Pin It

Bad Faith Denial by Insurance Companies of Injury Claims

Bad Faith Denial by Insurance CompaniesPrior to filing a motor vehicle or personal injury claim in Massachusetts, the Mass. Personal Injury Law firm will seek to negotiate and settle the claim with the indemnity company in good faith. Your Massachusetts tort attorneys will send documentation of your car accident, trucking wreck or slip and fall claim to the liability claims’ adjuster. This could include copies of police reports, relevant medical records, picture as well as witness statements.

The Massachusetts auto accident lawyer is attempting to settle the cause of action prior to lengthy, expensive and time consuming negligence litigation in Superior Court. The MA premises liability or Massachusetts car crash attorney may deliver an extensive demand letter to the insurance company seeking compensation for pain and suffering, lost wages, medical bills, disability and permanency among other damages.

In some situations the insurance company will stonewall and refuse to act reasonably or lowball the plaintiff requesting he take peanuts for the injury related cause of action. If liability is not open to dispute and the evidence is clear and convincing, the plaintiff can seek redress against the petulant insurance company by seeking relief under Massachusetts General Laws Chapters 93A & 176D. The following types of conduct is commonly referred to as  bad faith on the part of the insurance company.

MA General Law 176D Section 3 states:

“…(9) Unfair claim settlement practices: An unfair claim settlement practice shall consist of any of the following acts or omissions:

(a) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue;

(b) Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies;

(c) Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies;

(d) Refusing to pay claims without conducting a reasonable investigation based upon all available information;

(e) Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed;

(f) Failing to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear;

(g) 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;

(h) 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;

(i) Attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of the insured;

(j) Making claims payments to insured or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made;

(k) Making known to insured or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements of compromises less than the amount awarded in arbitration;

(l) Delaying the investigation or payment of claims by requiring that an insured or claimant, or the physician of either, 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;

(m) Failing to settle claims promptly, 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; or

(n) Failing to provide promptly a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement.

(10) Failure to maintain complaint handling procedures; failure of any person to maintain a complete record of all of the complaints which it has received since the date of its last examination, which record shall indicate in such form and detail as the commissioner may from time to time prescribe, the total number of complaints, their classification by line of insurance, and the nature, disposition, and time of processing of each complaint. For purposes of this subsection, “complaint” shall mean any written communication primarily expressing a grievance. Agents, brokers and adjusters shall maintain any written communications received by them which express a grievance for a period of two years from receipt, with a record of their disposition, which shall be available for examination by the commissioner at any time.

(11) Misrepresentation in insurance applications: making false or fraudulent statements or representations on or relative to an application for an insurance policy, for the purpose of obtaining a fee, commission, money, or other benefit from any insurers, agent, broker, or individual.”

See:  https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter176D/Section3

 

If the injured victims sends a 93A demand letter through their Massachusetts personal injury attorneys to the insurance company making a demand for settlement and the insurance company fails to make a reasonable offer within 30 days then the insurance company could be subject to paying double or triple damages as well as attorney’s fees

Be Sociable, Share!