How to File a Complaint Against an Insurance Company in New York

If an insurance company is denying or delaying your claim, there are a few basic steps New Yorkers can take to fight back and protect their rights. 

In this article, we go over the following options: 

1. Sending a Demand Letter

2. Filing a Complaint with the New York Department of Financial Services

3. Suing in Small Claims Court

Before filing a complaint against your insurance company, collect all important documents and information to help strengthen your complaint. 

• Review your policy. By carefully reviewing your insurance policy, you are confirming that you are right and the insurance company is in the wrong. 

• Document All Communication. Keep records of all communications, meetings, and any relevant documentation. Try to have as much information as possible in writing, as this will be part of your evidence, should you need it.

• Photographs and Screenshots. If applicable, take photos or screenshots to document any errors, discrepancies, or issues.

This way, if you later need to escalate to submitting a government complaint or suing in small claims court, you have your evidence ready. 

Reviewing past complaints can help you understand if the company has a history of similar issues. Here are a few methods you can use to look up complaints against insurance companies in New York:

1. National Association of Insurance Commissioners (NAIC)

• Use NAIC’s Consumer Information Search (CIS).

• This tool allows you to search for complaints, financial information, and licensing status for insurance companies operating nationwide, including New York.

2. Better Business Bureau (BBB)

• Visit the BBB website and search for the insurance company.

• You can find complaint records, customer reviews, and ratings.

3. Public Records and Legal Databases

• Search public records or legal databases like PACER for federal lawsuits or New York's Unified Court System for lawsuits in state court. 

Before escalating your complaint, you should try to resolve your complaint directly with your insurance company. 

• Contact customer service: Contact the insurance company’s customer service or claims department to try to resolve the issue directly. It's possible that there was a misunderstanding or clerical error. This could be via phone, email, or an online portal.

• Ask for an explanation in writing: If your claim was denied, request a detailed explanation of the reasons behind the denial.

• Escalate to a Supervisor: If unresolved, ask to speak to a supervisor to see if they can help get your claim resolved.

If communicating with the insurance company directly doesn’t work, consider sending a demand letter. A demand letter is a formal letter that explains what happened and requests that they resolve the problem.

Here are some reasons why you should consider sending a demand letter to your insurance company:

1. A demand letter signals to your insurance company that you are serious about the issue and willing to take action to resolve it. Many problems are resolved by simply sending a demand letter.

2. If you end up filing a small claims lawsuit later on, the judge in your case may ask if you tried to resolve the problem out of court. By sending a written demand letter, there is a record of your attempt to resolve the problem out of court that you can include in your evidence. 

3. A demand letter will also help you organize your facts and evidence and create a timeline of events. This will help you remain consistent and factual as you go through the steps to resolve your complaint. 

The BBB is a non-profit that serves as an intermediary between insurance companies and consumers. It’s not a government agency and cannot force the insurance company to resolve a disagreement with you. 

Before filing a complaint against the insurance company with the BBB, first check that the insurance company responds to BBB complaints by checking their BBB profile. Otherwise, you may be wasting your time filing a complaint. 

BBB reviews give other consumers confidence when choosing an insurance plan, and insurance companies don’t want negative BBB complaints.

Reasons Why Some Companies Respond to BBB Complaints 

• If the insurance company is accredited with the BBB and doesn't respond to a BBB complaint, its accreditation may be revoked, and the complaint becomes part of its BBB profile.

• If the insurance company is not accredited with the BBB, the complaint will become part of their BBB profile.

How to File a Complaint with the Better Business Bureau (BBB):

1. Go to the Better Business Bureau website. You will need to confirm whether the insurance company has a BBB profile. 

2. Scroll to the bottom of the page and click the button “File a Complaint” 

What to Expect Once you Submit your Complaint to the BBB:

• The BBB will forward your complaint to your insurance company within 2 business days.

• The company will be asked to respond within 14 days, and if a response is not received, a second request will be made.

• You will be notified of the company’s response when the BBB receives it (or notified that they received no response).

• Complaints against insurance companies are usually closed within 30 business days.

Review our guide about when it’s worth filing a BBB complaint. 

The New York State Department of Financial Services (DFS) is the agency responsible for regulating most insurance companies and professionals operating in New York. 

To file an insurance complaint with the New York State Department of Financial Services (DFS), follow these steps:

DFS handles complaints related to:

• Health, auto, life, renters, homeowners, and business insurance companies

• Title insurers and fraternal benefit societies

• Insurance agents, brokers, and adjusters

By filing a complaint, you may be able to resolve the issue without going to court. DFS will review your case, investigate the company’s response, and in some cases, help get your issue resolved.

1. Gather Relevant Information

Make sure you have the following details ready:

• Your insurance policy number.

• Claim number (if applicable).

• Name and contact information of the insurance company and agent/broker.

• A clear description of the issue.

• Supporting documents, such as correspondence, invoices, or denial letters.

2. File Your Complaint Online

• Go to the DFS Consumer Complaint Portal

• Click on "DFS Portal" and select "File a Complaint".

