New York City Insurance claims involve a variety of situations where a claim to an insurance company is denied or disclaimed and warrants legal intervention or litigation to resolve.
Insurance Claim, as a basic concept, is a contract or a defined arrangement, represented by a policy, whereby an individual or entity receives financial compensation or reimbursement in the event of some act or omission occurring usually a loss, damages, illness, death, in exchange for a premium (the price paid to the insurance company for that risk protection).
As is evident, insurance can cover all types of possible eventualities or risks, such as auto or homeowner’s insurance, business insurance, professional insurance, medical insurance, life insurance, etc. What insurance cannot insure as a matter of law (public policy) is intentional (criminal) acts or omissions.
New York City Insurance claims can also be first-party claims or third-party claims. Under first-party claims, the insured is automatically entitled to the benefits, as the insured paid a premium for that protection. For example, a tree falls through the roof of your house; as the homeowner-insured, your homeowner’s insurance is responsible to cover the cost and loss of that repair. Under third-party insurance, an insurance policy is purchased to pay the damages caused to another (a third) party by the insured’s own fault. It is purchased by the insured (the first party) from an insurance company (the second party) for protection against claims made by another party (a third party). For example, if you are injured in an auto accident, the vehicle’s insurance is responsible for you damages and loss. however, this is not automatic and it often requires a legal claim or lawsuit to be filed.
Even under first-party insurance claims, there are disputed issues, which may result in the denial of benefits or the disclaimer of coverage. An insurance contract and its fine print are seldom read if even understood by insureds. There are interpretation and trigger issues inherent in the administration of any insurance claim. Michael Manoussos & Co PLLC Lawyers not only is versed in reviewing and assessing insurance policy and claim issues, but as litigation lawyers brings its litigation perspective and experience to this matter which is invaluable. If you even think that you may have an insurance claim, please consult with us as there are terms and conditions in the policy that must be adhered to especially deadlines.