20 Best Health Insurance Lawyers in New York (2025 Guide)

Finding the right health insurance lawyer in New York can make all the difference when fighting a denied claim. In this comprehensive guide, we explain why legal help is often essential for insurance disputes, outline what these attorneys do, and list the top 20 insurance lawyers and law firms serving New York clients. We cover specialists in health insurance claims, car accident coverage, malpractice insurance, life insurance disputes, fraud cases, and general insurance disputes. By the end, you’ll understand how to choose the best attorney for your insurance issue and have real examples of highly rated New York lawyers. We also include key statistics and expert insights on insurance claim denials and appeals.

Why You May Need a Health Insurance Lawyer

Health insurance claims often involve complex policy language and strict deadlines. A claim denial can be devastating – whether it’s a life-saving treatment refused or a huge hospital bill left unpaid. Attorneys note that insurers must provide a written explanation for denials. Common denial reasons include missing pre-authorization, clerical errors, filing too late, out-of-network providers, or treatments deemed “experimental”. When facing such denials, policyholders have the right to appeal through internal and external reviews. A specialized lawyer guides you through these steps. As one attorney explains, “A health insurance benefits lawyer’s job is to get your claim paid by proving that your health insurer wrongfully denied your claim”. They increase your chances of success by ensuring all rules and deadlines are followed by health insurance lawyer.

Many Americans experience claim problems: a recent survey found 58% of insured adults reported issues with their coverage, including denied claims. In 2023, marketplace health plans denied about 19% of in-network claims nationwide. These high denial rates underscore the need for legal help. Lawyers have the expertise to interpret policies and challenge unfair practices. For example, New York ERISA appeals specialist Mark P. Scherzer notes that plan participants often need to exhaust appeals before suing, and a lawyer can navigate these rules. If insurers fail to handle claims fairly or promptly, policyholders can sometimes sue for breach of contract or bad faith. As one source advises: “If you believe your insurance provider has not upheld its duties or acted in good faith, you need to call an attorney”. In short, an attorney can relieve stress by handling complex paperwork, gathering medical evidence, and negotiating with insurers health insurance lawyer.

Common Health Insurance Claim Issues

Insurance claims can fail for many reasons. Understanding these issues can help you avoid problems or prepare a strong appeal. Common obstacles include:

• Claim Denials: Denials happen for reasons such as lack of medical necessity, missing documentation, or services not covered by the policy. (For example, failing to obtain pre-certification for a planned procedure often triggers a denial.)
• Coverage Disputes: Disagreements on whether a treatment or service is covered (e.g., experimental therapies or specific procedures) often require legal analysis of the policy health insurance lawyer.
• Administrative Errors: Simple mistakes like clerical errors on claim forms can lead to denials.
• Deadlines Missed: Filing a claim or appeal late can forfeit your rights. New York plans have strict deadlines; missing them may block your case.
• Out-of-Network Providers: Using a provider outside your network often means the insurer can refuse to pay.
• Benefit Limits: Policies may cap the number of visits or services (e.g., therapy sessions). Once limits are hit, insurers can deny further claims.
• Fraud Allegations: Insurers sometimes deny claims by alleging fraud or misrepresentation. Handling such accusations typically requires a skilled insurance fraud lawyer or a lawyer for insurance claim disputes health insurance lawyer.

Each of these issues can be challenged. Health insurance lawyers review the denial reason, verify policy terms, gather evidence, and appeal the decision. The appeals process itself has two levels: internal appeal within the insurer and, if that fails, an independent external review. Attorneys ensure appeals are filed correctly and on time, often finding grounds (like missing paperwork or scope of policy) to overturn denials.

Figure: A judge’s gavel and law books symbolize health insurance claim disputes and legal advocacy.

