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Dawson and Rosenthal
Dawson and Rosenthal

Elements of a Bad Faith Claim

When you enter into a contract with your insurance company, you don’t do so simply to pay monthly premiums. You have entered into the agreement assuming they will protect you from financial hardships if you ever need to file a claim. You have trusted them with your money in exchange for their protection.

But what happens if they fail to provide such protection? If this happens, you may have a bad faith claim on your hands.

The two main elements of a bad faith claim are:

  1. Your policy benefits were withheld
  2. There was no valid reason for these benefits to be withheld

If both of these statements are true, you likely have a bad faith insurance case.

Bad Faith Insurance Claims: Do You Have One?

Several factors point to bad faith practices. Ask yourself the questions below. If you answer some or all of them, your insurance company could be acting in bad faith

  • Was an incorrect assumption made, and your claim denied with nothing to substantiate it? You are entitled to a rapid and proper investigation. 
  • Is medical treatment involved? And are you being denied access to it? When your doctor or medical professional suggests a course of treatment, your insurance is obligated to fulfill that request promptly. Denial or delay of medical treatment without a legitimate reason might mean that they are acting in bad faith. 
  • Is your valid claim being denied? You have a binding agreement with the insurance company. You pay your premiums, mostly never needing any action from the company. But, when required, they are responsible for their part of the contract. When they do deny a claim, reasons for the denial need to be supplied.
  • Are you being offered less than what the claim is worth? For instance, the damage to your car after an accident will cost $8,000 to repair, and your insurance company only offers $3000. This could possibly be your insurance company acting in bad faith.
  • Is the company misstating the law or the language that is found in the contract? This is a tricky one. But, if you are concerned that the law is being misinterpreted, it might be time to have an attorney look it over for you.
  • Have you been denied access to the documents the company used to make its decision? You have the right to see the guidelines they used to deny your claim. 
  • Has your insurance company made statements that were threatening to you? Maybe they suggested you were attempting a fraudulent action. The objective would be to frighten you into dropping your claim. 

If you feel your insurance company isn’t acting in your best interest, this would be the time to speak to an attorney at Dawson & Rosenthal, P.C., about what you believe is happening to you.

What to do When you Suspect Bad Faith Practices

If you answered yes to the questions above, your insurance company is potentially acting in bad faith. You are entitled to what the company promised when you agreed to use them as your insurance carrier. 

Take a close look at your policy. Make sure you understand what you can realistically expect from the insurance company. If you do not have a copy of your policy, request one. Keep good records of your communications with them. If they aren’t upholding their part of the agreement and are behaving in bad faith, contacting an attorney is your next step. Depending on the state, laws may differ.

Please get in touch with Dawson & Rosenthal, P.C. if you need representation and legal expertise in San Diego or Arizona.