Is your insurance company trying to cheat you by denying your coverage?
Every insurance company owes its policyholders the duty of "good faith and fair dealing." If a policyholder experiences loss or harm because of the insurance company's failure to treat him fairly, the insurance company is legally responsible. It is not unusual for State Farm to fail to treat its insured customer "like a good neighbor" or for a policyholder not to "be in good hands" with Allstate.
Ryan Bisher Ryan represent many people involved in coverage disputes and bad faith disputes. We provide counsel for issues including but not limited to late notice, right to counsel, errors and omissions of insurance agents and bad faith.
My insurance company denied my claim, do I have any rights?
What should I expect or do when I am dealing with my insurance company after I have made a claim?
What is the time limit for asserting a bad faith claim?
My insurance company denied my claim. What are my rights?
If an insurance company refuses to abide by the terms and conditions of the policy in the payment of a legitimate claim, then it has violated the policy and you are entitled to the benefits which you were denied. In addition to suing for breach of the contract, if the insurance company's denial of the claim was in bad faith you would be entitled to additional damages, possibly including punitive damages.
Generally, it is unreasonable and/or unjustifiable handling of a policyholder's claim by their insurance company. Your insurance company has a duty of "good faith and fair dealing". This requires the insurance company to:
(1) adjust your claim (pay it or deny it) within a reasonably prompt time,
(2) cooperate with you on your claim by explaining requirements and benefits of the policy to you,
(3) respond to your inquiries within a reasonable time, and
(4) tell you in writing exactly why it is denying or reducing your claim by stating the policy provision or rule of law their decision is based upon.
Failure to follow the above requirements is "bad faith." Basically the insurance must try to find reasons to pay the claim rather than invent or find reasons to deny it. Some the following acts are examples of bad faith, but these are just a few examples.
- Inadequate investigation
- Failure to investigate promptly
- Failure to properly and reasonably evaluate facts regarding liability
- Unreasonable delay in paying a claim
- Insisting that the policyholder carry out unnecessary requirements before satisfying the claim
- Failure to offer the policyholder a reasonable settlement
- Requiring the policyholder to collect from a third party before paying underinsured motorist benefits
- Treating the insured as an adversary when they make a claim or hire an attorney
- Intentionally misreading policy provisions to cheat the policyholder
- Attempting to deceive the policyholder
- Failing to disclose policy benefits to the policyholder
- Concealing facts
- The following stories are examples of bad faith:
- John saved for many years and was finally able to purchase a home. He insured his home with ABC Insurance, and paid good money for a home replacement policy. The policy called for replacing the home at the prevailing market cost if it was destroyed. As a result of a tornado, John's home was completely destroyed. Luckily John and his family were not hurt, but they had to take up residence in a hotel with what little belongings that could gather from the site. Four weeks after the loss ABC hired an appraiser that had a long time business relationship with ABC to determine the replacement cost of John's home. This appraiser determined the replacement cost at $60,000. Two independent appraisers appraised the cost to replace John's home at $85,000 and $82,500. ABC refused to consider the independent bids and had no reasonable explanation for refusing. ABC told John that he either accept the $60,000 or they would quit paying his motel expenses immediately and he would have to make other arrangements for himself and his family. Because of the financial and emotional stress he was placed under by ABC's actions, John was forced to accept the $60,000. He thought his insurance company treated him unfairly. He was right. Juries have awarded millions of dollars to people like John.
- David was driving his car through an intersection at 8:30 a.m. when Joe ran the red light and collided into him. The police arrived and asked David if he needed to be taken to the hospital, and he responded that he was experiencing pain but he thought he would be alright. He said if it got worse he would go to the ER. The officer noted on the report that David "refused treatment," but when David spoke with him after he received a copy of the report, he admitted he remembered what David told him but just didn't write it in the report. The officer also noted that David had done nothing that caused the accident.
