THE BAD FAITH BUZZARDS
Sightings from The Catbird Seat
~ o ~
“It's The Law That Insurance Companies 'Willingly' Pay Claims
Properly And Promptly (Good Faith) And That
It Is Illegal To 'Willingly' Discount, Delay
Or Deny Payment Of Claims (Bad Faith)“
Fight Bad Faith Insurance Companies
~ ~ ~
What are "Bad Faith Insurance Claims?"
Bad Faith Claims
This term is applied when an insurance company's denial of coverage is wrongful and/or constitutes bad faith. Generally, this reference describes a carrier's contemptuous conduct and unscrupulous greed in their effort to avoid paying a policyholder's just claim.
Insurance policies are confusing, ambiguous and filled with loopholes by design - not just coincidence. Comprehensive interpretation is difficult for trained professionals and rare for laypersons. It 's also not unusual for insurers to offer promotional materials to help sell the policy that contain representations contrary to the policy that is actually issued. Prudent saving of any informational brochures and sales aids could prove valuable for future claims disputes.
Benefits discrepancies between offers and actual delivered underwritten policies are particularly widespread with regard to umbrella coverage. One very well known carrier publicly advertised that its umbrella policy will protect the insured from suits relating to:
false arrest, false imprisonment, wrongful eviction wrongful detention, malicious prosecution humiliation; libel, slander, defamation of character or invasion of rights of privacy; and assault and battery.
However, if a claim is actually filed for one of these, the insurance company may assert that Insurance Code 533 -- which states that an insurer is not liable for the willful act of the insured -- precludes coverage for intentional torts. Such conduct approaches actionable bait-and-switch sales tactics. The consequences of misrepresenting policy coverage in promotional material range from fraud-based punitive damages to bad faith liability.
By law, these discrepancies must be interpreted in favor of the policyholder. If any clause in the insurance contract was unconscionable at the time it was drafted, the court may refuse to enforce the contract or the offending stipulations. The insurer is responsible for meeting the objectively reasonable expectations of the insured and coverage must be provided accordingly.
Virtually every bad faith case reported over the past 20 years discusses the "peace of mind" motivation in purchasing insurance. This is a key motivation for the purchase of indemnity products.
Although the law requires an insurance company to consider the interests of the insured at least as much as its own, if there is any excuse for an insurance company to deny or limit coverage of a large claim, it probably will try to do so. Insurance companies are masters of claims negotiation.
What is “Bad Faith”?
Insurance Claims Consultants
1) Misrepresenting of pertinent facts of insurance policy provisions relating to coverage at issue.
2) Failing to acknowledge and act reasonably and promptly upon communications with respect to claims arising out of insurance policies.
3) Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies.
4) Refusing to pay claims without conducting a reasonable investigation based upon all available information.
5) Failing to confirm or deny coverage of claims within a reasonable time after proof of loss statement has been completed.
6) Not attempting in good faith to effectuate fair and equitable settlements of claims in which liability has become reasonably clear.
7) Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amount ultimately recovered in actions brought by such insured's.
8) Attempting to settle a claim for less than the amount to which a reasonable man would have believed he was entitled by reference to written or printed advertising material accompanying or made part of an application.
9) Attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of the insured.
10) Making claims payments to insured or beneficiaries not accompanied by a statement setting forth the coverage under which the payments are being made;
11) Making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration.
12) Delaying the investigation or payment of claims by requiring an insured, claimant, or the physician of either to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information.
13) Failing to promptly settle claims where liability has become reasonably clear under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
14) Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement.
Hawaii Injury Lawyer
Bad Faith Insurance Company Claims
Insurance policies are generally purchased by policy holders to bring peace of mind and security. They are supposed to provide “good neighbors” and “good hands” in time of need.
Increasingly, however, insurance companies take the approach that they are profit machines for their stockholders and insiders. Claims adjusters are taught to be difficult to reach, uncooperative when finally tracked down and evasive in their responses. Claim payment is often avoided on the thinnest of excuses with any eye toward forcing a financially weakened claimant into a position of economic desperation and obtaining a settlement which favors the insurance company. Such tactics are very common, but in an appropriate case they may give rise to an independent cause of action for bad faith...
- William Lawson, Esq.
# # #
* * * * *
NEW SONGS BY “THE WHISTLER”
* * * * *
MORE BUZZARDS TO BE TAGGED SOON!
For now, though, check out just some of the nests where
Bad Faith Buzzards allegedly have been sighted...
ACE UP THE SLEEVE
AIG: THE UN-AMERICAN INSURANCE GROUP
ALLIED WORLD ASSURANCE
THE BERMUDA FRAUDS
THE CHUBB GROUP
CITIGROUP: VAMPIRES IN THE CITY
THE EAGLE HOODED: THE 9-11 COVERUP CONTINUES
FIRST INSURANCE COMPANY OF HAWAII
THE GREAT NEST EGG ROBBERIES
HAWAIIAN INSURANCE COMPANIES
KEMPER INSURANCE COMPANIES
MARSH & McLENNAN: THE MARSH BIRDS
MARSH & McLENNAN’S MARSH AFFINITY SERVICES
NESTS OF THE INSURANCE VAMPIRES
THE PRUDENTIAL: A NEST ON SHAKY GROUND
RICO IN PARADISE
THE SILENCE OF THE WHISTLEBLOWERS
THE POOP ON AON
THE ROYAL & SUNAMERICA
THE TITLE INSURANCE VULTURES
TRANSYLVANIA TRAVELERS IN ST. PAUL
VAMPIRES IN THE VESTA INSURANCE GROUP
ZEPHYR INSURANCE COMPANY
ZEROING IN ON ZURICH FINANCIAL SERVICES
# # #
MORE OF THE CATBIRD’S FAVORITE LINKS
THE CATBIRD SEAT FORUM
THE CATBIRD SEAT
FAIR USE NOTICE. This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of environmental, political, human rights, economic, democracy, scientific, and social justice issues, etc. We believe this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.
For more information go to: http://www.law.cornell.edu/uscode/17/107.shtml. If you wish to use copyrighted material from this site for purposes of your own that go beyond 'fair use', you must obtain permission from the copyright owner.
Last Update April 29, 2007, by The Catbird