What is Your Insurance Company’s Agenda?
Nationwide is NOT on your side; You are NOT in good hands with Allstate; and State Farm is NOT there like your good neighbor.
Most people don’t know that insurance companies or corporate defendants sometimes intentionally deny and underpay insurance claims as part of their standard business model. The practice has been well documented. In “From Good Hands to Boxing Gloves – the Dark Side of Insurance,” author David Bernardinelli describes how every major insurance company—following the advice of high-powered New York consulting firm McKinsey & Co.—makes it routine practice to deny and underpay legitimate insurance claims in order to increase their profits.
The insurance companies or corporate defendants frequently bank on you doing nothing, and hire high powered lawyers and lobbyists to advance their agenda.
insurance companies or corporate defendants have spent millions creating propaganda to convince the general public that there are too many frivolous lawsuits and that the filing of lawsuits is bad. What they don’t tell you is that it is your constitutional right to file suit when your insurance company refuses to honor its contractual rights, cheats you, or engages in other acts of bad faith. When insurance companies or corporate defendants engage in these practices they are hoping to negotiate with you directly, and without skilled legal advice. Bad idea.
There is nothing wrong with hiring skilled counsel to enforce your rights – the insurance companies or corporate defendants do it every day, on every case, and have skilled negotiators evaluating your claims. Unfortunately for consumers, and to the advantage of insurance company’s bank accounts, only a very small percentage of people who are cheated by insurance companies or corporate defendants actually file suit.
The insurance industry knows this and banks on it. The amount of money they save on the customers whom they cheat is far more than the damages they have to pay to those who file suit. By convincing the public not to sue them, they make money. Don’t let them get away with improperly underpaying or denying your valid claim. You have paid premiums for many years. And no insurance company would allow you to forget to write them the premium checks they expect to receive from you.
What is the Insurance Company’s Duty?
Our Insurance Attorneys in Houston Explain
An insurance company’s duty varies from state to state, but as one might imagine, there are countless rules and regulations that require the insurance company to treat people and businesses they insure fairly.
Lawmakers in virtually every state have deemed it necessary to pass laws to make sure that insurance companies or corporate defendants do not abuse, take advantage of, needlessly delay, or otherwise abuse their insureds. These rules and regulations are often grouped together in an area of the law known as “bad faith.” And it’s exactly what it sounds like. The area of law dealing with the bad behavior of insurance companies or corporate defendants. Imagine: an entire body of law that now exists, and that has developed over the course of decades, because an entire industry routinely behaves badly.
As a result of this bad behavior, and on the heels of years of legislative action to curb it, states have enacted (and continue to enact) laws to penalize the insurance companies or corporate defendants that engage in these practices. Nevertheless, and despite these rules and the sometimes harsh penalties that accompany them, insurance companies or corporate defendants continue to take advantage of people and businesses.
Why? Because they can. They have the time, money, and resources to do it. Why don’t more people fight back? Many worry that filing a claim will result in loss of coverage. Or that filing suit is expensive. Or that they simply should not deal with the headache of battling a large sophisticated insurance company. All of these assumptions are false.
You Can Fight Back
If you think you have been treated unfairly by an insurance company, you probably have. The average judge or juror is not much different than you are, and it’s very common for people to become frustrated with the delay tactics and other games some insurance companies or corporate defendants employ to minimize or eliminate their obligation to make good on viable claims. Don’t sit and wonder if your insurance company has acted in bad faith, and violated its duties – find out.
What should you do? Level the playing field. Get expert advice – every single insurance company does, why shouldn’t you? It costs you nothing. The lawyers at Daly & Black, P.C. will analyze your policy, the facts of your case, and determine whether you have a bad faith or other claim. If you’re looking for a quick answer on this site, we cannot give it to you – because the law varies from state to state, and “bad faith” can turn on facts that require expert advice.
But here are some very general examples of the type of conduct that many states have deemed to be bad faith conduct:
- Unnecessarily delaying payment of claims;
- Blaming your loss on events other than the real cause;
- Wrongfully claiming your loss is not covered;
- Failing to perform an adequate investigation;
- Making up reasons for delaying or denying your claim;
- Dragging out the claims process without a good reason;
- Trying to settle with you for an amount the insurer knows is inadequate and less than what is fully covered;
- Failing to explain clearly why your claim was denied or underpaid;
- Intentionally misinterpreting the language in your policy;
- Telling you not to hire a lawyer;
- Performing a biased investigation of your claim; and
- Making wrongful threats to drop your coverage or deny your claim (essentially, bullying).
What kind of cases does your firm handle?
Much of our practice is devoted to helping ordinary people and businesses level the playing field when they find themselves at odds with a large insurance company.
Insurance companies, despite claims to the contrary, rarely have as their goal to maximize your recovery under an insurance policy. In fact, many times the insurance company tries to get away with paying as little as possible, despite being obligated to do more. And in some cases, the insurance company engages in practices to advance its own interests – those practices sometimes rise to the level of “bad faith” under the law, which may expose the insurance company to additional penalties depending on the state law in question and the particular conduct of the insurer.
Our firm frequently handles cases involving the rights of ordinary people and businesses that find themselves at odds with these insurance companies – over virtually any type of issue, and under virtually any kind of policy. Daly & Black, P.C. enforces the rights of ordinary people and businesses against these large insurers in order to level the playing field, and ensure a just result for the policyholder, our client.
