subject: Bad Faith Insurance Claims [print this page] Bad Faith Insurance Claims
When we make insurance premium payments every month or quarter, we do so believing that the insurance company will be there for us, and act in "good faith," when we need them. Unfortunately, instances of "bad faith insurance" happen all too frequently. This can occur when an insurance provider does not provide the promised coverage for a valid insurance claim. It is against the law for an insurance company to act in bad faith.
Types of Bad Faith Insurance
There are many different kinds of acts that equal bad faith, and they can happen at various phases of a customer's claim. Here are some examples of what may be bad faith:
Denial of coverage and/or payment for a legitimate claim
Failure to process or investigate a claim at all
Misrepresentation regarding a policy and its coverage
Settling a claim with a forged signature or application
Not acting and issuing payment in a reasonable amount of time once a liability has been determined
Failure to provide an appropriate settlement to an insured customer (often called "low-balling" in the industry)
What to Do if You Believe Your Insurance Company has Acted in Bad Faith
If your insurance company has denied coverage for a valid claim or is in some other way not acting in good faith over a claim, you could have grounds for a civil lawsuit.
An insurance policy you pay for is a legal contract between you and the insurance company. The company is bound by that contract to follow its terms and provide the coverage it promised. When the insurance company fails to do that, it can be considered a breach of contract.
For the lawsuit to be successful where benefits are contracted to be paid directly to you, the insured, you and your bad faith insurance attorney may need to prove:
There was no reasonable basis for the intentional delay in payment of the claim, denial of the claim or failure to pay the claim; and
The company knew it had no reasonable basis for its action or it failed to do an adequate evaluation or investigation to determine if its action had a reasonable basis.
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