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New York Insurance Bad Faith Questions & Answers
1 Answer | Asked in Insurance Bad Faith for New York on
Q: Can my old insurance charge me for medications they paid for after I lost coverage?

I am on a monthly medication paid for by my insurance, I switched jobs and thus got new insurance, but the pharmacy kept billing the old insurance.

The old insurance continued paying for my medications for 5 months. Now they're charging me a hefty ammount for the months they paid for... Read more »

Tim Akpinar
Tim Akpinar
answered on Apr 19, 2022

I'm sorry you find yourself at the end of a collection action with the medications. It's difficult to comment definitively on your position without seeing the terms of the policy and other paperwork. However, it sounds like they may be relying on the position that the patient has a... Read more »

1 Answer | Asked in Insurance Bad Faith and Insurance Defense for New York on
Q: Can i sue an insurance company

So my dilemma is I have a car accident reported on my car accident history last year. I have never been in an accident in my life. My mom got in an accident last may and i was in the car. She called me a week later and told me her insurance wanted to speak with me i explained the situation to them... Read more »

Tim Akpinar
Tim Akpinar
answered on Mar 12, 2022

Some elements of the scenario are not fully clear, but from the brief facts, it does not look like a case of insurance fraud. Insurance fraud cases generally involve deliberate conduct with the intent to deceive the other party. This looks more like it could be an administrative or communications... Read more »

1 Answer | Asked in Health Care Law, Insurance Bad Faith, Insurance Defense and Civil Rights for New York on
Q: Can a health care provider accept insurance based on merit of the patient?

A dentist office accepts my current insurance. But make me pay full price, bills my insurance separately then sends me a check for less than 50% of what I payed when my insurance covers 80% of the total visit. They also only make some people who have the same insurance pay. So if you and I both had... Read more »

Tim Akpinar
Tim Akpinar
answered on Feb 11, 2022

It could be difficult to speculate why a dental or medical office would apply different billing protocols. As a convenience to the patient, some offices do not bill patients but instead, have them complete paperwork enabling their billing staff or contractor to bill on patient's behalf. When... Read more »

1 Answer | Asked in Insurance Bad Faith and Insurance Defense for New York on
Q: Insurance company denied medically necessary breast reduction. My back is now more damaged. Can I sue?

Hi,

I have a very large chest and as such I also suffer from crippling back pain. It has gotten to the point I can no longer function normally and cannot even get out of bed some days due to sciatica. I tried to get my insurance company to pay for a breast reduction and they denied me. In... Read more »

Tim Akpinar
Tim Akpinar
answered on Dec 16, 2021

I'm sorry for your ordeal with the back pain. In terms of having a case on which to sue, a law firm could offer a more meaningful response after reviewing the file with the input of medical professionals. What you are really probably wondering is whether you could sue in a manner where a law... Read more »

2 Answers | Asked in Insurance Bad Faith, Personal Injury and Products Liability for New York on
Q: Why would a claims adjuster deny a claim and then turn around and want to offer payment for pain caused by the incident?

I am the third party in a product liability insurance claim. The claim was denied earlier this month and just yesterday, the adjuster called me wanting to "resolve" the claim by offering payment for "pain" from the injury.

Before the insured sent the complaint over to... Read more »

Tim Akpinar
Tim Akpinar
answered on Sep 30, 2021

It's difficult to say what the cause for the change in position on the part of the insurance carrier was without seeing the file and all communications. But what you describe is not uncommon. A claim could initially be denied because the examiner has not been presented with sufficient evidence... Read more »

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2 Answers | Asked in Personal Injury and Insurance Bad Faith for New York on
Q: How somebody can claim personal injuries in front of my house if there is no obstacles, potholes or cracked sidewalk?

If somebody claims that got hurt in front of my house how can request to be paid by my house liability insurance? My security system is old and cannot record, just view. Out of nowhere you just try to get money from your neighbors ?

