Georgina Clatworthy – April 5, 2013
When you purchase an insurance policy of any type, you do so under the belief that the policy is there to protect you and your loved ones. You purchase specific policies, such as car insurance or life insurance with the intent that if something should happen your claims will be paid. Businesses also do this, purchasing insurance to protect their employees through workers compensation and business protection insurance.
Sadly, it is never in the best interest of the insurance company to pay out on a claim. These companies are there to collect premiums so that the company can invest the money elsewhere to generate a profit. When a claim is made, it means less money they have to invest, therefore hindering their profit. When this happens, there are two legal terms that come into play: Insurance Dispute and Bad Faith. Understanding the difference between these two types of terms will allow you to know which course of legal action you should take.
Insurance Disputes
An insurance dispute is considered a disagreement between the insured and the insurer about the value of a claim. For instance, a claim made against a home owners policy for a roof that was damaged in a wind storm may have two very different values. The home owner may have gathered several quotations stating that the replacement cost of the roof is $10,000. However, the insurance company , after sending out an adjuster simply wants to patch the roof and offers a claim amount of $3,000.
In this example, there is a dispute as to how the roof should be repaired and at what cost. The insurance company has held up their contractual obligations by sending out an adjuster, but the home owner does not agree with the findings. This is a classic dispute that most likely will result in the use of an attorney to try and have the roof replaced.
Bad Faith
Bad faith is defined as the insurance company acting in a manner that is unfair or unreasonable. This can include a wide variety of actions such as:
• Failing to investigate a claim.
• Unreasonable interpretations of the insurance policy wording.
• Failing to make the rightful payments due on a claim.
• Denying a claim that should have rightfully been paid.
These are just a few examples; there are many other scenarios which can include acts of bad faith.
A classic example of bad faith actions is those recently taken by the Zurich work comp insurance division. Zurich willfully denied workers compensation claims for injured employees, denied access to medical care, and failed to pay employee payroll benefits in an effort to reduce the amount of money they had to pay out.
These actions were contrary to what their workers compensation policies stated they would do in the event an employee was injured, creating a bad faith action on their part.
What To Look For In An Insurer
Before you decide to purchase any type of insurance product, it would be wise to do a little research on the company. Besides the standard price and benefit comparison that most people perform, look into any complaints made against the company for bad faith.
There are several websites, including the Better Business Bureau and your state insurance bureau that can help you research if your company has a history of making bad faith actions against its clients. Furthermore, if you find yourself on the receiving end of a bad faith action by your insurer then you should seek the advice of an attorney who specializes in such claims. They will be able to guide you on what to do next and help recover the monies owed to you.
via The Differences Between Insurance Disputes And Bad Faith | USBlawg.