost to hire a brain injury lawyer for an insurance appeal?
Many brain injury attorneys work on a contingency fee basis, meaning you pay no upfront costs and the attorney receives payment only if you recover compensation. The contingency fee is typically a percentage of your recovery. Contact us for a free consultation to discuss your case and fee arrangements.
What evidence do I need to overturn an insurance denial for brain injury treatment?
Strong appeals require comprehensive medical documentation including diagnostic imaging, neurological evaluations, neuropsychological testing, treatment notes from specialists, physician statements explaining medical necessity, and evidence of functional impairments. Expert medical opinions linking your brain injury to the accident and supporting recommended treatment are particularly persuasive. An experienced attorney can help you gather and present this evidence effectively.
Take Action After an Insurance Denial for Your Brain Injury Claim
Insurance denials for brain injury claims in New York are common, but they are not final. You have significant legal rights under New York law, including internal and external appeals, regulatory complaints, and legal action against insurers who act in bad faith.
The appeals process is time-sensitive, with strict deadlines that can permanently bar your rights if missed. Research shows that up to 75% of insurance appeals succeed when properly pursued, but you must act quickly and present compelling medical evidence.
Brain injuries often result in lifetime treatment needs and costs ranging from hundreds of thousands to millions of dollars. Don’t let insurance companies deny you the benefits you paid for and deserve. Experienced legal representation can make the difference between a denied claim and full recovery of the compensation you need for ongoing care, rehabilitation, and quality of life.
If your brain injury insurance claim has been denied in New York, contact our office today. We offer free consultations to review your denial, explain your appeal rights, and discuss strategies for overturning the denial and securing maximum compensation for your injuries.