The Role of an Insurance Lawyer in Claim Disputes

Insurance lawyers specialize in protecting policyholders’ rights. When a claim is denied or underpaid, these attorneys take on the insurer on your behalf. Here’s what they do:

• Interpret Policy Language: Insurance policies are notoriously complex. A lawyer translates the terms, coverage limits, and exclusions of your health insurance policy or other insurance contract. They look for legal obligations your insurer must fulfill.
• File Appeals: They handle internal and external appeals. Lawyers know how to present medical records and expert opinions to strengthen your case. They “submit appeals to comply with insurer requirements, increasing the likelihood of a favorable outcome”.
• Negotiate with Insurers: Many claims can be settled without court. Attorneys negotiate with claims adjusters or attorneys to secure fair payments based on the damages and policy terms health insurance lawyer.
• Litigate if Needed: If appeals fail, lawyers can sue. They may file ERISA lawsuits (for employer plans) or state court claims (e.g., bad faith) against insurers that wrongfully denied coverage.
• Provide Specialized Expertise: Different lawyers handle different cases. For example, a car accident insurance lawyer assists with auto insurance claims; a lawyer for insurance claims auto deals with accident benefits. Doctors may hire a lawyer malpractice insurance to resolve disputes with their malpractice insurer. Life insurance disputes require a life insurance lawyer skilled in death-benefit claims. An insurance fraud lawyer might defend or prosecute cases involving fraudulent claims. A general insurance dispute lawyer can handle any complex claims issue.

Simply put, a competent insurance attorney “works with healthcare providers to obtain documentation and expert opinions” and can escalate cases through litigation if necessary. They are especially valuable for chronic or catastrophic cases (like long-term care) where delays or coverage denials can be life-altering health insurance lawyer.

How to Choose the Right Insurance Attorney

Not all lawyers are equal. Here are key factors when selecting a health insurance lawyer or related specialist in New York:

• Relevant Experience: Ensure the attorney has handled cases like yours. For a medical bill dispute, a lawyer with health insurance and ERISA experience is best. For auto claims, look for a car accident insurance lawyer with auto policy know-how.
• Specialization: Some firms focus on insurance disputes. For example, Kantor & Kantor, LLP specializes in life and health insurance claims. Schwartz Law Firm handles insurance bad-faith and denied claims. Check their practice areas.
• Track Record: Look for success stories or verdicts. Super Lawyers, for instance, vets top attorneys; their list for New York includes Jonathan Wilkofsky, Stefan Kalina, Kenneth Bloom, Howard Shafer, and others rated for insurance coverage litigation. Attorneys with a Super Lawyers badge have typically won high peer recognition.
• Reputation: Client testimonials and peer reviews (like Avvo or Lawyers.com) can give insight. Firms like Kantor & Kantor and Jonathan M. Cooper’s office have positive reviews for resolving tough insurance cases.
• Accessibility and Fees: Many firms offer free initial consultations. Understand their fee structure – many work on contingency (they get paid only if you win) or hourly depending on case type health insurance lawyer.

Important: New York law may impose deadlines on lawsuits (often 2 years from denial) for breach of contract or bad faith. Acting quickly by contacting an attorney as soon as your internal appeals are exhausted is critical health insurance lawyer.

Top 20 Insurance and Health Insurance Lawyers in New York

Below are 20 highly regarded law firms and attorneys in New York who handle insurance disputes. They have expertise in various specialties (health, auto, life, malpractice, fraud, etc.) and have earned strong reputations. (In some cases, firm names are listed to protect individual attorneys’ privacy.)