Tim Akpinar
Tim Akpinar
answered on Sep 25, 2021

Your homeowner insurance company will thoroughly investigate the matter. It is not enough for someone to simply fall. They must show that it resulted from a defect in the surface or negligence on your part. The claims adjustor or defense attorney from your insurance company should be able to... Read more »

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1 Answer | Asked in Insurance Bad Faith for New York on
Q: Is it illegal for grandmother to keep insurance cards if I’m 19?

So I live with my grandmother. I’m 19 years old and moving out in august. She loves having control of everything! The thing is she has my insurance cards and refuses to give them to me. I’m going to need them when I move out. My college requires me to have my own insurance and I would like to... Read more »

Tim Akpinar
Tim Akpinar
answered on Jul 7, 2021

One option might be to contact the insurance carrier to request duplicate cards. Good luck

Tim Akpinar

1 Answer | Asked in Consumer Law and Insurance Bad Faith for New York on
Q: 1. How to find life insurance company's divisible surplus for last 15 to 30 years? 2.by insurance class? $0 div?

year 1968 participating $5,000 whole life policy. no dividends for last 15 years. Prior to that, div increased each year (to $96) then decreased in the next 4 yrs to zero; for 12 yrs $0 , however cash value increased each yr ($3,900 currently and increases a small amount each yr), no loans ,... Read more »

Jonathan David Warner
Jonathan David Warner
answered on May 31, 2021

I'd recommend looking into New York's State's Unclaimed Funds registry, which can be found by clicking on this link:

https://www.osc.state.ny.us/unclaimed-funds

If you're entitled to funds that are unclaimed, they might be held by the State in escrow.

Good luck with your case!

1 Answer | Asked in Banking, Insurance Bad Faith and Insurance Defense for New York on
Q: what to do if my bank refuses my father's life insurance claim?

My father's bank refuses to pay me by telling me that my father did not contributed the last months before his death without giving me any official paper or proof. My father contributed to this insurance for more than 30 years and it's a shame not to get any penny..

Tim Akpinar
Tim Akpinar
answered on May 9, 2021

I'm sorry for your ordeal that makes a difficult situation even more painful. It appears you've already requested records. It's difficult to offer step-by-step instructions here, as the next step could possibly require litigating the claim, depending on the situation. Reach out to... Read more »

1 Answer | Asked in Insurance Bad Faith for New York on
Q: Hedgepeth v Home Savings and Loan Assoc 361 S.E 2d 888 ( NC App. 1987) Please briefly describe what occurred in the cas
Tim Akpinar
Tim Akpinar
answered on Nov 12, 2020

There is a resource on the case here on the Justia site. Enter the following page link in your browser:

https://law.justia.com/cases/north-carolina/court-of-appeals/1987/8715sc224-1.html

Good luck

Tim Akpinar

1 Answer | Asked in Insurance Bad Faith for New York on
Q: An insurance company we were with for 11 years quadrupled our homeowners premiums during this time Is this legal?

We Filed a couple of homeowners claims several years back and they kept exorbitantly upping our premiums year after year Annually I would call them and ask what could be done to better our rates. They offered nothing. our Renewal policies came in through the roof For oct 2020 so we decided to... Read more »

Tim Akpinar
Tim Akpinar
answered on Sep 29, 2020

Multiple claims could cause a significant rise in premiums. In terms of the other matter, you may need to review the file with an attorney in terms of the basis for the retroactive assessment - whether stemming from representations upon which their underwriters assessed the risk. Based on the... Read more »

1 Answer | Asked in Insurance Bad Faith for New York on
Q: Hello i need to sue an international health insurance company located in Britain and works here in NYC?

They declined covering me each and every time i need medical service claiming all are preexisting conditions without adequate proof?

Tim Akpinar
Tim Akpinar
answered on Jul 2, 2020

I'm sorry that your procedures were denied. There wasn't a question, but a starting point for your situation could be to start contacting attorneys who handle health insurance claim disputes. Depending on the policy, there could be provisions for appeals. Good luck

Tim Akpinar

1 Answer | Asked in Health Care Law, Insurance Bad Faith and Landlord - Tenant for New York on
Q: What is a landlords responsibility if a tenants apartment is uninhabitable due to health violations?

