How to Deal with a Bad Faith Insurance Claim - Aha!NOW (2024)

Table of Contents
  1. 6 Steps to Filing a Bad Faith Insurance Claim
    1. Take a Look at What Your Policy Covers
    2. Compile All Documents of Your Claim
    3. Compile All Documents of the Denial of Claim
    4. Re-approach the Insurance Company
    5. Complain to the Department of Insurance
    6. File a Bad Faith Insurance Claim Lawsuit
  2. Wrapping It Up

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When you buy an insurance plan, you expect protection and support from the insurance company. But as it happens, sometimes the insurance companies let you down. In such cases, you need to fight for your rights. Learn about the steps you should take to deal with and file a bad faith insurance claim. ~ Ed.

Getting insurance is important because it protects many important things in your life like your house, health, and even your car.

You pay into your insurance plan every month, so you expect when an accident occurs and you file an insurance claim it will be covered. But what if your insurance company either refuses to extend your coverage or does not extend you the amount you were expecting?

If you feel like you are being cheated by the insurance company or that they violated your policy, then your best bet is to file a bad faith insurance claim against the organization.

In this case, you should go to an attorney and see if it’s possible for you to sue the insurance company to get the money you were promised so you can get your life back on track.

This article will go over all you need to know when you’re faced with a bad faith insurance claim.

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6 Steps to Filing a Bad Faith Insurance Claim

You depend on the insurance and put your trust in the insurance company. However, if the insurance company does not commit to their promise to support you, then you need to do something about it. Here are the steps and tips to help you deal with such cases.

Take a Look at What Your Policy Covers

First of all, you need to take a look at your insurance plan to see if you should be covered in the event of an incident. If your plan is meant to cover a specific incident, but your insurance company refuses to cover you then you could have a case for a bad faith insurance claim lawsuit.

For example, if you pay into a house insurance policy that covers natural disasters you should be covered in the event something of that nature happens. If a tornado comes and damages your home but the insurance company refuses to pay for damages, then you could have a case against the company.

On the other hand, if an incident happens that isn’t part of your plan odds are that you won’t be able to make a claim. For example, if you pay into an auto insurance plan that doesn’t cover vandalism and your car gets keyed, then you probably won’t be able to file a lawsuit against the company.

Compile All Documents of Your Claim

If you think you can file a lawsuit then the next step is to compile all the information about your plan and the claim that you filed with the insurance company.

If you have a copy of your original plan, you need to make copies of it and have it on hand. Check if there were any amendments made to your plan, you should hold on to these too. Also, track down any proof of payments to the insurance company for your plan so you can prove that all your payments are up to date and your plan is still valid.

Finally, you need to provide evidence of the claim that you sent off to the insurance company before it was rejected or not fully paid.

Compile All Documents of the Denial of Claim

When you file your insurance claim, your insurance company will either accept, partially accept or deny it. Before going to your lawyer with all your other documents, you’re going to have to get proof that your insurance company denied or unfairly partially accepted your claim.

For example, if you get a bad illness and can’t work for a few months but your health insurance company denies your claim, they will send you a document outlining why they are rejecting your claim. In this case, be sure to keep copies of the original documents and if you tried to appeal the denial of the claim then hold on to these files as well.

Re-approach the Insurance Company

If you’ve already appealed your denial of the insurance claim and it was rejected again, you should book a preliminary consultation with a lawyer. You should do this so you can find out more from a bad faith insurance claim specialist about the fine print in your insurance contract and your legal rights in these sorts of situations.

Once you’ve consulted the lawyer and they think you have a case for a lawsuit, you then can re-approach your insurance company to see if you can resolve the dispute.

Sometimes the mere threat of taking the insurance company to court can make them cough up the money for your claim and the fact that you tried to appeal multiple times to the company can help you out in court. There is also the chance that the insurance company will offer a settlement but if this amount isn’t to your liking, you should proceed to take them to court.

Complain to the Department of Insurance

If you live in the United States, your state will have a Department of Insurance that helps regulate insurance. Similarly, in Canada, there is a federal Department of Insurance that has the same function.

By filing a claim to this department, you can receive certain types of assistance to help resolve the dispute before going to court and they will also take note of your insurance company’s reaction to the attempted claim to see if they are acting criminally.

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The main service these departments offer is usually a settlement mediation. If you don’t think you have the time or resources to go through a full-court case, this could be a good solution.

File a Bad Faith Insurance Claim Lawsuit

Once you’ve gone to your insurance company multiple times and they haven’t offered to settle or provide you with the claim that’s entitled to you, it’s now time to take the company to court.

When suing the company you should file for compensation for the claim you tried to file but also for any inconveniences or damages caused by the bad faith of the insurance company.

If you’ve appealed to your insurance company and they eventually settle your claim after a while, you can still sue them for bad faith for all the time and damages you incurred trying to get the claim settled in the first place.

Wrapping It Up

Filing a bad faith insurance claim can seem like a daunting task but if you follow the standard procedure, it can be much simpler than it appears.

First, take a look at your insurance plan to see if you should be entitled to your claim. Next, collect all the documents concerning your claim and its denial. Then you should re-approach the company to try to appeal your claim.

