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Elements of a Bad Faith Insurance Claim

Feb 21, 2019

Insurance companies are well-known for using technicalities in assessing all claims. Their primary obligation is to make sure they make the most money. Their clients and best interests of claimants come after this.

There is a specific protocol that insurance companies must follow when evaluating validity for a claim, and most adhere to the requirements for the most part. However, they also set company policy in a manner that they can use to their advantage to deny insurance claims or use bad faith tactics in approving or denying a claim.

It is the responsibility of a plaintiff's legal counsel to prove the insurance provider acted in bad faith during the claim deliberation, and actually must know they were violating laws establishing bad faith actions during the process. Experienced attorneys understand this advantage that insurance companies hold, and it always takes experienced legal representation to win a bad faith claim.

Investigating the Claim

All insurance companies are legally required to investigate claims of responsibility for the covered individual. The problem is that they can also conduct unreasonable investigations and use trivial and even invalid reasons to deny a claim.

While they may actually be looking for evidence that makes the company liable for benefit payment, they also commonly look for issues that can be used against the claimant. The extent of injury to the claimant is not necessarily the primary concern for the adjuster.

Even when claims are obviously valid, the adjuster understands that any comparative negligence assessment to the claimant can result in a lower settlement. In addition, there must be evidence of intentionally mishandling the case in a premeditated fashion or purposely delaying a claim for bad faith to exist.

Unreasonable Claim Denials

Insurance companies deny claims on a regular basis, but they cannot deny benefits based on frivolous defenses. They can, however, use certain facts to apply in a claim settlement negotiation. Insurance providers typically do not want to take a case to court, but they will do so if they think they have a solid defense for dismissal or significant value reduction. The common scenario is a settlement to avoid revealing company tactics that could be considered bad faith, but it is relatively easy for the company to establish evaluation policy that is borderline bad faith without significantly crossing the legal line.

Intentional Claim Payment Delays

The additional element of bad faith tactics by insurance companies is purposely delaying a claim with a low-ball offer being previously submitted. This is effectively a "take it or leave it" position by the insurance provider and can be bad faith is some situations.

The question is the reasoning supporting the low offer. This failure to act in good faith can also be used as a method of holding out on paying the claim in hopes the claimant is in dire straits financially and will accept the claim.

All attorneys understand this borderline negotiation move by insurance claims agents, and lawyers can often use the information supplied during a claim settlement discussion to establish possible punitive damages when a case eventually goes to trial.

How The Spence Law Firm Attorneys Can Help

Our attorneys realize bad faith issues are much more common in case settlements than the typical injured party knows, and not all attorneys will be willing to go after the insurance provider for acting in bad faith.

Always make sure to retain aggressive legal counsel for your injury claim with an established track record of taking all necessary steps to secure maximum damages for their clients. The attorneys at The Spence Law Firm are experienced in going head-to-head with insurance companies and are not afraid to step into the legal arena.

If you need help battling an insurance company, don't hesitate to contact our firm. We will fight for you and for what is right.

Contact The Spence Law Firm at (844) 447-5497 to compassionate and seasoned counsel.

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If you are struggling with a serious injury, or are fighting against seemingly impossible odds against big corporations, insurance companies or the government, call us to speak with our team of trial lawyers who will fight for you. We take no fee unless we earn it by winning your case.