Maximize Your Insurance Claim with Our Skilled New York Legal Team

Our attorneys have extensive insurance law knowledge and a strong understanding of New York statutes and regulations, allowing us to advocate effectively for you. We carefully examine every clause of your policy, gather solid evidence, and negotiate tirelessly with insurance carriers to ensure you receive the full compensation you deserve. Schedule a consultation today to protect your rights and safeguard your property.

Smoke-Damage Coverage in NY

Most New York homeowner policies (HO-3/HO-5) treat smoke as a covered peril, meaning your insurer must pay for damage caused by a fire or a sudden accidental puff-back. The obligation is anchored in the state’s standard fire policy requirements under Insurance Law § 3404.

What that generally translates to is:

  • Structural repairs: Cleaning, deodorizing, and rebuilding walls, ceilings, floors, and other fixed elements.
  • Personal-property restoration or replacement: Furniture, clothing, electronics, and other belongings are protected, usually up to 50% of the dwelling limit, per the Department of Financial Services’ Basic Coverage chart.
  • Additional Living Expenses (Loss-of-Use): Hotel bills, meals, and commuting costs if the home is uninhabitable. These are typically capped at 20% of the dwelling limit and are confirmed by the DFS chart above.
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Why Smoke Claims Get Denied

Insurers don’t always pay without a fight. The most common grounds for denial are:

  • Policy-condition issues: Late notice, failure to mitigate damage, or alleged misrepresentations. The standard fire policy, which requires homeowners to use “all reasonable means” to protect the property (§ 3404, lines 19-21), can be voided for concealment or fraud.
  • Disputes over the scope or cost of repairs: When you and the carrier can’t agree on how much work is needed, either side may invoke the appraisal clause to decide “the amount of loss,” as outlined in a DFS opinion letter.
  • Suspicion of fraud or arson: If the company believes the fire was intentional or the claim inflated, it can rely on the fraud language in § 3404 to deny or void coverage.

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.

New York Imposes Strict Deadlines on Smoke Damage Insurance Claims

  • Under New York law, you must give your insurer written notice of a smoke‐damage loss “as soon as reasonably practicable” to preserve coverage under
  • You must also comply with any proof‐of‐loss requirements specified in your policy, or risk forfeiting your claim under Insurance Law § 3407
  • Finally, if you need to sue for unpaid benefits, New York’s Civil Practice Law & Rules gives you six years from the date of loss to initiate a breach‐of‐contract action under CPLR 213(2)—wait any longer, and you may lose your right to recover

Vargas Gonzalez Delombard: The Legal Team NY Turns to After Roof Storm Damage

Our experienced attorneys provide trusted legal guidance to homeowners navigating complex insurance claims. We ensure strict compliance with New York State insurance laws and New York City building code requirements, helping clients overcome insurer pushback and secure the full compensation they’re owed.

Most importantly, VGD supports you at every stage of the claims process—from documenting the loss and meeting critical deadlines to negotiating with insurers and, when necessary, pursuing litigation. Don’t face your roof damage claim alone. Contact us today by phone or online for skilled, personalized legal assistance.

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