Bad Faith Claim

Bad Faith Claim Insurance companies make money by accepting premiums, not by paying claims. For this reason, they will always make it easy for you to pay, but they might be less than forthcoming when you file a claim.

If the insurance company behaves in a dishonest or exploitative manner when processing your claim, you may have a bad faith claim.

This claim is separate from the original personal injury claim for which you may have been seeking compensation.

Table of Contents

Bringing Bad Faith Claim Against Your Insurance Company

The standards for bringing a bad faith insurance claim vary dramatically from state to state. Although New York has no statutory basis for filing a bad faith insurance claim, you can still bring a bad faith claim under common law.

Red flags that might indicate the presence of bad faith include situations where the insurance company:

Unfairly denies your claim, especially if it conducted no investigation;
Demands extensive information as a condition for paying your claim;
Unnecessarily delays claim processing even when liability is clear;
Forces you to sue to obtain payment; or
Fails to either accept or deny your claim within a reasonable time.

It is difficult to win a bad-faith claim. Nevertheless, you can win with a strong claim and a good lawyer.

The Insurance Company’s Unfair Strategies

Insurance adjusters have a multitude of “black hat” tactics that either qualify as bad faith on their own or qualify as bad faith when combined with similar tactics. They also use tactics that are either legal but questionable or that sit right on the borderline between legal and illegal.

Playing Games With Policy Language

Policy terms can be technical and difficult to understand; insurance companies like to take advantage of that fact. Fortunately, a court will construe any ambiguity in an adhesion contract (a contract presented to the consumer on a “take it or leave it” basis) in favor of the consumer.

Although insurance companies typically do the opposite, a court has the final say. You’ll have more negotiating power if you can credibly threaten a bad-faith lawsuit against the insurance company.

Stonewalling

In New York, the statute of limitations for personal injury is three years for most cases. If you miss the deadline, your claim will become worthless. The insurance company might burden you with numerous small delays, hoping you’ll miss the statute of limitations deadline. Unreasonable delay can justify a bad faith claim.

Snooping Around Your Social Network Accounts

The insurance company can use the content of your social network accounts against you (a photo of you drinking a beer at a party, for example). Suspend your social network accounts until the money is in your hand.

Playing Doctor

Your doctor, not the insurance company, decides what treatment you need or don’t need. Still, the insurance company may try to claim that your medical care was not “reasonably necessary.” They may try to pay less than the full value of your medical bills.

The Blame Game

Under New York’s “pure” comparative negligence system, you can lose a portion of your damages if you share fault for your injuries or accident. For example, if you were 10% responsible, you would lose 10% of your damages.

You can be sure that the insurance company will try to exploit this rule to your disadvantage. For every bit of blame they shift to you, they pay less. The only question is whether they do so in a fair or an unfair manner.

Recording an Interview With You

Don’t ever let an insurance company record an interview with you. They will ask you questions designed to elicit answers that undermine your claim.

The Fishing Expedition

In a “fishing expedition,” the insurance company will ask you to sign permission for them to access all of your medical records. They will then “go fishing” by scouring your records, looking for any past injury to which they can attribute your current symptoms. The insurance company is off the hook if your injuries existed before the accident.

Lowballing You

“Lowballing” means offering you a ridiculously low settlement, hoping that you will accept it to get money now rather than later. Don’t take the bait. This tactic constitutes an abuse of a dominant bargaining position.

Ignoring Your Non-Economic Damages

Non-economic damages such as pain and suffering typically add up to more than half of the value of a personal injury claim. If you don’t know this, the insurance company may drastically undervalue these damages.

Tell You You Don’t Need a Lawyer

This could be the most damaging tactic of all. The insurance company will tell you that you don’t need a lawyer for certain claims. However, they don’t want you to have a lawyer because having legal representation will put you in a better position to get the full value of your claim.

Your Insurance Adjuster vs. Your Lawyer: The Differing Incentives

Your lawyer will work on a contingency fee basis. This means your legal fees will equal a percentage of the amount you win. It also means that the more you make, the more your lawyer will make. This alone puts you two on the same side.

By contrast, the insurance company’s interests are adverse to yours. The more money you win, the less the insurance company gets to keep.

Contact an NYC Personal Injury Lawyer for Help

Insurance companies are most likely to use the “black hat” tactics described above against an unrepresented claimant. Most insurance companies would not dare try any of these tactics against a personal injury lawyer with a strong reputation. Hiring the right lawyer is your best defense against insurance company bullying.

Contact the Law Offices of Jay S. Knispel Personal Injury Lawyers to schedule a free consultation to discuss your claim at (212) 564 2800.