1. Kantor & Kantor, LLP (New York, NY): Specializes in life and health insurance claims. Known for successfully representing clients against insurance companies.
2. Law Offices of Jonathan M. Cooper (Kew Gardens, NY): Handles life insurance, business litigation, and contract disputes. Praised for dedication to clients and insurance case expertise.
3. The Law Offices of David S. Rich, LLC (New York, NY): Focuses on employment and insurance law, with years of experience in life and health insurance disputes.
4. Greenberg & Stein, P.C. (New York, NY): Primarily personal injury attorneys, they also handle numerous life/health insurance claims and coverage issues health insurance lawyer.
5. Schwartz Law Firm (New York, NY): Concentrates on insurance bad faith and denied claims. They have a strong track record in representing policyholders in disputes health insurance lawyer.
6. Wilkofsky Friedman (New York, NY): Jonathan Wilkofsky is a Super Lawyers-rated insurance coverage attorney in NYC, helping clients with disaster and casualty insurance claims.
7. Cox Padmore Skolnik & Shakarchy LLP (New York, NY): Stefan Kalina, listed as a top insurance coverage lawyer, helps corporations and individuals with a wide variety of insurance disputes.
8. Gartner + Bloom P.C. (New York, NY): Kenneth A. Bloom, an experienced insurance coverage attorney in NY.
9. Shafer Partners, LLP (New York, NY): Howard S. Shafer, rated for insurance coverage, assists New Yorkers with their insurance needs.
10. Houser LLP (New York, NY): Jordan W. Schur focuses on insurance coverage issues and has been selected as a top-rated insurance lawyer.
11. Susman Godfrey LLP (New York, NY): Steven M. Shepard is an insurance litigation specialist serving New York area clients.
12. Melito & Adolfsen P.C. (New York, NY): Louis G. Adolfsen, with decades of insurance coverage practice in NY.
13. Zetlin & De Chiara LLP (New York, NY): James H. Rowland, experienced insurance attorney assisting clients in NY insurance disputes.
14. Lowenstein Sandler LLP (New York, NY): Jeremy M. King, top-rated insurance coverage lawyer in NY.
15. Rosenberg & Estis, P.C. (New York, NY): Michael E. Lefkowitz, insurance coverage expert.
16. Simon•Lesser PC (New York, NY): Renee Simon Lesser, specializes in insurance litigation health insurance lawyer.
17. Simmons Hanly Conroy (New York, NY): Daniel P. Blouin, known for helping clients with insurance coverage issues.
18. Law Offices of Michael E. Pressman (New York, NY): Michael E. Pressman, experienced in insurance coverage representation.
19. Dupée & Monroe (New York, NY): Specialists in insurance disputes and bad faith claims.
20. Richman Law Firm, PLLC (New York, NY): Insurance dispute attorneys noted for handling underpayments and denials in New York insurance claims.

These firms and attorneys have built reputations on insurance law. Some focus on health insurance appeals, others on auto claims or malpractice insurance, and many handle all types of insurance disputes. When choosing among them, consider their specialty, location, and client reviews. Super Lawyers’ patented process only selects the top 5% of attorneys each year, which is a useful credential.

Insurance Lawyer Specialties

Insurance law has many subfields. Your specific issue often determines the type of lawyer to hire:

• Health Insurance Lawyer: Handles denials of medical care claims, appeals under health plans (including ERISA plans), and disputes over coverage of treatments health insurance lawyer.
• Car Accident/Auto Insurance Lawyer: Focuses on claims arising from auto accidents. They ensure both medical and vehicle damage claims are paid. These attorneys negotiate with auto insurers or file lawsuits if claims are unfairly denied.
• Life Insurance Lawyer: Deals with death-benefit claims. Common issues include beneficiary disputes and claim denials for alleged misrepresentations. (See Top 5 life insurance lawyers listed above.)
• Malpractice Insurance Lawyer: For medical professionals facing issues with their malpractice insurance (e.g., denied indemnification or coverage disputes). They understand both tort law and insurance policy nuances health insurance lawyer.
• Insurance Fraud Lawyer: Handles cases of insurance fraud – either defending clients accused of fraud or prosecuting those who defraud insurers. Insurance fraud attorneys may work closely with criminal defense or white-collar teams.
• Insurance Dispute Lawyer: A generalist insurance attorney who can handle various disputes, from property and casualty to liability claims. They often litigate against big insurance companies over wrongful denials health insurance lawyer.

