2012 Consumer Guide to Automobile Insurance

If You Have a Complaint or Inquiry

A. Complaints and General Inquiries

The New York State Department of Financial Services licenses insurance companies, brokers, agents, and adjusters to operate in this State. If you feel that one of these licensees has failed to act in accordance with your contract or New York Insurance Law and Regulation, we urge you to contact us in writing, setting forth the nature of your complaint. You may do this by mailing in the Consumer Assistance Unit complaint form found in the back of this Guide. The Department also has a Web site that contains a great deal of information on automobile insurance, in addition to other topics of interest to consumers. Visit the Department’s website at www.dfs.ny.gov, click on the box titled “Consumers” and follow the instructions under the topic “How to File a Complaint or Make an Inquiry Using Our Online Form.” You can then submit your complaint or inquiry electronically or if you prefer, simply download the form, fill it out and mail it to one of the addresses listed below.

Our Financial Fraud & Consumer Protection Division investigates complaints by policyholders and claimants against their insurance companies, brokers, agents or adjusters regarding claims, cancellations, and other issues regarding auto insurance and other types of insurance. You may write or visit the Financial Fraud & Consumer Protection Division at any of the following offices of the New York State Department of Financial Services:

For general information and complaints regarding auto insurance rates, discounts, surcharges, coverage, premium verification, claims (other than No-Fault), cancellations or non-renewals, or if you wish to complain about an insurance broker, agent or adjuster, call our Consumer Assistance Unit:

The Consumer Assistance Unit employs a team of specially trained Agency Services Representatives to answer phone calls about the range of New York insurance issues. They can be reached Monday through Friday, 9:00 a.m. to 5:00 p.m. If they cannot provide you with the necessary information, they will advise you to file a written inquiry or complaint with the Consumer Assistance Unit.

B. No-Fault Issues or Claims, Complaints and Arbitration Requests

For No-Fault issues or claims, call the Department at 212-480-5662.

If you submit a No-Fault claim to an insurance company and the insurer does not respond to your submission within 30 days of their receipt, or if the insurer issues a formal denial of claim form (NF-10) your options are as follows:

• You may file a written complaint with the Consumer Assistance Unit of the Department, or
• You may file for No-Fault arbitration, or
• You may take the insurer to court.

If you choose to file a complaint, you may use the Financial Fraud & Consumer Protection Division complaint form at the back of this Guide. There is no fee required to file a complaint.

C. To file for No-Fault arbitration:

If an insurer issues a denial of claim form (NF-10) applicable to any individual element of a No-Fault claim and you wish to arbitrate the basis of that denial, complete and sign both the affirmation and the grid on the back of the denial, itemize all bills in dispute (including the name of medical provider, amount of bill in dispute, and the date bill was mailed to insurer) and attach copies of all bills listed. If lost wages are also at issue, complete the section of the grid applicable to lost wages. If a medical provider files for arbitration as an assignee of the injured party, that provider should also include a copy of the assignment of benefits form with the injured party's signature.

If you are not in receipt of a denial of claim form, you can file for arbitration by fully completing and submitting an Arbitration Request Form (AAA Form AR) to the American Arbitration Association (AAA). Complete and sign the back of the AAA Form AR as outlined above (for an NF-10), and attach all applicable documentation. An AAA Form AR form is available at the back of this Guide and may also be downloaded from the AAA’s website at www.adr.org.

Whichever method you use to initiate the arbitration process, your filing must also include a $40.00 filing fee made payable to the American Arbitration Association. Mail your completed No-Fault arbitration request to:

American Arbitration Association
New York Insurance Case Management Center
65 Broadway
New York, New York 10006

If you prevail in No-Fault arbitration or settle your dispute during the arbitration process, you should not have any difficulty in collecting from the insurer. You should contact the Claims Administration Unit of the Department in writing or by phone at 212-480-5662 if there is a problem.

Additional information on No-Fault arbitration can be obtained from the American Arbitration Association’s website at www.adr.org or by calling (800) 778-7879.

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