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Understanding Public Health Law Bad Faith Claims in New York: Your Right to Sue Insurance Companies
No-Fault

Understanding Public Health Law Bad Faith Claims in New York: Your Right to Sue Insurance Companies

By Jason Tenenbaum 8 min read

Key Takeaway

Learn about Public Health Law bad faith insurance claims in New York. Expert legal guidance. Call 516-750-0595 for consultation.

This article is part of our ongoing no-fault coverage, with 271 published articles analyzing no-fault issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.

When insurance companies fail to handle claims properly under New York’s Public Health Law, injured parties may have additional recourse beyond traditional coverage disputes. Understanding your rights under PHL bad faith provisions can provide crucial leverage in securing fair treatment from insurance carriers and obtaining proper compensation for your injuries. If you’re dealing with a no-fault insurance defense matter, an experienced attorney can help protect your rights.

What is Public Health Law Bad Faith?

Public Health Law bad faith occurs when insurance companies fail to meet their obligations under New York’s comprehensive insurance regulatory framework. Unlike general bad faith claims, PHL bad faith specifically addresses insurance practices that violate statutory requirements designed to protect consumers and ensure fair claims handling.

Key Elements of PHL Bad Faith Claims

Successful PHL bad faith claims typically require demonstrating:

  • Statutory Violation: The insurance company violated specific Public Health Law requirements
  • Unreasonable Conduct: The insurer’s actions fell below acceptable industry standards
  • Damages: The violation resulted in actual harm beyond the underlying claim
  • Causal Connection: The insurer’s conduct directly caused the additional damages

Common PHL Bad Faith Scenarios

PHL bad faith claims frequently arise in several contexts:

Delayed Claims Processing

When insurers unreasonably delay processing legitimate claims, causing additional harm to claimants who need immediate medical care or financial support.

Inadequate Investigation

Failure to conduct thorough, fair investigations of claims, leading to wrongful denials or inadequate settlements.

Misrepresentation of Coverage

Providing false or misleading information about policy coverage, benefits, or claim procedures.

Failure to Communicate

Not maintaining proper communication with claimants regarding claim status, requirements, or decisions.

Damages Available in PHL Bad Faith Cases

Successful PHL bad faith claims can result in various forms of compensation:

  • Consequential Damages: Additional costs incurred due to improper claims handling
  • Emotional Distress: Compensation for psychological harm caused by insurer misconduct
  • Attorney Fees: Recovery of legal costs in pursuing the bad faith claim
  • Punitive Damages: Additional compensation designed to punish and deter improper conduct

Strategic Considerations

PHL bad faith claims require careful strategic planning and thorough documentation of insurer misconduct. These cases often involve complex legal and factual issues that require experienced representation.

Frequently Asked Questions

How long do I have to file a PHL bad faith claim?

The statute of limitations for PHL bad faith claims depends on specific circumstances, but generally must be filed within six years of the conduct giving rise to the claim.

Can I sue for bad faith if my original claim was denied?

Yes, you may be able to pursue bad faith claims even if your underlying insurance claim was denied, provided the denial was handled improperly under PHL requirements.

What evidence do I need for a PHL bad faith claim?

Evidence typically includes all communications with the insurer, claim files, documentation of delays, and records showing how the insurer’s conduct caused additional harm.

Are PHL bad faith claims worth pursuing?

The value depends on specific circumstances, but successful claims can result in significant additional compensation beyond the original claim value.

PHL bad faith claims involve complex legal standards and require thorough understanding of both insurance law and Public Health Law requirements. Insurance companies have sophisticated legal teams defending these claims, making experienced representation essential for success.

If you believe an insurance company has handled your claim in bad faith under New York’s Public Health Law, don’t let their misconduct go unchallenged. These cases can provide important additional compensation and help ensure fair treatment. Call 516-750-0595 for a free consultation with our experienced insurance bad faith team.

This article is for educational purposes only and does not constitute legal advice. PHL bad faith claims involve complex legal issues that require professional evaluation. Consult with a qualified attorney for advice regarding your specific situation.

Legal Context

Why This Matters for Your Case

New York's no-fault insurance system, established under Insurance Law Article 51, is one of the most complex insurance frameworks in the country. Every motorist must carry Personal Injury Protection coverage that pays medical expenses and lost wages regardless of fault, up to $50,000 per person.

But insurers routinely deny valid claims using peer reviews, EUO scheduling tactics, fee schedule reductions, and coverage defenses. The Law Office of Jason Tenenbaum has handled over 100,000 no-fault cases since 2002 — from initial claim submissions through arbitration before the American Arbitration Association, trials in Civil Court and Supreme Court, and appeals to the Appellate Term and Appellate Division. Jason Tenenbaum is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.

His 2,353+ published legal articles on no-fault practice are cited by attorneys throughout New York. Whether you are dealing with a medical necessity denial, an EUO no-show defense, a fee schedule dispute, or a coverage question, this article provides the kind of detailed case-law analysis that helps practitioners and claimants understand exactly where the law stands.

About This Topic

New York No-Fault Insurance Law

New York's no-fault insurance system requires every driver to carry Personal Injury Protection (PIP) coverage that pays medical expenses and lost wages regardless of who caused the accident. But insurers routinely deny, delay, and underpay valid claims — using peer reviews, IME no-shows, and fee schedule defenses to avoid paying providers and injured claimants. Attorney Jason Tenenbaum has litigated thousands of no-fault arbitrations and court cases since 2002.

271 published articles in No-Fault

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Attorney Jason Tenenbaum

About the Author

Jason Tenenbaum, Esq.

Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.

Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.

24+ years in practice 1,000+ appeals written 100K+ no-fault cases $100M+ recovered

Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.

New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.

If you need legal help with a no-fault matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.

Filed under: No-Fault
Jason Tenenbaum, Personal Injury Attorney serving Long Island, Nassau County and Suffolk County

About the Author

Jason Tenenbaum

Jason Tenenbaum is a personal injury attorney serving Long Island, Nassau & Suffolk Counties, and New York City. Admitted to practice in NY, NJ, FL, TX, GA, MI, and Federal courts, Jason is one of the few attorneys who writes his own appeals and tries his own cases. Since 2002, he has authored over 2,353 articles on no-fault insurance law, personal injury, and employment law — a resource other attorneys rely on to stay current on New York appellate decisions.

Education
Syracuse University College of Law
Experience
24+ Years
Articles
2,353+ Published
Licensed In
7 States + Federal

Discussion

Comments (3)

Archived from the original blog discussion.

D
DMG
It is scheduled to be argued on October 16, 2019. http://www.nycourts.gov/ctapps/calendar/2019/Daily/CAL101619.pdf
NM
Not My department
The First Department case doesn’t seem that great. As the Second Circuit noted “The First Department, with no further analysis, remarked that N.Y. Pub. Health [918 F.3d 235] Law § 230(11)(b) also created a private right of action “[f]or similar reasons,” noting that Section 230(11)(b) “immunizes from suit insurers and others who make good faith reports to” the OPMC.” That no further analysis part is questionable. More to the point, the purpose rule of statutory construction further results in a finding that, since the statute’s purpose was to further reporting, reading the creation of an inverse cause of action into it (which is the issue here), is antithetical. Given the statutory language, I’d argue that it absolutely does not create any private right to sue for alleged bad faith. Any such right would have to derive from common law, with the additional loophole that provenance of good faith is an absolute bar to recovery.
KL
Kurt Lundgren
I don’t see the private right of action either. It isn’t even implied in statute. Haar should have tried GBL 349 and conbined it with the public health law to get a valid cause of action. There is precedent for that. .

Legal Resources

Understanding New York No-Fault Law

New York has a unique legal landscape that affects how no-fault cases are litigated and resolved. The state's court system includes the Civil Court (for claims up to $25,000), the Supreme Court (the primary trial court for unlimited jurisdiction), the Appellate Term (which hears appeals from lower courts), the Appellate Division (divided into four Departments, with the Second Department covering Long Island, Brooklyn, Queens, Staten Island, and several upstate counties), and the Court of Appeals (the state's highest court). Each court has its own procedural requirements, local rules, and case-assignment practices that can significantly impact the outcome of your case.

For no-fault matters on Long Island, cases are typically filed in Nassau County Supreme Court (at the courthouse in Mineola) or Suffolk County Supreme Court (in Riverhead). No-fault arbitrations are heard through the American Arbitration Association, which assigns arbitrators throughout the metropolitan area. Workers' compensation claims go to the Workers' Compensation Board, with hearings at district offices across the state. Understanding which forum is appropriate for your case — and the specific procedural rules that apply — is essential for a successful outcome.

The procedural landscape in New York also includes important timing requirements that can affect your case. Most civil actions are subject to statutes of limitations ranging from one year (for intentional torts and claims against municipalities) to six years (for contract actions). Personal injury cases generally have a three-year deadline under CPLR 214(5), while medical malpractice claims must be filed within two and a half years under CPLR 214-a. No-fault insurance claims have their own regulatory deadlines, including 30-day filing requirements for applications and 45-day deadlines for provider claims. Understanding and complying with these deadlines is critical — missing a filing deadline can permanently bar your claim, regardless of how strong your case may be on the merits.

Attorney Jason Tenenbaum regularly practices in all of these venues. His office at 326 Walt Whitman Road, Suite C, Huntington Station, NY 11746, is centrally located on Long Island, providing convenient access to courts and offices throughout Nassau County, Suffolk County, and New York City. Whether you need representation in a no-fault arbitration, a personal injury trial, an employment discrimination hearing, or an appeal to the Appellate Division, the Law Office of Jason Tenenbaum, P.C. brings $24+ years of real courtroom experience to your case. If you have questions about the legal issues discussed in this article, call (516) 750-0595 for a free, no-obligation consultation.

New York's substantive law also presents distinct challenges. In motor vehicle cases, the no-fault system under Insurance Law Article 51 provides first-party benefits regardless of fault, but limits the right to sue for non-economic damages unless the plaintiff establishes a "serious injury" under one of nine statutory categories. This threshold — codified at Insurance Law Section 5102(d) — requires medical evidence showing more than a minor or subjective injury, and courts have developed detailed standards for each category. Fractures must be documented through imaging studies. Claims of permanent consequential limitation or significant limitation of use require quantified range-of-motion testing with comparison to norms. The 90/180-day category demands proof that the plaintiff was unable to perform substantially all of their usual daily activities for at least 90 of the 180 days following the accident.

In employment discrimination cases, the legal standards vary depending on whether the claim arises under state or local law. The New York State Human Rights Law employs a burden-shifting framework: the plaintiff must first establish a prima facie case by showing membership in a protected class, qualification for the position, an adverse employment action, and circumstances giving rise to an inference of discrimination. The burden then shifts to the employer to articulate a legitimate, non-discriminatory reason for its decision. If the employer meets this burden, the plaintiff must demonstrate that the stated reason is pretextual. The New York City Human Rights Law, by contrast, applies a broader standard, asking whether the plaintiff was treated less well than other employees because of a protected characteristic.

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