What Can I Do if My Smoke Damage Insurance Claim in NY Is Unfairly Denied?
If your smoke-damage claim has been denied, you have support from the DFS to fight back. Start by understanding why the insurer said “no,” then follow a clear path to challenge that decision. Begin by gathering all the facts and communicating with your insurer—if that doesn’t work, escalate your dispute through formal channels and, if necessary, the courts.
Review the written denial
New York insurers must provide a denial letter that clearly states their reasons. Under Insurance Law § 3420, they’re required to:
- Issue a written notice with specific grounds for refusal within 15 days after proof of loss
- Pay any undisputed portion within 30 days or incur statutory interest
Compile robust evidence
Document the damage immediately:
- Photograph and video every affected area
- Prepare a detailed inventory of ruined items with receipts or proof of purchase
- Secure any fire department or environmental reports
- Preserve all emails and adjuster notes
- Collect contractor or restoration estimates
Request reconsideration
If the carrier misinterprets the extent or cause of damage, submit a formal re-evaluation request to its claims or appeals unit, including any new information or expert opinions that address the gaps in their initial decision.
Invoke your internal appeal process
Many policies include an internal appeal or dispute procedure. Follow the policy’s instructions carefully—deadlines and form requirements are essential. Consider negotiating directly or obtaining a second estimate to resolve disagreements over the scope or cost of repairs.
Consult Vargas Gonzalez Delombard’s specialized attorneys
At Vargas Gonzalez Delombard, our experienced insurance litigators identify contractual breaches and engage in unfair claims practices under Insurance Law § 2601. We negotiate stronger settlements on your behalf and, if necessary, file lawsuits to secure the full compensation you deserve.
File a complaint with DFS
When you suspect bad faith—unreasonable delays, misrepresentations, or outright refusal to pay—submit a report through the DFS Consumer Complaint Form to trigger a regulatory investigation.
Consider litigation
If all other options fail, you can consider suing under § 3420 for unpaid benefits, including interest and fees, and § 2601 for penalties related to unfair claims practices. This legal action can compel the full payment of your claim and may allow you to recover attorneys’ fees and additional damages.