How to sue an insurance company?

by ty_ger88 » Fri Sep 14, 2007 02:20 pm

Many a times you may be unhappy with your insurance company for not paying you your dues or for delaying your payments or for any other reason. Your insurance company does not always have the upper hand. There are laws to protect you if you have a dishonest insurer.

When can you sue your insurance company?

You can sue your insurance company on grounds of:
  • Bad faith and
  • Breach of contract

If your insurer tries to trick you by not paying up a legitimate claim you can put up a civil suit against the company for having acted in bad faith. A company shows bad faith when it unreasonably denies a legitimate claim. This may mean that:
  • The company has failed to carry out proper investigations
  • Undue delay in processing a claim
  • Disregarding the rights of the policyholder
  • Inadequate compensation provided against claim filed

You can sue your insurance company for the full amount of benefits that has been denied to you as well as for any economic loss or emotional distress that you may have had to suffer as a result of the refusal. If your insurance company has been dishonest you may also get punitive damages. This is a means to make the insurance company behave more responsibly in future correspondences.

It is good to keep all paper works organized so that you can find them as soon as you need them. You may think of an old receipt as unimportant but it might hold great importance when you have a case standing against your insurer for bad faith or breach of contract.

Related Readings

I'm confused, please help. Here's my story and question. I'll try to make it short. My car was hit about a month ago. I was not in the car. It was parked on the side street. The driver of the truck that hit me left a note with all of his information. Now, it has been almost a month, and his insurance is not doing much. At first, they promised to have the damage estimated, but then nothing was sent to the car shop where my car located. I ended up going through my own insurance company. The problem is before I went with my insurance company, I had rented a car and had discussed this with the other insurance company. They said they would reimburse me all the fees. Now, they're not answering my calls. They keep on telling me that the agent is busy and will get back to me. It has been 4 days since I faxed in my car rental bill. What can I do? Can I sue them? Would you tell me how to sue an insurance company? The bill was paid for by my credit card, and I don't want to owe interests on it. Please help. Thanks.

Total Comments: 380

Posted: Fri Jun 25, 2010 10:23 pm Post Subject:

My question is can i sue my insurance company for giving me a wrong policy?

You CAN sue anyone you want, but you won't win...It's YOUR responsibility to review your policy and coverages, in fact if you look at the statement it will say something EXACTLY like that.

Posted: Sun Jul 11, 2010 03:28 am Post Subject: CAN I SUE AND HOW

July 20, 2009 my daycare center had a fire, my insurance companies still have not paid my claims nor have they paid any loss of business, I paid all my bills on time until I ran out of money it will be one year in 10 days what can I do I have complied with every thing they have asked me for. Please help me. I have lost all my clients 135 families to be exact. I have done 3 euo's

Posted: Sun Jul 11, 2010 12:56 pm Post Subject:

This is WAY too long to investigate a claim "assuming" that you have complied with all requested information....the only reason i can even imagine that they haven't either paid or denied your claim is that they are waiting on additional (already requested) information...

When did you complete the EUO? How long ago? What is 'the problem' with your claim? Clearly your claim had some 'red flags' that caused your carrier to investigate this deeper..what are the issues? when was the last time you talked to your carrier? What have they said re: what's taking so long? Have you filed a complaint with your states dept of insurance? If not do so now!

Posted: Sun Jul 18, 2010 10:43 pm Post Subject: Mislead by the LIC Agent

Hi,

I’m not sure if you can help me or this is the Correct e-mail id to escalate but I’m desperately looking for Legal assistance. I have been cheated & mislead by an LIC agent which cost me loss of more than Rs. 1lakh hard earned money. I doubt if I can get the money back but I want some kind of legal assistance & get this guy in right track. I want his License to be cancelled or take necessary legal actions. Please read the mail below written in brief.

I don’t want any other innocent person to get into the same trap as I did, I have learnt from my mistake not to Trust in terms of Money but if you can help me will be very Grateful

Thanks,

Tanveer

Posted: Sun Jul 18, 2010 10:52 pm Post Subject:

Tenveer Ahmed . . .

What state are you a resident of? And please re-read your post above, because I think there are a few things that were typed incorrectly. Your "mail below written in brief" did not post.

Posted: Sun Jul 18, 2010 10:56 pm Post Subject:

Tenveer Ahmed . . .

What state are you a resident of? And please re-read your post above, because I think there are a few things that were typed incorrectly. Your "mail below written in brief" did not post.

Posted: Sun Jul 18, 2010 11:12 pm Post Subject:

i heard that if you sue too many times the judge might dismiss your case because you are the type of person to do that



Actually, it is possible to be declared a "vexatious litigant" if one files too many suits that are dismissed without merit or are simply designed to harass without a true cause of action.

The reason for this is simple. (1) It takes up the court's time unnecessarily, detracting from other legitimate matters it needs to hear, and (2) when someone sues you, you are supposed to file a response.

