Insurance Bad Faith

Bad faith claims arise when a company with whom you have a contract fails to act within the terms of that contract. In the case of your insurance company, this may happen if it fails to promptly or properly defend or pay a claim. An insurance company has a duty to deal fairly with its customers. Whenever your insurance company fails to honor its obligations in its contract with you, you may have a claim for bad faith. An insurance company is required to investigate all claims and find out information about anything that might support their insured’s claim.

Insurance contracts are written to reflect current case law. Known terms which seem self-evident to the insured may actually have special interpretations to the insurance company and not to the insured. Generally, any terms which are not clear will be interpreted to benefit the insured. You do not have to prove that the company intended to cause harm, only that they failed to honor their agreement and did not have an arguable reason to deny the claim. The duty of good faith applies to all insurance contracts including health insurance, automobile liability, medical payment coverage, uninsured motorist coverage, home insurance, general liability insurance and workers compensation insurance. If an insurance company is not paying what you think they should please contact us to discuss your case.

While there are many different types of bad faith cases, the most common are:

  1. Uninsured / underinsured motorist insurance companies failing to fairly evaluate the damages sustained by their own insured or attempting to condition medical payment coverage to settling the uninsured motorist claim. (For example---Insurance company offers $2,000.00 to settle an uninsured motorist claim with clear liability and medical expenses of $5,000.00 or tells its insured that it will not pay the medical payments coverage unless the insured settles the entire uninsured motorist claim.)
  2. Medical insurance companies using definitions to deny coverage which are different than those stated in the policy. (For example---Insurance company denies the claim stating that “your expenses were not reasonable and necessary” where the insurance policy does not contain those conditions.)
  3. Workers’ Compensation insurance companies denying medical treatment or wage benefits to individuals injured at work. (For example---Insurance company denies the claim for medical treatment after your treating physician says that the treatment is necessary and that you were injured while on the job.)
  4. Long term disability insurance companies hiring bogus medical review companies to say insureds are not disabled. (For example---Insurance company portrays a medical review company as unbiased and uses their opinion to deny a claim where the medical review company is paid based on the number of claim denials or employs non-medical employees to make medical decisions.)
  5. Auto liability insurance companies failing to honestly evaluate their insured’s exposure. (For example---Insurance company fails to make an offer to a plaintiff in good faith to resolve the claim and an excess judgment is entered against you.)
  6. Home insurance companies denying fire claims alleging material misrepresentation or arson on the part of the insured without any evidence to support the claim decision.

While these are the most common, many other actions on the part of an insurance company may create a bad faith situation. For example, the following have been held to be bad faith conduct:

  1. Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue;
  2. Failing to acknowledge and act with reasonable promptness upon communications with respect to claims arising under 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 affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed;
  6. Not attempting in good faith to effectuate prompt, 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 amounts ultimately recovered in actions brought by such insureds;
  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. 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; and
  11. 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.

If you or a loved one is in need of legal assistance, call Robert Boyd and Associates at (601) 925-5511or Toll Free at (866) 925-HURT or submit an online questionnaire. The initial consultation is free of charge, and if we agree to handle your case, we will work on a contingency fee basis, which means we get paid for our services only if there is a monetary recovery of funds. In many cases, a lawsuit must be filed before an applicable expiration date, known as a statute of limitations. Please call right away to ensure that you do not waive your right to possible compensation.



Robert Boyd and Associates serves the entire state of Mississippi, such as the following cities: Jackson, Clinton, Byram, Raymond, Terry, Bolton, Edwards, Brandon, Pearl, Brookhaven, Canton, Crystal Springs, Fayette, Florence, Hazlehurst, Lexington, Marion, Newton, Port Gibson, Richland, Madison, Ridgeland, McComb, Summit, Vicksburg, Wesson, Woodville, Yazoo City, Biloxi, Gulfport, Long Beach, Ocean Springs, Pascagoula, Moss Point, Pass Christian, Waveland, Clarksdale, Cleveland, Columbus, Columbia, Corinth, Greenville, Greenwood, Grenada, Hattiesburg, Magee, Tylertown, Laurel, Lucedale, Meridian, Natchez, Olive Branch, Southaven, Oxford, Philadelphia, Picayune, Starkville, Tupelo, Batesville, Aberdeen, Belzoni, Bentonia, Carthage, Kosciusko, Louisville, Cleveland, Leland, Clarksdale, Durant, Lexington, Ellisville, Florence, Flowood, Forest, Flora, Hollandale, Holly Springs, Horn Lake, Houston, Indianola, New Albany, Senatobia, Raleigh, Waynesboro, Wiggins, and Winona.

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