Insurance adjusters investigate claims involving car accidents and other mishaps. They work directly for the insurance company or are independent contractors. If you received an insurance claim denial for your car accident and believe the insurance adjuster acted in bad faith, you may be able to sue them and the insurer in court. Bad faith basically means that your claim was unreasonably denied or you didn’t get the full compensation you should have. Tight-fisted and unethical adjusters may unfairly deny or reduce claims because they want to save the insurance company money at your expense. Unreasonable and unfair insurance claim denials are against consumer laws.
Understanding Your Rights in Insurance Claims
The Texas Department of Insurance website details consumer rights in filing insurance claims, including the right to fair and honest treatment. These rights are set out in Chapter 541 and Chapter 542 of the state’s insurance code. If you believe the treatment you received from the adjuster or the insurance company itself wasn’t fair and honest, you can file a complaint with TDI. You can fill out an online form at the website or call (800) 252-3439. You can also file a civil lawsuit. People who are successful in these types of lawsuits typically have the help of experienced injury attorneys who understand consumer insurance laws and how insurers operate.Ways that Insurance Adjusters Act in Bad Faith
Insurance adjusters act in bad faith by:- Offering extremely low settlements. Adjusters that do this may believe that policyholders will simply take the low offer because they don’t realize they have the right to reject settlement offers.
- Not conducting proper investigations into accidents. If the adjuster isn’t asking you for all the evidence in your claim, they may not be giving it the attention it deserves.
- Using stalling tactics to delay the processing of a claim. In general, when you make a claim against your own policy, you should receive a decision of acceptance or denial in writing, within 15 business days after the insurer has received all the information it needs to make a decision.
- Delaying the payment of approved claims. If your claim is approved, it must be paid within 5 business days.
- Using experts who are biased toward the insurer to evaluate claims. Sometimes assistance from accident reconstruction professionals, doctors or other experts may be needed to evaluate claims. These experts should be neutral parties, but bad faith insurance adjusters might use experts who are biased toward insurers.
- Making misleading statements about what is covered in a policy. This also includes making communications about policies so complex that policyholders are unsure what is being said.
- Not providing notice to you in writing as to why your claim was denied. You have the right to be told in writing why your claim—whether all or part of it—was denied.
- Canceling your policy after you file a claim. Your insurer can’t cancel your policy for making a claim for an accident for which you weren’t at fault, unless there are two or more claims in a one-year period.
How to Sue an Insurance Adjuster for Bad Faith
To be successful in a lawsuit against an insurance adjuster and insurance company requires clear and strong evidence of bad faith. There are steps to take to help establish the evidence when you have an insurance claim denial. You can take any of these steps on your own or consider getting the help of an attorney to handle them for you.- Read your insurance policy to understand what is and isn’t covered.
- Keep written records of all your communications with the adjuster and insurer that include what was said and the date and time.
- Maintain an organized file with all the evidence in your case that you provided to the insurer, including medical records, police reports, witness statements, photographs, and anything else.
- If you received a denial, ask that the insurance company review their decision.
- If a review isn’t forthcoming or successful, consider filing a complaint with TDI.
- Mail a final demand letter giving the insurer one more chance to pay the claim and advising them that if they don’t, you will file a bad faith lawsuit.
Damages in Bad Faith Insurance Cases
There are a variety of damages you can pursue in a bad faith insurance lawsuit. Depending on all the circumstances in your case, you could get the following, if successful:- Up to three times the money you would have gotten in a properly processed claim
- Compensation for your attorney’s fees and court costs
- Interest at the rate of 18% annually for delayed payment
- Punitive damages to punish the adjuster and/or insurance company.