Table Of Contents
- Why Choose Dolman Law Group Accident Injury Lawyers, PA?
- Good Faith Insurance Laws in the U.S.
- How Much Is a Bad Faith Insurance Claim Worth?
- Common Types of Bad Faith Insurance Practices
- Demanding Compensation When Providers Act in Bad Faith
- Frequently Asked Questions About Bad Faith Insurance Claims
- What to Do if You Suspect Your Insurer Is Not Acting in Good Faith
- Contact a Knowledgeable Bad Faith Insurance Claims Lawyer Now
Why Choose Dolman Law Group Accident Injury Lawyers, PA?
When you purchase insurance, you reasonably expect access to the benefits outlined in your policy. Unfortunately, many insurance policyholders are stunned and dismayed to learn that filing an insurance claim is just the beginning of their problems. Instead of the total and fair compensation they need to cover their expenses and move forward, some policyholders receive only bad faith attempts to resolve their claims. At Dolman Law Group Accident Injury Lawyers, PA, our distinguished legal team represents individuals and small businesses, never big corporations. We know how frustrating it is when the insurance company denies seemingly valid claims and how daunting it can be to go up against huge insurance companies as the little guy. That's why our attorneys are dedicated to leveling the playing field for our clients. Here are just a few examples of what sets us apart from other firms:- Decades of experience—Our firm was founded in 2004 with the mission of providing the same type of personalized and compassionate advocacy we would expect for our loved ones. Since then, our team has expanded to include several gifted attorneys with more than 120 years of combined experience across various legal practice areas. We work tirelessly to protect the best interests of those we represent and demand fair compensation for victims across the U.S.
- Reputation and results—The determination and experience we bring to the table have allowed us to secure millions of dollars in fair compensation for our deserving clients. Due to our strong track record of outstanding case results, insurance companies and other law firms recognize and respect us.
- A comprehensive approach—We understand that you have a lot on your plate if you have already filed an insurance claim. That's why we are happy to handle every aspect of your claim from start to finish, including managing necessary paperwork, looking out for filing deadlines, communicating with other parties on your behalf, and negotiating tirelessly to maximize your case value.
- Convenience and affordability—Our firm has convenient office locations nationwide, so help is never far away when you need us. We are prepared to meet with you at your convenience, virtually or in person, when face-to-face meetings are possible. And because we know that many of our clients come to us in tight financial spots, we offer affordable rates and payment options for every budget. We accept cases on a contingency basis, which means we charge you nothing up-front or out-of-pocket to begin work on your case. You only pay us a percentage of your settlement if and when we secure compensation for your claim.
Good Faith Insurance Laws in the U.S.
Insurance plays a vital role in American society. By paying into insurance systems, policyholders pool their risks together, providing financial security and stability to both individuals and businesses. Many of us are all too familiar with the fact that insurance coverage can mean the difference between a full recovery and total ruin after an unfortunate event. In fact, insurance is such a key element in the modern world that we are often required by law to purchase coverage for our homes, vehicles, companies, personal health, and more. Many courts have recognized the services rendered by insurance companies as vital to the public interest. And companies that provide such essential services are expected to seriously consider the public interest at all times, sometimes even placing the public interest above the company's own interest in making profits, when appropriate. In some cases, this means an insurance provider ought to go above and beyond the basic expectations outlined in its policy agreements. After all, acting in good faith involves inherent elements of human decency and understanding that often transcend policies. One key consideration in any interaction between an insurance company and a policyholder is that the insurer always has the upper hand. Insurance providers are in control of drafting their own policy agreements, establishing rates, investigating claims, and deciding if and how much to pay for those claims. Additionally, providers have vast industry expertise, negotiating experience, and legal and financial resources that far surpass those of most insured people. This substantial gap in leverage is all the more important because an insurance company's primary goal is always to earn money, a goal that often directly opposes its duty to pay policyholder claims. Because the insurance industry is essential, it is closely regulated. Every state has laws and procedures for monitoring insurance companies, their policy rates, how they market their products, and how they handle claims. To make sure providers take their positions of public trust seriously, state legislatures and court systems have developed standards and rendered decisions to define what “good faith” insurance practices look like. Good faith insurance laws stipulate that every policy contains an implicit understanding that the insurance carrier will act in good faith, even when policies do not spell this information out explicitly. When insurance companies act in good faith, policyholders can count on providers to:- Treat policyholder interests and claims with the same consideration as the insurance provider's own interests
- Assist policyholders with initiating, understanding, and navigating their claims
- Inform policyholders of all potential coverage types, benefits, and deadlines that may apply to their claims
- Respond promptly to claim inquiries and communications from policyholders
- Communicate with policyholders regularly to keep them updated on active claims
- Adopt and implement reasonable standards for evaluating and adjusting policyholder claims in a fair and timely manner
- Conduct complete, proper, and timely investigations into policyholder claims at the company's own expense
- Estimate the values of covered replacement costs fairly, without deducting depreciation costs from claim values
- Refrain from denying claims, wholly or in part, based on information or evidence that is biased, suspicious, speculative, or incomplete
- Avoid misrepresenting factual information or the specifics of policy provisions
- Refrain from ignoring evidence in support of valid claims or making unreasonably low settlement offers to policyholders
- Refrain from discriminating in the claims settlement process based on protected characteristics like gender, race, income, disability, or sexual orientation
- Provide clear, written explanations when issuing partial or complete denials, which should include details from relevant policies that provide the basis for denial
How Much Is a Bad Faith Insurance Claim Worth?
