Insurance Claim vs Lawsuit: Know the Difference
Published 10:41 am Monday, April 7, 2025
In New York, if you have been injured in an accident, and said accident was the result of someone else’s negligence, you may be entitled to recover compensation in the form of an insurance claim or lawsuit.What should you consider? A claim or a lawsuit?
While you see many instances where the two terms are used interchangeably, they are not the same. At Alex Yadgarov & Associates, as some of the top accident lawyers in New York we’ve had years of experience helping our clients in both insurance claims and lawsuits, and we believe understanding the difference between the two is a crucial part of protecting your legal rights and maximizing your compensation.
Insurance Claims
In New York, filing an insurance claim is the first step that can be taken to recover compensation. It is a formal and legal demand that can be made by an injured party. Depending on the type of accident and the insurance coverage, a claim can be submitted with the insurance provider of the injured party or that of the at-fault party.
For example, New York is considered a “no-fault” insurance state when it comes to dealing with car accidents. This means that if you have been injured in a car accident, you can file a claim with the help of a car accident attorney in New York with your own insurance company to be reimbursed for medical costs and other losses, regardless of the fault you bear in the accident.
However, in certain cases, injured parties are allowed to submit insurance claims directly to the insurance provider of the party at fault. These cases often involve injuries, which satisfy New York’s serious injury threshold.
What are the steps for filing a claim?
Notify the insurance company.
Delays can hurt your case and the chances of maximizing your compensation. Notify your insurance company of the accident as soon as you are able. However, as a New York personal injury attorney, we advise that you do not do the following:
- Admit fault or apologize for the incident since such statements can be used to reduce your compensation under New York’s comparative negligence law.
- Post about the accident on social media.
- Make any official statements or representations without prior consultation with your attorney.
Gather evidence.
With the help of an attorney, you can build your case by gathering all the relevant evidence. Documents such as medical bills, repair estimates for damaged property, and police reports can help quantify the compensation for the accident.
Submit your claim.
Once you’ve gathered everything together, file the claim with the relevant insurance company. The insurance company will promptly open an investigation, review the documents, and come back with their offer.
Handling settlement offers.
You have the option to accept, reject, or make a counteroffer when the insurance presents you with a settlement. Since the goal of insurers is to pay as little as possible, the rule of thumb is not to accept the first offer. If you cannot reach a fair settlement, a lawsuit will be the next step.
Lawsuits
A lawsuit is a claim or a dispute that is brought to the attention of a court of law where the court may decide on the matter. Filing a lawsuit is often a last resort. However, there are many reasons why people choose to file lawsuits. Some of them include:
- The settlement offer is not enough to cover expenses.
- The claim is denied.
- The insurance company is delaying payments and acting in bad faith.
- The party responsible is uninsured or underinsured.
- Insurance claims not accounting for non-economic damages
- The at-fault party is a government entity.
The filing of lawsuits comes under a ticking clock in the form of the statute of limitations. For personal injury lawsuits, the statute of limitations stands at 3 years from the date of the accident. However, this time can change depending on the type of personal injury and the defendants in the case.
Once the lawsuit is initiated, the other party shall receive a copy of the lawsuit. The other party, as the defendants, can respond in one of two ways. First, they may attempt to reach a settlement out of court. Alternatively, they may decide to fight your lawsuit and file responses. If no agreement is reached, the case moves to litigation; the parties will present their cases to the judge and jury, who will decide the outcome and award damages accordingly.
Conclusion
In the path to recovering compensation for the injuries you’ve sustained in New York, your options are to either file an insurance claim or file a lawsuit. While each path has its own advantages and disadvantages, depending on the circumstances of your case, an experienced lawyer can advise you on the best way forward.
At Alex Yadagrov & Associates, we have some of the best auto accident and work- related accident attorneys in New York and we will guide you throughout the whole insurance and lawsuit process and secure the compensation you deserve. Schedule a free consultation with us and let us take the fight for you.