How to Appeal a Low Insurance Settlement Offer After an Accident in New York
Disclaimer: This is general information, not legal advice. I am not a lawyer. If you need legal advice about your specific situation, consult a licensed New York attorney.
Detailed answer: step-by-step process under New York law
If an insurance company offers a settlement you believe is too low after an accident in New York, you have several options. This guide explains practical steps, how appeals and disputes typically work, and important New York rules you must consider (including filing deadlines).
1. Confirm the offer and your goals
Read the written offer and release carefully. A full-and-final release usually gives up your right to sue for the accident’s injuries. Decide whether you want more money, a partial release, or to preserve the right to sue. Know the value you seek — this includes medical bills, lost wages, future care, pain and suffering, and other losses.
2. Gather and organize your evidence
Strong documentation helps you challenge a low offer. Typical proof includes:
- Medical records, diagnostic images, and doctors’ opinions about prognosis and future treatment.
- Bills, receipts, and proof of lost income.
- Accident reports, photos, surveillance, witness statements, and repair estimates.
- Records of communications with the insurer (dates, times, names, content).
3. Make a written demand
Send a clear written demand letter that explains your facts, injuries, and why the insurer’s offer is too low. Include itemized damages and supporting documents. State a specific settlement amount and a reasonable deadline for response. A formal demand often triggers a better offer or forces the insurer to put its position in writing.
4. Use the insurer’s internal appeal or dispute process
Many insurers have an internal appeals hotline or unit for claim disputes. Ask for the name and title of the person reviewing your appeal and request written confirmation of their decision. Document every contact. If the insurer denies or stands by the low offer, request a written explanation of the reasons.
5. File a complaint with New York regulators
If the insurer’s handling seems unfair, you can file a complaint with the New York State Department of Financial Services (DFS). The DFS investigates consumer complaints about insurers and can sometimes prompt a reevaluation of a claim. See the DFS complaint information here: https://www.dfs.ny.gov/consumers/file_complaint.
6. Consider alternative dispute resolution: mediation or appraisal
Mediation can be a fast, cost-effective way to resolve a dispute. The parties agree to meet with a neutral mediator who helps negotiate a settlement. Some insurance policies (or third-party contracts) also provide for appraisal or arbitration. Review your policy and any written agreements to see if ADR is required or available.
7. Evaluate suing the insurer or the at-fault party
If negotiations and appeals fail, you may sue. For most New York personal injury claims arising from an accident, the statute of limitations is three years from the date of the injury. See New York Civil Practice Law & Rules (CPLR) § 214(5): https://www.nysenate.gov/legislation/laws/CPLR/214. File before the statute of limitations runs or you likely lose the right to sue.
Common litigation steps:
- File a complaint and serve the defendant(s).
- Exchange documents and take depositions during discovery.
- Participate in motions, settlement conferences, and possibly trial.
In many cases, the at-fault party’s insurer will defend and indemnify, so suing the at-fault party is the usual route.
8. Know the limits on claims against insurers
New York law and case law limit some claims against insurers themselves. Whether you can sue an insurer directly (for example, for bad-faith refusal to pay) depends on the type of claim (first-party vs. third-party) and the policy terms. Consult counsel to evaluate whether a direct claim against the insurer is appropriate.
9. Weigh costs and likely recovery
Litigation is costly and takes time. Compare the insurer’s offer, the likely trial award, your out-of-pocket costs, and the emotional toll. Attorneys often work on contingency for personal injury — they advance costs and take a percentage of recovery — which can make pursuing a lawsuit practical when damages are substantial.
10. If you settle, protect yourself in the release
If you accept a revised offer, make sure the settlement agreement (release) accurately describes what you are giving up and any retained rights (for example, limited releases for medical lien resolution). Consider retaining a lawyer to review releases to avoid unintentionally signing away additional claims.
Key New York resources and statutes
- Statute of limitations for personal injury: CPLR § 214(5) — https://www.nysenate.gov/legislation/laws/CPLR/214.
- New York Insurance Law (general): https://www.nysenate.gov/legislation/laws/INS.
- File a complaint with the New York State Department of Financial Services (DFS): https://www.dfs.ny.gov/consumers/file_complaint.
- Small claims and court help (New York State Unified Court System): https://www.nycourts.gov/courthelp/SmallClaims/.
Helpful hints
- Act quickly: preserve evidence, meet medical appointments, and track deadlines (especially the statute of limitations).
- Put important communications in writing; follow up phone conversations with an email summarizing the discussion and request confirmation.
- Get a medical opinion on future treatment and long-term prognosis; future damages can dramatically affect value.
- Ask for itemized reasoning when an insurer reduces or denies payment; a clear written rationale helps your appeal or regulator complaint.
- Don’t sign a full release until you understand all consequences. If you have liens (medical providers, health insurers, Medicare/Medicaid), address them before accepting final payment.
- Consider a lawyer early, especially if your damages exceed small-claims limits or the insurer’s position is unreasonable. Many personal injury attorneys work on contingency.
- Use mediation before suing to save time and expense. Courts often encourage settlement conferences and mediation.
- If you file a complaint with DFS, continue negotiating with the insurer — DFS involvement does not prevent settlement discussions.