At the same time, you should file a complaint to your local Department of Insurance for support. Finally, if you’ve exhausted all other means to get your claim, you need to take the insurance company to court under a bad faith insurance claim lawsuit.

Don’t let insurance companies boss you around – if you think you’re in the right you need to fight back!

Over to you

Did you ever face a bad faith insurance claim? Share your tips and experiences in the comments to help others.

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Disclaimer: Though the views expressed are of the author’s own, this article has been checked for its authenticity of information and resource links provided for a better and deeper understanding of the subject matter. However, you're suggested to make your diligent research and consult subject experts to decide what is best for you. If you spot any factual errors, spelling, or grammatical mistakes in the article, please report at [emailprotected]. Thanks.

How to Deal with a Bad Faith Insurance Claim - Aha!NOW (2024)

FAQs

Is it hard to win a bad faith claim? ›

Winning a bad faith insurance lawsuit in California is a complex process that requires expertise in state insurance laws, strategic litigation skills, and a thorough understanding of insurance practices.

Under what circ*mstances would a claim of bad faith be justified? ›

You may have a claim for bad faith when an insurance company deliberately undervalues your claim, wrongfully denies your claim, or engages in a pattern of behavior intended to limit their payout on your claim.

What is bad faith claims handling? ›

Looking for evidence that supports the insurance company's basis for denying a claim and ignoring evidence that supports the policyholder's basis for making a claim is considered bad faith. If an insurer fails to promptly reply to a policyholder's claim, that act of negligence, willful or not, is considered bad faith.

What are three ways in which an insurer can be liable for bad faith? ›

Insurance Bad Faith – Frequently Asked Questions
  • interpreting the language of the policy in an unreasonable manner;
  • unreasonably failing to reimburse the insured for the entire amount of the loss;
  • unreasonably failing to settle the lawsuit;
  • unreasonable refusal to defend a lawsuit;

How is bad faith proven? ›

Breach of the Duty of Good Faith and Fair Dealing: To prove a bad faith claim, the policyholder must demonstrate that the insurance company breached its duty of good faith and fair dealing. This duty requires insurers to act reasonably, honestly, fairly, and promptly in handling claims.

What is a good faith settlement offer? ›

If the party making a nominal offer of settlement has an informed basis to believe that it has no liability (such as a legal argument that can dispose of the case on a dispositive motion), such an offer will likely be found to have been made in good faith.

What are the two types of bad faith? ›

Insurance claims generally fall into two categories: first-party and third-party claims. In both types of claims, the insurer can be guilty of unjust practices such as delaying claim investigation, underpaying claims, or refusing to defend a claim without a valid reason.

What is a common cause of action under bad faith? ›

In general, most bad faith insurance claims fall in a few areas: Claim denial. Underpayment of a claim or unreasonable settlement offer. Delay in payment of claim.

What is the burden of proof for good faith? ›

(d) The party asserting the lack of good faith shall have the burden of proof on that issue. (e) When a determination of the good faith or lack of good faith of a settlement is made, any party aggrieved by the determination may petition the proper court to review the determination by writ of mandate.

What is evidence of bad faith? ›

Depending on the exact setting, bad faith may mean a dishonest belief or purpose, untrustworthy performance of duties, neglect of fair dealing standards, or a fraudulent intent.

What is an example of a bad faith argument? ›

The concept of “do as I say, not as I do” describes a position held in bad faith. For example, if an instructor forbids their students from citing Wikipedia in their work but uses content from Wikipedia in their lessons, they're holding their anti-Wikipedia stance in bad faith.

What is the tort of bad faith insurance? ›

An insurer can be liable for bad faith if the insurer failed to fulfill their obligations of good faith and fair dealing. This means if the insurer acts unfairly in processing or paying a claim, they could potentially be liable for bad faith.

What is it called when an insurance company refuses to pay a claim? ›

If they fail to defend their policy holder, then it could be considered in “bad faith” by the insurer. If an insurance company fails to cover a valid claim, it's considered acting in "bad faith."

Which of the following types of damages are available for bad faith? ›

You can recover three types of damages in a bad faith case. These are the contract damages, the extracontractual damages, and punitive damages.

What is good faith violation in insurance? ›

Breach of the good faith duty, which occurs when an insurance company withholds policy benefits unreasonably or without proper cause, allows for tort damages and a punitive damage claim under California law. That duty, however, only extends to first party claims, not third party claims.

How do you prove a bad faith contract? ›

How You Prove Bad Faith Depends on Your State Laws
  1. Unreasonable delays;
  2. Improper investigation of your claim;
  3. Misrepresentation in the claims process;
  4. Refusal to explain the reason for a claim denial;
  5. Failure to communicate with you or provide necessary information; or.
Oct 25, 2023

What makes an argument bad faith? ›

When a person argues in bad faith, they intend to deceive and mislead when engaged in argument. A person can engage in bad faith arguing in many ways. One way to argue in bad faith is to knowingly use fallacies (errors in logic) to try to get the audience to accept a claim as true (or reject one as false).

Does bad faith void a contract? ›

The Implications of Bad Faith Contracts

Voidability: A contract formed under bad faith can be voided or declared invalid. For instance, if one party was misled or deceived into agreeing to the contract's terms, they might have grounds to nullify the agreement.

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