Well, in Los Angeles County, CA, filing a response to a civil suit costs a minimum of $340 plus the cost to serve the plaintiff, plus attorney's fees. One's out of pocket expense for a frivolous suit could easily exceed $1000. For what? To have the suit dismissed when it comes before the court in a month or two? More attorney's fees and lost time -- maybe another $1000 or more. Without a motion that seeks attorney's fees and court costs, those expenses remain out of pocket.

If declared a "vexatious litigant," then before the person can sue someone else, he/she must obtain consent of a judge in the court of jurisdiction. If the judge finds no merit to the complaint, permission to sue can be denied. While not exactly the same as having a case dismissed, it prevents the case from ever coming before the court to be dismissed.

Also, in CA (don't know about other states), in Small Claims Court, if a person has filed suit more than a certain number times in the past 12 months, then they cannot sue for the current maximum of $7500, and instead are limited to suing for no more than $6,000. Or they have to sue in Superior Court, which is more expensive, time consuming, and lawyers are allowed.

Posted: Tue Jul 20, 2010 11:15 pm Post Subject: Denied Claim

I was injured at work back in September of 2009. Long story short, I was lifting something over my head onto a shelf and when I did I injured my rotator cuff. I had to have x-rays, MRIs, and physical therapy 2-3 times a week for about 2 months. I filed a workers comp claim at my job; however, that claim was denied.
I hired a lawyer to try to get my part of the medical bills paid. I was not by any stretch trying to "make" any money off of the lawsuit, I just didn't feel I should have to pay for an injury that occurred at work. My employer's insurance company ended up settling out of court for a very small amount of money; just enough to cover my part of my medical bills. The worker's comp claim remained denied.
June of 2010 I received a bill from two of my doctors requesting money. I knew that I was up to date with them both, so I called them to find out what the bills were for. They both stated that my insurance company (BCBS of Alabama) had requested their money back. One of these doctors office had previously requested a copy of the workers comp denial letter so they could try to "fight" with BCBS. Eventually, according to the doctors office, they couldn't fight anymore. They stated they had to give the money back because BCBS was refusing to pay other patients claims until they got their money back for my claims.
I had also personally faxed BCBS a copy of the denial letter. I called BCBS and through SEVERAL conversations over SEVERAL months they continued to state they weren't receiving my faxes. I finally threatened a law suit and their tone changed, suddenly their fax machines were working.
Then we came to another screeching hault. On 6/28/2010 I spoke to Sean at BCBS and he told me he had received the fax. He said he was going to talk to his team leader and figure out what to do and he would call me once he found out. I did not hear from him for almost three weeks.
I called BCBS on 7/19/2010 at around 5pm and they said he was on the phone and they would have him call me before he left (which was in a little over an hour). I called back 45 minutes later and they said he was still on the phone but that he would call me on 7/20/2010. By 5pm on 7/20/2010 I still hadn't heard from him so I called. After being on hold for almost 10 minutes they finally got him on the phone. He then put me on hold for another 5-10 minutes telling me he was talking to his "team leader." When he came back to the phone he said that he had to send the fax I had sent to their "imaging center" and that was why he hadn't gotten back with me. I asked what this meant and he explained the fax had to be scanned into the system. I questioned why this took 3 weeks and he said it was because he didn't know how to do it and his team leader had been on vacation. He then put me back on hold and when he came back he said they had gotten it scanned and that they had put a priority on it. He said he would call me in the next few days, which I asked him to define (he said before the end of the week). So, here we go again!! :evil:

Posted: Tue Jul 20, 2010 11:46 pm Post Subject:

They both stated that my insurance company (BCBS of Alabama) had requested their money back.



For what? Are they involved in this claim?


Eventually, according to the doctors office, they couldn't fight anymore.They stated they had to give the money back because BCBS was refusing to pay other patients claims until they got their money back for my claims



That's their problem, not yours. Besides, I thought that your employer's carrier settled on an amount of money and not the actual claim-per the denial letter.

What happened to the money that you said covered your bills? I'm confused.

Posted: Wed Jul 21, 2010 04:33 pm Post Subject:

Something doesn't make sense here.

Workers' Compensation would only NOT COVER a claim for a work injury if it was determined that the injury did not/could not have occurred at work. Essentially, Workers' Compensation is a "no fault" system in which liability does not have to be proved -- the burden is on the employer (or their insurer) to prove it did not occur at/in the course of one's work.

Is this the case? Because if you did not injure yourself at work, but tried to make it a work-related injury, the carrier can deny the claim and you could be criminally charged with insurance fraud.

If the insurance company paid anything, that should be proof that this was a Workers' Compensation claim, and in some states, medical bills must be paid without limitation as to time or amount.

So, again, something is missing from the information you posted.

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