Attorney's Fees & Interest

If a valid claim or portion was overdue, the claimant recovers a reasonable attorney's fee, subject to the superintendent's limits (Insurance Law § 5106(a)). For most disputes the fee is 20 percent of the benefits and interest awarded, per applicant per proceeding, up to $1,360 (11 NYCRR 65-4.6(d)); for policy-issue disputes, up to $70 per hour, maximum $1,400, plus up to $80 per hour for each appearance (11 NYCRR 65-4.6(c)); no fee if the claim was not denied or overdue when filed (11 NYCRR 65-4.6(a)). The fee is computed per insured, not per bill (LMK Psychological Servs., P.C. v State Farm Mut. Auto. Ins. Co., 12 NY3d 217 (2009)).

Usually not from the other side. Under New York's general rule, attorney's fees are incidents of litigation, and a prevailing party may not collect them from the loser unless an award is authorized by agreement, statute or court rule (Hooper Assoc. v AGS Computers, 74 NY2d 487 (1989)). Personal injury plaintiffs pay their own lawyer, ordinarily by a contingency percentage of the recovery set in a written retainer, and the fee comes out of the settlement or judgment. No-fault is an exception: an overdue claim carries a capped attorney's fee paid by the insurer (Insurance Law § 5106(a); 11 NYCRR 65-4.6). Ask what percentage applies and what expenses are deducted.

The fee schedule is 11 NYCRR 65-4.6, issued under Insurance Law § 5106(a). If the claim is resolved by the designated organization before an arbitrator is assigned and it was denied or overdue, the fee is 20 percent of the benefits and interest, up to $1,360 (11 NYCRR 65-4.6(b)). In arbitration or court the same 20 percent and $1,360 cap apply per applicant per proceeding (11 NYCRR 65-4.6(d)); policy-issue disputes are paid at up to $70 per hour, maximum $1,400, plus up to $80 per hour for each appearance (11 NYCRR 65-4.6(c)). An arbitrator or court may exceed the limits for novel or unique issues (11 NYCRR 65-4.6(e)).