Is Your Denial Bad Faith?

When to Contact a Bad Faith Lawyer

Some states have established laws protecting consumers against bad faith by insurance companies. Bad faith is defined as “the unfair or unreasonable denial or underpayment of legitimate insurance claims.”   Insurance companies who break these laws are engaging in “bad faith” practices.  A policyholder whose claim was handled unfairly (in bad faith) may recover not just the policy benefits in question, but all losses suffered as a result of the bad faith conduct. This includes such things as loss of savings, loss of equity in property, losses caused by resultant bankruptcy or foreclosure or emotional distress and punitive damages.

California, among other states, has established laws protecting consumers against bad faith by insurance companies. Bad faith is defined as the unfair or unreasonable denial or underpayment of legitimate insurance claims.

Insurance companies who break these laws are engaging in “bad faith” practices. A policyholder suing an insurer for bad faith practices may recover not just the policy benefits in question but all losses suffered as a result of the bad faith conduct. This includes such things as loss of savings, loss of equity in property, losses caused by resultant bankruptcy or foreclosure or emotional distress and punitive damages. Although there is no exhaustive list of bad faith conduct, examples include:

• Unreasonable delay in handling a claim;
• Unfair denial of benefits;
• Misrepresenting policy benefits;
• Failure to develop reasonable standards for claims processing;
• Failure to notify the insured of coverage of claims within a reasonable time after filing requirements  have been completed;
• Failing to complete prompt, fair and equitable settlements of claims once liability has become reasonably clear;
• Pushing claimants toward litigation by underpaying benefits which are reasonably similar to those recovered by the insurer;
• Attempting to settle for less than the amount a reasonable person would have believed is owed.
• Promising benefits in promotional literature that are not paid when owed;
• Altering an application without the knowledge of the insured, then attempting to settle a claim based on that application;
• Failing to notify a policyholder, after claims are paid, under which coverage the payment was made;
• Failing to pay benefits under a section of a policy (once liability has become apparent) in order to affect settlements based on other sections of the policy;
• Failing to promptly provide a reasonable explanation of basis of facts or applicable law used in denial of claim or compromise of settlement;
• Directly advising a claimant not to obtain the services of an attorney and
• Misleading a claimant as to applicable statutes of limitations.

Bad Faith Insurance Laws address many potential issues, but they do not outline every scenario. If you have been denied long-term disability benefits, and feel the denial is unfair, contact us before responding to your insurer’s denial. Properly addressing this issue can make a huge difference in your future.