My bathroom ceiling is dripping meriatic acid due to an upstairs neighbor pouring it down the drains. The entire apartment filled with smoke due to the chemical reaction when in contact with metal. What is the protocol for a situation like this? Is it the landlords responsibility to provide us with... Read more »

Gregory Byrnes
Gregory Byrnes
answered on May 13, 2020

Your landlord should fix the issue. Your first step should be to let your landlord know so they can fix it.

2 Answers | Asked in Insurance Bad Faith for New York on
Q: My wife's health insurance was cancelled because she missed three payments. She has pancreatic cancer.

My wife's condition is dire. She is in near constant pain and takes a lot of morphine. Novavirus restrictions have added to the anxiety. The insurance company has to make an exception in her case. Can you help?

Michael David Siegel
Michael David Siegel
answered on Apr 20, 2020

If you qualify for Medicaid, you can apply for that. You can also sign up for Obamacare exchange coverage at New York State of Health. But you are going to have to pay.

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2 Answers | Asked in Insurance Bad Faith for New York on
Q: Where do I even start with a bad faith claim against my car insurance company?
William P. Lalor
William P. Lalor
answered on Dec 7, 2018

Bad faith law is governed by state law. Depending on your jurisdiction there may be avenues to pursue through the state or ultimately through litigation. Many insurance lawyers will speak with you at no cost to give you some idea of your options and avenues to pursue.

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1 Answer | Asked in Insurance Bad Faith for New York on
Q: What is third party bad faith and how does it relate to an insurance company?
Tim Akpinar
Tim Akpinar
answered on Oct 29, 2018

Third-party bad faith consists of actions on the part of someone else’s insurance carrier. It is distinguished from first-party bad faith, where the conduct involves someone’s own insurance carrier.

Tim Akpinar

1 Answer | Asked in Insurance Bad Faith for New York on
Q: My insurance company won't reimburse the whole amount of my loss, even though it's within the scope of my policy. What

can I do?

Tim Akpinar
Tim Akpinar
answered on Sep 15, 2018

It isn’t stated what type of loss the non-reimbursement involves, or if non-payment involves a deductible. In some cases, when an insurance carrier issues a denial, it lists available options. These include litigation, arbitration, or complaint with the Department of Insurance. In other cases, a... Read more »

1 Answer | Asked in Insurance Bad Faith for New York on
Q: If my claim has been approved how long does my insurance company have to pay me after a car accident?
Tim Akpinar
Tim Akpinar
answered on Sep 4, 2018

If by approved you mean that there is a court order by a judge, the order could stipulate a time period for payment. If you mean settled, then it could depend on how quickly third-party liens (if applicable) are identified and lienholders (medical providers, government agencies that paid health... Read more »

1 Answer | Asked in Contracts and Insurance Bad Faith for New York on
Q: I have had a whole life insurance policy now for over 25 years.

My agent has now retired since. Now the agent assigned to me gives me a call and says the cost of insurance has gone up and there is going to be a change in my premium. I thought you paid 1 amount for whole life and that never changes. Why now after my first agent retires I get a call asking for... Read more »

Michael David Siegel
Michael David Siegel
answered on Aug 20, 2018

Your policy governs. Call the actual insurance company. Ask for the legal counsel's office.

1 Answer | Asked in Insurance Bad Faith for New York on
Q: My father died almost three years ago and his home where I lived and rental properties were in trust and transferred to

me ...I have been paying homeowners on all and it has come to my attention that the agent did not put my name on the policies ...is she liable for not correcting this and can I get the money I paid in premiums on policies that she still kept in my fathers name for some reason reimbursed to me..I... Read more »

William P. Lalor
William P. Lalor
answered on Jul 24, 2018

I don't fully understand your situation, but if there was an underwriting mistake or omission, whether because of the agent or otherwise, as a result of which you are not an insured when you ought to have been an insured, you might have avenues to pursue.

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