And we always bet on our own abilities, never taking a fee unless the client recovers. We do not charge clients by the hour, we do not take a case unless we believe it has merit, and we will not settle a case until you are satisfied that your rights have been protected and fully enforced.
What is a first party insurance case?
When a person or business has an insurance contract or policy, and a disagreement with that insurance company over whether the insurer has fully complied under its contract, you have a first party insurance claim.
What if my claim was not denied, but I don’t think the insurer paid what it was supposed to pay?
This is very common. In these instances you may still have a first party claim. The most obvious form of a first party insurance claim is where the insurer simply refuses to pay what is owed. But more frequently the insurance company underpays the claim – this can still be a breach of the agreement. Our lawyers will analyze the contract to determine whether such a claim exists in underpayment situations.
Why do insurers deny or underpay claims?
Insurance companies make money when they collect premiums, and “lose” money when they pay claims. Like any business, the insurance industry is profit-driven and will, on occasion, put its bottom-line ahead of its customers’ rights.
Insurance companies might try to cut corners, pay less than what is truly owed, or even bully customers in an effort to save money. When these practices are undertaken on a large scale, insurance companies can save millions, particularly if the practices are not policed or ever challenged.
Which types of policies are affected by denial or underpayment of claim?
Virtually all types of policies might be the subject of improper denials or underpayment of claims. This includes, auto, health, life, homeowners, disability, and recreational vehicle agreements.
What kinds of first party insurance disputes do you most commonly come across?
Our firm comes across a wide variety of first party insurance claims. Residential claims are very common, particularly following storm damage, be it wind, hail, hurricane, tornado, or other natural disasters such as fires or earthquakes. Businesses sometimes have commercial insurance claims or business interruption claims that are unique to its business and require special expertise. Condominium losses are also not uncommon, and can differ from ordinary claims in that they require expertise construing condominium bylaws and other documents to properly prosecute and adjust the claim.
What types of first party insurance claims will your firm consider handling?
Our firm is happy to review any such claim, at no cost to the policyholder, to determine whether a valid claim exists under the policy in question, and applicable state law.
Our firm will consider handling first party insurance claims in the following areas:
What are examples of unlawful insurance practices?
What is deemed unlawful, illegal, or bad faith depends on the state law. Typically your state of residence controls what state’s law will apply to this question.
By way of example, in Texas the Texas Unfair Claim Settlement Practices Act has defined a list of practices considered to be wrongful.
They include such things as:
- Knowingly misrepresenting policy provisions
- Failing to acknowledge claims in a timely manner
- Inadequate claim investigations
- Underpaying or denying reasonable claims
If I think I have a claim, or that an insurance company has engaged in bad faith, what should I do?
Call us. Insurance companies, and the representatives they send to adjust or review your claims, do not always have your best interests at heart. We do. If you believe your insurance company has improperly denied or underpaid a claim, or behaved wrongfully, we will review the case at no cost to you. And if we agree that the case has merit, we will prosecute your rights and level the playing field against the insurer so that you or your business is made whole.
Our attorneys will make sure that your rights are enforced and that the insurer is held accountable for any wrongdoing. And we will not take a penny unless you are satisfied that the insurer is finally doing the right thing.
What are examples of bad faith practices?
The simple definition of bad faith insurance practices is dishonesty in order to avoid having to fulfil contractual obligations, however, this can take many forms. For example, if your insurer fails to disclose important policy details, this is considered just as much of a problem as denying a reasonable claim.
Bad faith insurance practices can include:
- Denial of coverage for no apparent reason
- Failure to communicate with the client, such as not returning calls, taking unreasonably long to return calls, and refusing to listen to the client’s story
- Not disclosing policy limits
- Harassing requests for an impossible amount of information before handling a case
- Cherry-picking investigation information for their own purposes
- Misrepresentation of their policies
- Threatening clients
Courts are aware that insurance companies or corporate defendants do not always act ethically, but it is crucial to have the help of an aggressive attorney on your side when suing for compensation.
Will my insurance offer me a fair settlement?
While this answer depends on the insurer, the goal of all insurance companies or corporate defendants is the same: make money. If there is a feasible way for them to avoid paying out a fair settlement, they are likely to take advantage of it. When you file a claim, you should feel confident that your needs will be fully covered. If it doesn’t feel that way, contact an experienced Houston insurance claim lawyer for more information.
Can my insurer deny my claim?
Yes. The fine print on your insurance policy contains many conditions through which you may not be eligible for compensation. Their legal teams are keenly aware of these conditions, so when a claim is submitted for approval, they look things over closely before paying out a settlement. If your claim is denied, it does not mean you do not have a right to compensation. An experienced legal professional can help you understand if your insurer is acting unethically.
My insurer won’t return my calls. Does that mean they are working on my case?
No. Your insure is obligated to communicate with you throughout the process, so if you are unable to get in contact with them, they may be hoping you will just give up. Daly & Black, P.C. can help you hold them accountable for what they owe you.
My claim was simple, but the insurance company still denied it. What happened?
Unfortunately, this story is all too common. Daly & Black, P.C. have 30 years of experience dealing with this very problem. We know how to handle insurers that mistreat their customers. When an insurance company deals with a customer in bad faith, they expect the customer to put up with it and give up, but it should not work that way. Our team can help you understand if you have a case, so call for a free consultation.