Steps to Appealing a Denied Claim

If you have a denied claim, act quickly. Generally:

1. Internal Appeal: File a written appeal to the insurance company, following their required form and timeline. Gather supporting evidence (doctor’s notes, medical records, billing codes).
2. External Review: If the insurer upholds denial, request an independent external review by your state’s health care appeals board or review organization. Certain state and federal rules allow for this step.
3. Hire an Attorney: Even before suing, you can involve a lawyer at any stage. An attorney will ensure your appeal is thorough. “If this process seems intimidating, you can hire a lawyer to help you get the job done”.
4. Litigation: If appeals fail, the lawyer may file a lawsuit. For employer-sponsored plans, this is often under ERISA. Otherwise, a state court case or bad faith claim could be possible. Lawyers can challenge unfair delays or denials, and seek damages or full payment.

Remember, statutes of limitations apply. In New York, you often have just two years from the denial date to sue an insurer. An attorney will ensure you do not miss this deadline health insurance lawyer.

How to Find a Qualified Lawyer

Here are tips for finding the right attorney:

• Consult Legal Directories: Use sites like SuperLawyers, Avvo, or Lawyers.com for top-rated New York insurance attorneys.
• Ask About Fees: Many insurance lawyers work on contingency for denials (no upfront fee; they take a percentage of recovery). Confirm this before hiring health insurance lawyer.
• Meet Multiple Attorneys: Interview a few lawyers or firms, ask about their experience with similar cases, success rate, and approach.
• Check State Bar: Verify the attorney’s license and disciplinary history at the New York State Bar website.

Choosing the right health insurance lawyer or insurance dispute lawyer means finding someone knowledgeable about both insurance law and your specific policy type. A good match will maximize your chances of a favorable outcome.

FAQs

Q: When should I hire a health insurance lawyer?
A: You should consider hiring a lawyer as soon as your claim is denied and appeals have failed or look difficult. If you have serious medical bills or urgent care needs and an insurer refuses to pay, a lawyer can step in at any stage, even during the internal appeals process. Also consult an attorney if you suspect bad faith, fraud, or if your appeal deadline is approaching, to ensure compliance with all requirements health insurance lawyer.

Q: How does a lawyer help with auto insurance claims?
A: A car accident insurance lawyer helps by handling the paperwork and negotiations with the auto insurer. They gather evidence (police reports, medical records), challenge unfair lowball offers, and can sue for damages if needed. Their specialized knowledge of auto insurance law and personal injury damages means clients usually get more compensation than they would alone.

Q: What does a life insurance lawyer do?
A: A life insurance lawyer assists beneficiaries who have a claim denied or disputed after an insured’s death. They handle issues like contestability (the insurer’s right to investigate the claim period) and beneficiary disputes. They know how to read life insurance contracts and can sue for the death benefit if the insurer wrongfully refuses to pay.

Q: How much will hiring an insurance claims lawyer cost?
A: Many insurance lawyers work on a contingency fee basis, meaning they only get paid if you win. They typically take a percentage of the recovery. Others may charge hourly rates. Be sure to discuss fees upfront. Also inquire if the lawyer offers a free initial consultation to evaluate your case, which many do health insurance lawyer.

Q: What should I look for in an insurance dispute lawyer?
A: Look for experience with your type of claim and success in that field. Check qualifications (board certifications, peer reviews, awards like Super Lawyers) and client testimonials. Good communication is key: your lawyer should explain policy language clearly. As one article notes, expertise in appeals and familiarity with regulations (like ERISA for health plans) is very important.

By following these guidelines and working with a top-rated lawyer, you can significantly improve the outcome of your insurance claim. If you’re facing a denied health care claim, car accident coverage issue, life insurance dispute, or any complex insurance problem, consulting an experienced health insurance lawyer or relevant specialist in New York is often the most effective step. Don’t navigate the appeals process alone – get legal help and secure the coverage you deserve health insurance lawyer.

Sources: Advice and data in this article are drawn from legal experts and industry research.