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Understanding Claim for Reimbursement

Author : Donghoo Sohn, Esq.



A claim for reimbursement is a formal request to recover funds that have been paid out on behalf of another party or for expenses incurred that should be covered by insurance, an employer, or a responsible third party. In New York, individuals and businesses frequently file claims for reimbursement in various contexts, including workers' compensation cases, family law matters, and financial disputes. Understanding the legal framework governing these claims is essential to ensure you receive the compensation you are entitled to under state law.

Contents


1. Claim for Reimbursement in New York : Legal Foundations and Requirements


New York law provides specific protections and procedures for filing a claim for reimbursement, particularly in workers' compensation cases governed by § 237 of the New York Workers' Compensation Law. When an employee has received benefits for an existing disability or family leave, and those benefits should have been covered by the insurance carrier, a claim for reimbursement must be filed with the carrier before the benefits are paid. This ensures that funds are properly allocated and that individuals are not double-compensated for the same injury or leave period.



Filing Requirements and Timelines


To successfully pursue a claim for reimbursement in New York, you must understand the strict filing requirements and timelines established by state law. The claim must be submitted to the insurance carrier prior to payment of the benefits to ensure eligibility for reimbursement. Failure to file within the appropriate timeframe may result in forfeiture of your right to recover funds. Additionally, you must provide clear documentation demonstrating that the expenses or benefits were incurred on your behalf and that you are entitled to reimbursement under applicable law.



Documentation and Evidence


Supporting documentation is critical when filing a claim for reimbursement. You should gather receipts, invoices, benefit statements, and any correspondence with the insurance carrier or responsible party. This evidence must clearly establish the amount owed and the reason for the reimbursement request. In workers' compensation cases, medical records and wage statements may be necessary to support your claim.



2. Claim for Reimbursement in New York : Workers' Compensation Applications


Workers' compensation law in New York frequently involves claims for reimbursement when employees have received benefits that should have been paid by the insurance carrier. Under § 237 of the New York Workers' Compensation Law, an employee who has been reimbursed for an existing disability or family leave may seek reimbursement from the carrier if a claim is filed before the carrier makes payment. This provision protects workers from being required to repay benefits they legitimately received.



Eligibility and Covered Benefits


Not all benefits are eligible for reimbursement under workers' compensation law. Typically, reimbursement applies to disability benefits and family leave payments that were paid due to a work-related injury or condition. To qualify, you must demonstrate that the benefits were paid in error or that the insurance carrier was responsible for payment. Bankruptcy for tax relief may be relevant in cases where significant financial obligations arise from disputes over benefit payments.



3. Claim for Reimbursement in New York : Family Law and Spousal Support


In family law matters, claims for reimbursement often arise in connection with spousal support, child support, and property division. One spouse may seek reimbursement for expenses paid on behalf of the other spouse or for contributions made during the marriage. Alimony claims frequently include requests for reimbursement of past support obligations or contributions made by one party. New York courts have the authority to order reimbursement as part of a divorce settlement or support order.



Types of Reimbursable Expenses in Family Law


Family law reimbursement claims may cover various expenses, including medical costs, educational expenses, mortgage payments, and other financial obligations paid during the marriage. Courts consider the financial circumstances of both parties and the fairness of the reimbursement request when making decisions. The following table outlines common types of reimbursable expenses in New York family law cases:

Expense CategoryDescriptionReimbursement Eligibility
Medical ExpensesHealthcare costs paid by one spouse for family membersGenerally reimbursable if documented
Educational CostsTuition and school expenses for children or spouseOften reimbursable in property division
Mortgage PaymentsHome payments made during separation or divorceReimbursable under certain circumstances
Debt PaymentsCredit card or loan payments made for family benefitReimbursable if incurred for marital purposes


4. Claim for Reimbursement in New York : Procedural Steps and Legal Remedies


Filing a claim for reimbursement in New York involves several procedural steps that must be followed carefully to protect your rights. First, you must identify the responsible party, whether an insurance carrier, employer, or other entity. Second, you must gather all supporting documentation and prepare a detailed claim letter outlining the amount owed and the basis for your claim. Third, you should submit the claim through the appropriate channels and maintain records of all correspondence. If the claim is denied or disputed, you may pursue legal remedies through the courts or administrative agencies.



Dispute Resolution and Legal Action


When a claim for reimbursement is denied or partially paid, you have several options for pursuing your claim. You may file a complaint with the New York Department of Financial Services if the issue involves an insurance carrier, or you may pursue a civil lawsuit in the appropriate court. Consulting with an attorney experienced in reimbursement claims can help you understand your options and determine the most effective strategy for recovering the funds owed to you. Many claims are resolved through negotiation and settlement before litigation becomes necessary.


04 Feb, 2026


The information provided in this article is for general informational purposes only and does not constitute legal advice. Reading or relying on the contents of this article does not create an attorney-client relationship with our firm. For advice regarding your specific situation, please consult a qualified attorney licensed in your jurisdiction.
Certain informational content on this website may utilize technology-assisted drafting tools and is subject to attorney review.

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