As a New York contractor, having a liability claim denied by your commercial general liability (CGL) insurance company can be a frustrating and costly experience. However, a denial does not mean the end of the road. There are several steps you can take to challenge the decision and potentially get the insurance company to cover your claim. This article provides a step-by-step guide on how to appeal a denied liability claim and what actions you can take to improve your chances of success.
Step 1: Review the Denial Letter Carefully
When your insurance company denies your claim, they will send a denial letter outlining the reasons. Carefully review this document to understand why the claim was denied. Common reasons for denial include:
- The claim falls under an exclusion in your policy.
- There was a lapse in coverage.
- The claim was filed late.
- The insurer believes you were negligent beyond what your policy covers.
Understanding the reason for denial will help you determine the best course of action.
Step 2: Review Your Policy
Next, obtain a copy of your CGL policy and go through it carefully. Look for language that might contradict the denial reasons. Pay close attention to:
- Covered events and exclusions
- Reporting requirements
- Endorsements that may modify coverage
If you find that the policy does indeed cover your situation, you will have strong grounds for an appeal.
Step 3: Gather Supporting Documentation
To strengthen your appeal, gather all necessary documents, including:
- The original contract related to the work in question
- Incident reports and photographs
- Witness statements
- Correspondence with the insurance company
- Any expert opinions or reports
Strong documentation can help you prove that your claim should be covered.
Step 4: File a Formal Appeal
Most insurance companies have an internal appeals process. Follow these steps:
- Write a formal appeal letter addressing the denial reason and presenting evidence that supports your case.
- Attach all relevant documentation to reinforce your argument.
- Request a reconsideration of your claim based on the facts you provide.
- Send the appeal via certified mail to ensure receipt.
Step 5: Engage a Legal or Insurance Professional
If your appeal is denied, consider consulting with an insurance attorney or a professional specializing in construction insurance, such as a broker. They can:
- Interpret complex insurance language
- Advocate on your behalf
- Negotiate with the insurance company
An experienced professional can make a significant difference in overturning a denial.
Step 6: File a Complaint with Regulatory Authorities
If you believe the denial is unfair or violates insurance regulations, you can file a complaint with the New York State Department of Financial Services (DFS). DFS oversees insurance practices and can review your case.
Step 7: Consider Litigation
If all else fails, you may need to take legal action against the insurance company. This should be a last resort due to the costs involved, but in some cases, a lawsuit can force the insurer to honor the policy.
BGES Group: Experts in New York Construction Insurance
If you are a New York contractor facing an insurance denial, BGES Group is here to help. BGES Group specializes in New York construction insurance and has extensive experience dealing with liability claims and insurance disputes.
Why Choose BGES Group?
- Expertise in New York Construction Insurance – They understand the complexities of insurance policies specific to the construction industry.
- Mom-and-Pop Boutique Service – Unlike big insurance firms, BGES Group provides personalized service with a hands-on approach.
- Advocacy for Contractors – They work diligently to ensure you have the right coverage and assist in appealing denied claims.
Contact BGES Group
- Gary Wallach
- Phone: 914-806-5853
- Email: bgesgroup@gmail.com
- Website: www.bgesgroup.com
If you need help appealing a liability claim denial or ensuring you have the right insurance coverage, reach out to BGES Group today!