Filing Claims Under Your Own Policy | Department of Financial Services
report an accident
If you are involved in a car accident, you should immediately report it to your insurance company as well as your local police department. If the amount of damage caused in the accident exceeds $1,000, or if someone is injured in any way, you must file an accident report with the Department of Motor Vehicles. This form, MV-104, will usually be included with any claim forms your insurer sends you.
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The insurance policy is probably the most bought but least read contract that exists. It is extremely important that you read your policy to determine exactly what reporting requirements are included so that you can meet them and reduce any difficulties in handling your claim. Some people don’t realize what their policy does and doesn’t cover until it’s too late.
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filing a no-fault claim
If you are injured in a car accident, file a written notice of claim with the no-fault insurer that identifies the injured person(s), along with reasonably obtainable information about the time, place and the circumstances of the accident, as soon as reasonably possible, but in no event more than 30 calendar days after the date of the accident, unless you can submit written proof that provides clear and reasonable justification for the late filing. Generally, if the accident occurred in New York State, you should file your no-fault claim with the insurer of the vehicle you were in when the accident occurred or, if you were a pedestrian, with the insurer of the vehicle that covered you. hit . If the accident occurred outside of New York State and you were in a vehicle that was not your own, file your claim with your own insurance company. If you were injured in a car accident while a passenger on a bus, your no-fault benefits would be provided by your auto policy or the auto policy of a member of your household. If you or a member of your household does not have auto insurance, the bus insurer will provide your benefits at no fault.
If you (or a family member you live with) do not have an auto insurance policy and are injured by or while in an uninsured vehicle, or by a hit-and-run driver, you should file your claim no -failure benefits with mvaic. It is important that the accident is reported to the competent authority within 24 hours.
Within five business days after the insurer (or mvaic) receives this claim notice, they must send you an application for benefits and a letter explaining the no-fault coverage available and your rights and obligations. once you receive the benefit application form, please complete it and return it as soon as possible.
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If you need medical treatment, you: (1) can pay the doctor or hospital directly and submit your receipts or bills to the insurer for reimbursement; or (2) allow the doctor or hospital to submit your bills directly to the insurer without fault for payment.
No-fault benefits are paid according to prescribed fee schedules, which are required by law to be accepted by the health care provider as payment in full. It is important that you make it clear to the health care provider that you are being treated for injuries related to a car accident. Unless additional verification is requested, payment must be made by the insurer within 30 days of receipt of your health care provider’s claim with proof of medical necessity or your employer’s lost earnings report (or self-employed worker).
If the insurer fails to make timely payment of a no-fault claim, you must pay 2% monthly interest on the unpaid amounts and reasonable attorneys’ fees (according to insurance rules) incurred to collect your overdue no-fault benefits.
If all or part of your no-fault benefits are denied or paid late, you can: (1) file a complaint with the department, as detailed later in this guide; (2) request no-fault arbitration; or (3) bring an action in court. No-fault arbitration may be requested if the insurer denies your claim in whole or in part, fails to make a timely payment of benefits due, or fails to inform you in a timely manner if your claim has been denied.
The no-fault arbitration process is designed to resolve disputes as quickly as possible. the results of the arbitration are final and binding on all parties (unless appealed under certain strict circumstances). for a detailed description of how to file a no-fault arbitration request, see chapter xiv.
filing a physical damage claim
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If your car is damaged or stolen and you have comprehensive or auto collision insurance coverage, you are entitled to prompt and fair payment from your insurance company, either in the amount of the damage or the actual value in car cash. , whichever is lower. If your car is stolen and you later get it back, your insurer must pay for the damage done to the car while it was lost, the cost of towing, any reasonable storage charges, and substitute transportation expenses.
ny regulation 64 is designed to ensure a quick and fair settlement from your insurance company. This regulation provides the guidelines and time limits within which an insurer must handle any claims you make, under auto collision and comprehensive insurance, and property damage liability claims you make against another driver. .
Under these regulatory rules, when responding to a claim made under your policy’s comprehensive or collision coverages, your auto insurer must do the following:
- Inspect the damaged vehicle and bid in good faith within six business days of receiving notice of loss, provided your car is available for inspection. a bona fide offer is one that can be supported by the name of a repair shop registered with the department of motor vehicles that will perform the repairs according to the insurer’s offer;
- promptly provide you or your authorized representative with an itemized written estimate of the cost of the repairs;
- if requested, identify a conveniently located auto repair shop that will repair your automobile at the insurance company’s estimated repair cost and provide you with a written warranty, backed by your insurer, for the work performed; however, you retain the right, under insurance law, to choose which shop will repair your damaged vehicle;
- pay actual cash value (retail value plus sales tax), which is subject to depreciation and appropriate deductions, if your car is a total loss because it was stolen or damaged beyond repair, or replace it with a car substantially similar, in accordance with current regulatory standards;
- make payment within five (5) business days after you and the insurer have reached an agreement;
- provide you with a written explanation of the reasons for the delay if your claim has not been resolved within 30 days from the date you notified the insurer of the loss.
If your car is stolen, most insurers will reimburse you for your car rental costs up to the amount stated in the policy. Some auto insurers issue a policy with “optional auto rental reimbursement coverage,” which also pays such expenses when your car becomes inoperable during a covered collision or comprehensive loss, other than theft.
With respect to collision and other physical damage claims, your insurance company must obtain an “Auto Repair Certification” form from you and your auto body repair shop, to determine the extent to which your automobile was damaged. it has been fixed. repaired if you do not submit this form, your loss settlement may be reduced by a subsequent loss. furthermore, in the event of a loss involving a deployed or stolen airbag, the airbag must be replaced. (The insurer has the right to verify that the airbag was deployed or stolen and to take possession of a deployed airbag.)