- In one recent year, almost 11,000 regulators in the U.S. were responsible for monitoring insurance companies.
- That same year, there were more than 1,783 insurance company investigations into things like financial practices and market conduct.
- State budgets for insurance regulation programs have grown to more than $1.4 billion combined.
- In Gruber v. Marshall, a Kansas court awarded a policyholder roughly $11.6 million for a claim against a policy with a limit of $100,000. The court determined that the policyholder's estate would have been protected from liability if its provider had offered full compensation promptly.
- In Boicourt v. Amex Assurance Co., a California court awarded more than $2 million to a policyholder whose carrier refused to disclose the limits of the available policy, which provided $100,000 in coverage.
- In Matson Terminals v. Home Insurance Co., a California court awarded a policyholder $23.5 million in compensation and an additional $11 million in punitive damages for the unfair denial of a $10 million earthquake claim.
- In Metropolitan Property and Casualty Insurance Company v. Hedlund, a California court ordered an insurance company to pay $5 million in compensation for failing to respond promptly to a claim against a $250,000 policy.
- In O'Neill v. Gallant Insurance Co., an Illinois court awarded a policyholder more than $3 million for extra-contractual losses they incurred due to the insurance company's bad faith actions regarding a claim against a $20,000 policy.
- Out-of-pocket medical bills you would never have incurred if you had coverage for prompt hospital visits, diagnostic tests, and prescribed treatments
- Wage losses you incur as a result of your inability to work, if your provider's bad faith insurance practices contributed to delayed medical care or return to work
- Projected losses in your future earning potential, if your provider's bad faith practices contributed to a worsening of your condition that left you disabled
- Revenue losses your business suffers due to unnecessarily long closures caused by providers that stall and drag out the claims process
- The intangible costs of the additional pain and suffering you would never have had to endure if not for bad faith insurance practices
- Any legal costs or attorney's fees you incur in the pursuit of your bad faith claim
- Answering your questions and evaluating your case at zero charge or obligation to you during your initial consultation session
- Helping you understand how the insurance laws work in your state and how they apply to your unique situation
- Conducting an independent investigation into your claim to determine how much you are owed and identify possible bad faith insurance practices
- Gathering valuable evidence for your claim, such as documentation of your losses, statements from reliable witnesses, and testimony from experts
- Communicating with insurance providers and other attorneys on your behalf
- Preparing demand letters, legal motions, and other documentation for your case
- Representing you in court during mediation, hearings, trials, and appeals
Common Types of Bad Faith Insurance Practices
When you pay your monthly premiums as a policyholder, you have the right to expect the legal and financial protection you have purchased with your payments. Unfortunately, many insurance companies rely on bad faith practices to prioritize profitability over their policyholders. Common examples of these bad faith insurance practices include:- Giving bad recommendations or advice—Insurance providers are far more familiar with the ins and outs of their policy agreements than their customers. Sometimes, insurers act in bad faith by knowingly providing bad recommendations or lousy advice when policyholders come to them for help.
- Neglecting or refusing to respond to inquiries—When policyholders file claims, they deserve to know what's going on. Insurance companies that fail or refuse to respond to reasonable questions and other communications from their customers may be liable for bad faith insurance practices.
- Misrepresenting terms of policy agreements—This could include intentionally providing policyholders with confusing information, making contradictory statements, or twisting the meaning of certain words or provisions in insurance policies in different circumstances.
- Using false or biased evidence to deny claims—When insurance companies investigate claims, they have an obligation to conduct those investigations in good faith. Relying on obviously false, distorted, or biased evidence goes against this important duty.
- Neglecting to investigate properly or promptly—In addition to using evidence gathered through their investigations, insurance companies must conduct those investigations promptly and thoroughly. Bad faith insurance providers often conduct superficial, incomplete, or intentionally slow-moving claim investigations.
- Refusing to cover valid policyholder claims—In the most blatant scenarios, insurance carriers simply refuse to pay valid claims, even when they are explicitly covered according to the terms of the policy. When this happens, providers often use vague or ill-defined terms to justify their decisions.
- Undervaluing covered assets or valid claims—One of the easiest ways for providers to decrease their payment obligations is by reducing the value of covered assets, properties, or events. They could insist on valuations from “preferred” appraisers or deduct depreciation costs.
- Delaying or refusing to make claim payments—The timing of a claim payout can be just as important as the amount. When policyholders don't get their benefits promptly, they can incur additional losses unnecessarily. Bad faith insurance providers know this but still choose to delay settlement payouts or refuse to pay compensation at all.
- Neglecting to provide explanations for denials—Insurance companies must provide clear reasons for partial or total claim denials so customers know how to respond. When insurers act in bad faith, policyholders may receive only murky or convoluted excuses in response to their claims.
- Refusing to defend policyholders from lawsuits—Some insurance policy agreements include a “duty to defend,” which obliges insurers to appoint and pay for legal representation when policyholders are subject to litigation. In bad faith scenarios, carriers may refuse to provide counsel to customers as promised.
- Altering or canceling policies without approval—This bad faith practice may include making arbitrary changes to deductible requirements or imposing surprise waiting periods before or during the claims process. Sometimes, providers may even try to cancel policies without notice to avoid paying out valid claims.