• When asked “Which product or service best describes your complaint?,” select “Insurance” from the options.

• Fill out the online form and upload any supporting documents.

• Questions about the Online Consumer Complaint Process?

DFS strongly encourages consumers to submit complaints online through the DFS Consumer Complaint Portal to avoid any delays, however, they do accept mailed complaints as well. You can find the Consumer Complaint paper form here.

Mailing Address:
Department of Financial Services
Consumer Assistance Unit

1 State Street
New York, NY 10004

3. Call DFS for Assistance

If you need help or have questions, you can call the DFS Consumer Hotline:

• Phone: Call DFS at (800) 342-3736 or send an email.

• They can guide you through the complaint process.

4. Follow Up on Your Complaint

• Once filed, you’ll receive an acknowledgment with a case number.

• You can track the status of your complaint online or by calling the hotline.

DFS will investigate the issue and attempt to resolve it with the insurance company. 

After filing an insurance complaint with the New York State Department of Financial Services (DFS), the process generally unfolds as follows:

1. Complaint Acknowledgment

• DFS Response: DFS will send you an acknowledgment letter or email confirming that they’ve received your complaint.

• Case Number: You’ll be assigned a case number to track your complaint.

• DFS will send you a confirmation letter or email with your case number.

2. Insurer's Response and Complaint Review

• Initial Review: DFS reviews the details of your complaint and the supporting documents you submitted.

• Contact with the Insurer: They will send a copy of your complaint to the insurance company and request a response from them. 

• Timeframe depends on:

  • The complexity of the complaint.

  • The responsiveness of the insurance company.

  • Whether DFS requires additional documentation or investigation.

3. Additional Investigation and Possible Mediation

• Investigation: If necessary, DFS may conduct a deeper investigation into the matter, especially if the insurer’s actions appear to violate New York insurance laws or regulations.

• Mediation: DFS may act as an intermediary between you and the insurance company to try to resolve the issue.

4. Resolution

• Outcome Notification: DFS will notify you of the outcome of the investigation. This could include: A resolution in your favor (e.g., the company agreeing to pay the claim or correct an issue) or an explanation of why the insurer's actions comply with the law, even if you disagree.

5. Additional Steps if Unresolved

• Appeal Options: If the resolution isn’t satisfactory, DFS may advise you on additional steps, such as:

  • Requesting a review of the decision.

  • Filing a lawsuit or seeking arbitration if the matter involves contractual disputes.

• Legal Action: If DFS finds evidence of legal violations, it may take enforcement actions against the insurer, such as fines or penalties.

Tips for Follow-Up

• Track Your Complaint: Use the case number to check the status of your complaint by calling DFS or visiting their online portal.

• Stay Informed: Keep copies of all communications, as they may be useful if further action is needed.

Factors That Can Affect the Timeline

1. Complexity of the Complaint: Claims disputes involving multiple parties or technical issues may take longer.

2. Response Time from the Insurer: Delays in the insurer providing information to DFS can slow the process.

3. Additional Documentation Needed: If DFS requests more information from you, the resolution may be delayed until it’s provided.

How to Follow Up with DFS

Use your case number to check the status of your complaint:

• Call the DFS Consumer Hotline: (800) 342-3736.

• Visit the DFS Online Portal.

Past Experience Filing a Complaint with DFS

Here are a few insights from individuals who have filed complaints with DFS:

• Positive Outcomes: While we didn’t find any Redditors with positive outcomes after filing a complaint with DFS, we did find a Redditor who had success after filing a complaint against their insurance company with the New York Attorney General. They reported that after filing a complaint with the New York Attorney General's office, they received helpful assistance, including coordinated communication with all parties involved.

• Unknown Outcome: Another person also on Reddit filed a renter's insurance complaint with DFS due to difficulties with their insurance provider over a payout. While they took this step, the outcome of their complaint wasn't detailed.

General Advice:

• It's noted that filing a complaint can be worthwhile, especially if there's a systemic issue. DFS may broaden its investigation if multiple complaints reveal a pattern of wrongdoing by an insurance company.

• The NYDFS tracks consumer complaints and publishes reports. (In 2024, they received 36,805 insurance complaints, closed 32,724 insurance complaints, and recovered over $139 million on behalf of consumers and providers. Source)

• If you believe your complaint is part of a larger issue, call (800) 342-3736 or email [email protected] to inquire if an investigation is ongoing.

• DFS publishes annual consumer complaint rankings of insurers, for auto and health insurance, which can provide insight into how companies are performing in terms of consumer satisfaction and complaint resolution.

• While individual experiences vary, filing a complaint with DFS can potentially lead to resolutions and also helps regulators monitor and address broader issues within the insurance industry.

If sending a demand letter and filing a complaint with DFS did not get you the results you wanted, then your next step may be filing a claim in New York Small Claims Court. Suing an insurance company is a very common type of small claims lawsuit. Make sure to review your insurance policy for any requirements prior to filing a lawsuit.

New York Small claims courts were created to help everyday people resolve their legal disputes with other individuals or businesses affordably and efficiently.