David went the hospital at 8:00 p.m., complaining of pain in his low back. He was diagnosed with a herniated disc and started treatment with a neurologist who first attempted medication and when that failed, David had back surgery. His medical bills were over $20,000 and since Joe only had minimum coverage as is required by Oklahoma law ($10,000), Joe's insurance company offered to pay the $10,000 limit.
David advised his insurance company that he was making a claim under his underinsured motorist policy, since he had $50,000 in underinsured motorist coverage and Joe was underinsured. David's insurance company, without speaking with the officer, examining the scene of the accident or the cars involved, told David that they thought he was partially at fault and therefore would reduce his claim.
Without ever discussing David's care with any of his treating physicians, his insurance company sent him to a doctor that they used on a regular basis to deny claims. This doctor sent the company a report stating that the accident only aggravated a pre-existing condition and that the herniated disc would have occurred some time in the future regardless of the accident.
David thought that Joe's insurance company was treating him more fairly than his own. David paid premiums to his company for 10 years and they were treating him like an adversary. David was right, his insurance company failed to perform an adequate investigation. It should not treat him as an adversary and place its interests ahead of his by using its own doctors to support its position. A jury, under similar facts, awarded an insured such as David 9.5 million dollars.
What should I expect or do when I am dealing with my insurance company after I have made a claim?
The best thing to do is to "put it in writing" or "get it in writing". You should expect that you are going to be dealing with a professional who handles claims everyday. This person most likely will place the insurance company's interests ahead of yours - it's his job to save the company money. Therefore, phone calls are OK for quick contacts, but get the adjuster to put his position about your claim in writing. In Oklahoma you can even tape a telephone conversation between yourself and the adjuster without telling the adjuster, as long as you don't record anyone else involved in the conversation who is not aware that it is being recorded. If you are having problems with the adjuster when discussing the merits of your claim, it may be a good idea to tape the conversation and always ask the adjuster to "put it in writing".
NO. The law recognizes that insurance policies can be somewhat complex. The law also recognizes that most of these polices are "boiler plate," not giving the policyholder much bargaining power. The courts have developed certain rules of interpretation for reading insurance policies. If the language is not absolutely clear, the court will support an interpretation that gives coverage to the insured rather an interpretation that would deny coverage.
What is the time limit for asserting a bad faith claim?
Suit must be filed within two years from the date of an insurance company's unreasonable conduct. Sometimes the time limit in these cases is difficult to determine. So it is important to contact an attorney immediately if you feel like your insurance company is acting unfairly.
YES. The reason insurance companies treat their policyholders unfairly is because they think they can get away with it. Juries across the country are letting insurance companies know that they will not tolerate such conduct. In Bad Faith cases, we do not charge an attorney fee for personally consulting with you about your case. In fact, many people do not have the money to hire a lawyer to protect their rights. We understand. Protecting your rights is important to us. That's the reason our fee is paid at the end of the case out of a portion of the recovery. If we are unable recover compensation for you, you do not owe us a fee. This is called a "contingency fee" arrangement and is common among attorneys for this type of case.
The attorneys put up large sums of money on these complex cases in order to hire experts, take depositions, gather evidence and oppose the lawyers of large insurance firms. The attorney you choose must be able to cover the expenses for such battles. Not only does Ryan Bisher Ryan have the resources, we have the experience, skill and dedication to successfully handle these cases.
As much as a jury thinks its worth based on the conduct of the insurance company. Verdicts range from thousands to millions of dollars. The jury is to consider the financial losses you suffered because of the bad faith conduct, your embarrassment and loss of reputation, and your mental pain and suffering. Under certain circumstances the jury will also consider awarding punitive damages.
If you have been treated unfairly by an insurance company, call the Oklahoma City or Tulsa offices of Ryan Bisher Ryan. Let us use our knowledge, experience and resources to compel corporate responsibility for their negligence. We will vigorously pursue the maximum allowable compensation for your loss under the law. There is no charge for discussing your situation with us.
