NYC Insurance Coverage Disputes

It’s good to have insurance. It’s even better when your insurance company pays your claims. If your business has become involved in an insurance claim dispute with your insurer in the greater New York area, you need a business law firm with knowledgeable insurance claims attorneys and a track record of successful litigation — you need Scaffidi & Associates. Our astute attorneys have dealt with recalcitrant, and even dishonest, insurance companies many times and are well up to the challenge of filing a lawsuit (usually a declaratory judgment action) on your behalf to force your insurance company to pay what it owes. After all, most likely you’ve been paying high insurance premiums for years; you have a right to expect your insurance company to hold up its end of the bargain.

Types of Insurance Claims Often Denied

Whether you are the owner of a small business or the CEO of a large corporation, your company may be sued, perhaps more than once, during its years of operation. Common lawsuits against your business may include personal injury cases based on premises liability, especially if you have many customers or vendors visiting your office or factory. Though you carry coverage for such incidents, when push comes to shove your insurer may deny your claim, however legitimate it may be. This is when our insurance claims attorneys are ready to step in and defend your rights.

Premises Liability

In cases of premises liability, your company may be sued for personal injury damages which your insurer should pay. Your company may be accused in the lawsuit against you of negligence in terms of sanitation, maintenance or reckless storage that has resulted in, for example:

  • Slip and falls due to wet floors, broken tiles or obstacles on pathways
  • Head injuries resulting from objects falling from heights
  • Shocks due to improper wiring

The amounts involved may be limited if the victim has suffered a broken arm or exorbitant if he or she has suffered a traumatic brain or spinal cord injury.

Property Damage

Cases of property damage for which you yourself file a claim with your insurer may include:

  • Burglary, theft and/or vandalism
  • Fire damage
  • Weather damage due to high winds, heavy rain, snow, hail, or sub-zero temperatures

Most people, regardless of the type of business or industry they oversee, are unaware of how frequently property damage occurs and how calamitous it can be. Here are two unnerving statistics: [1] twenty percent of commercial insurance claims are related to theft and [2] over 25 percent of businesses that close because of a natural disaster never re-open.

Most proprietors and corporate executives are well-aware of the importance of carrying sufficient insurance coverage to protect their real estate and their inventory in case of theft or destruction. One frozen water pipe, electrical short, vandal with spray paint, or thief with a moving van, can bring a business to its knees financially unless the insurance company kicks in for clean up, replacement of lost property, repair and/or restoration. This is why you need Scaffidi & Associates to file a lawsuit against an insurer who won’t pay a claim and to fight ferociously to preserve your rights.

When Claims Are Denied

Once you make a liability insurance claim, your insurer should investigate the claim to confirm what happened and your broker should check your policy to see precisely what is covered my your policy. It’s possible for your claim to be denied for a number of reasons:

  • Your policy doesn’t cover this particular type of loss
  • You didn’t file your claim quickly enough
  • The injury-related or property costs have been exaggerated
  • The accident, theft, fire, or flood  never actually took place (i.e. either you or the person suing you is guilty of fraud)

In the case of personal injury cases against you, your insurance company may take the position that your negligence was not the cause of the injury, claiming, for example, that the person who fell on your office floor broke her hip because of a pre-existing medical condition that caused her to lose her balance. It is also common for the insurer to claim that your company was only partially responsible for the accident (comparative negligence) and that they therefore are only responsible for paying a percentage of the damages.

When You Insurance Company Acts in Bad Faith

Just as your insurance company may accuse you (or the person suing you) of misconduct in filing your claim, Scaffidi’s insurance claims attorneys have the ability to sue the insurance company for acting in “bad faith,” meaning that the company is deliberately looking for ways to wiggle out of its legal obligation. Our well-seasoned attorneys not only have comprehensive knowledge of insurance contract law, we are fully aware of the varied methods your insurance company may use to cut their costs by unjustly denying you fair payment.

The insurance company may, for instance:

  • Fail to conduct a reasonable investigation
  • Withhold relevant information
  • Delay payment of a valid claim
  • Attempt to settle for substantially less money than the claim is worth
  • Fail to provide a reasonable explanation for the denial of your claim
  • Fail to disclose (or make ambiguous) policy limits in the original policy
  • Fail to negotiate in order to settle your claim

Scaffidi & Associates Will Level the Playing Field

Our insurance claims attorneys have effective strategies for dealing with insurance companies that are attempting to treat you unfairly. Although large insurance companies typically have powerful law firms representing them, Scaffidi & Associates has the ability to leverage its years of experience and well-honed skills to give you the best possible chance of winning the case. We know which tactics will work best in your particular situation and are committed to arriving at a successful outcome for your company.

Knowing your insurer is legally required to investigate, negotiate, and settle claims in good faith, we will not permit dishonest manipulations. If your insurance company is disputing your reasonable claim, get in touch with Scaffidi & Associate by phone or through our website. We will hold your insurer accountable and work forcefully to see that your claim is settled fairly so your business can continue to thrive.


We encourage you to take the time to explore this website as the information provided here will answer many of your questions. We believe that an educated client is our best client. We are also readily available to discuss your case in confidence, whether it’s a matter involving personal injury, medical malpractice, real estate, or other legal challenges. Regardless of the issue you are facing, we are uniquely qualified to provide you with exceptional legal representation and personal service. Call our office or complete the contact form on our website to set up a consultation.