Can I sue my Insurance Company:- Most insurance adjusters like to process claims in a straightforward and quick manner. However, some adjusters will make an effort to intimidate or irritate you into accepting a settlement that is significantly less than what your claim is actually worth.
When an adjuster is unresponsive or offers a ridiculous counteroffer, you have a few options. One choice is to submit a grievance to your state’s insurance department.
Fortunately, there are various rules intended to safeguard customers like you, and it’s not unusual for a policyholder to take their insurer to court.
It’s difficult enough to deal with misfortunes like property loss, injuries, a loved one’s passing, or other issues. Therefore, it’s simple to feel overburdened if you also have to fight your insurance provider on top of everything else.
Is It Legal to Sue My Insurance Company? (Can I sue my Insurance Company?)
There are various reasons why someone might want to sue their own insurance provider, and this happens frequently. The legal relationship between the individual who gets insurance (the “insured”) and their insurance company must be understood in order to comprehend why it is feasible to sue an insurance company.
In essence, insurance is a contract—the “insurance policy”—wherein one party agrees to pay a premium in return for the other—the “insurer”—providing coverage for the insured. The insurance provider will shield the insured from losses, damages, or liability in the event that a loss results from an occurrence that was covered by the insurance policy.
As a result, there is a legal contract between an insured, who agrees to pay a premium for coverage, and an insurer, who undertakes to defend the insured in the event of a covered incident.
As a result, lawsuits frequently result when an insurance provider fails to indemnify, or protect, the insured from a covered act under the policy, or when a provider otherwise fails to uphold their half of the bargain, such as by incorrectly rejecting an insurance claim.
How to Prepare for Complaint Filing
You should undertake these steps before submitting a formal complaint if your aim is to achieve a settlement with the insurance provider.
Consult your Adjuster
Prior to taking the dispute to the next level, give the adjuster a fair opportunity to resolve your claim. Even though your claim is the most significant claim in the entire world to you, the adjuster must simultaneously handle many other claims.
Discuss the issue with the adjuster in a cool, professional manner. Several phone calls or letters may be necessary. If the adjuster doesn’t respond, keep trying and be patient. Try to schedule a meeting or establish a due date for a response to your demand letter.
Speak to a Manager
Ask to talk to a supervisor or the claims manager if you are having trouble with the adjuster. The adjuster might not be able to give you the offer you deserve because of a backlog of claims or because they lack the authority to. In order to reach a settlement, a supervisor will examine your claim with fresh eyes and greater discretion.
What is the procedure for suing my insurance provider?
It’s crucial to be ready by gathering the required paperwork and following the right procedure before bringing a case against your insurance provider. As the insured, it is your responsibility to notify the insurance company that a covered incident has occurred. Despite the obviousness of this, you should contact your insurance company first by submitting an insurance claim with the business.
After a triggering event happens, you can contact your insurance carrier via phone, online claim form, or written notification.
You might think about suing the insurance company if they reject your claim or fail to pay it on time and you think the rejection was unfair.
Following your decision to sue your insurance provider, you should take the following actions:
- If you do not already have a copy of your insurance policy, ask your insurance company to give it to you;
- Write a letter to your insurance provider requesting that they provide a formal denial of your claim along with specific justifications and demanding that they pay up your claim;
- If your insurance company responds to your demand for payment, give them a reasonable amount of time since they might make a good settlement offer;
- Submit a request for an administrative hearing with your insurer regarding the rejection of your insurance claim. This is a crucial step since your insurance policy can have a clause requiring you to “exhaust all available remedies” before filing a civil action; if you don’t, your lawsuit might be dismissed; and
- You should initiate a civil action against your insurance provider to demand that they honour your claim if all administrative and out-of-court remedies fail.
The process of suing an insurance company is likely to be drawn out and challenging without an expert attorney. The insurance provider will prefer to put off paying your claim, especially if they have a good reason to reject it.
However, the law requires insurance providers to promptly honour a properly submitted insurance claim. Therefore, before launching a lawsuit, it is crucial to correctly submit your claim to the insurance provider in writing. Federal law further stipulates that insurance providers have a “implied covenant of good faith and fair dealing” with their insureds.
What Your Complaint Must Establish?
There are various things your complaint to the state insurance department can achieve. The claims manager or director will first learn about your claim and that you want to take all necessary steps to obtain a fair and acceptable personal injury payment.
Your tenacity alone might result in a fair settlement proposal. Additionally, the insurance provider will work harder to resolve your claim because filing a grievance with the state insurance department adds another layer of effort for the provider.
Rarely, a claimant’s representative is actually spoken to in person by an insurance company by an investigator for the state insurance agency. This can persuade the insurance adjuster to present a more fair settlement proposal.
Reasons Why Your Insurance Claim Might Be Rejected
An insurance company can deny your claim for a variety of reasons, some of which are valid and some of which are not. Among the more widespread explanations are:
- Lack of coverage: They can contend that your insurance policy does not provide coverage for your claim. Review the list of exclusions in your policy to learn more about what is not covered. Ambiguities in the policy are interpreted in the policyholder’s favour rather than the insurer’s.
- Application mistakes: An insurer may assert that you made certain false statements on your initial application, which renders your policy’s coverage void.
- Claim mistakes To find out the requirements for alerting the insurance company of a claim, check your policy. Some timeframes are only 24 hours long.
- Insurance fraud: Making fraudulent or inflated claims may constitute insurance fraud, which is punishable by both civil and criminal law.
- Bad faith denial: An insurer may provide numerous excuses, dressed up in convoluted policy jargon, to merely hide the reality that they simply don’t want to pay for the claim. Of course, they won’t give you this reason.