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:
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:
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.
- 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.
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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.
Posted: Sat May 21, 2011 05:12 am Post Subject: do we have a legitimate civil suit
I don't understand, my church has been insured by this insurance company for over a year and a half. We had damage done to the ceiling of our church, a small portion of the ceiling fell on October the 16th 2010. The claim was reported to the insurance company on October 18th, 2010. After reporting these damages to the insurance company they sent their engineer out to take a look. The engineer explained to us that the church was a total lose because of the roof having damage do to hell, ice, rain and snow. We had no idea of such damages, we were only under the impresstion that we were just dealing with ceiling tiel repairs. The insurance engineer made us aware of these other damages.We have full coverage with insuring our church. The insurance company has not paid the legitimate claim and in the meantime dropped the insurance, and offering us by letter $10,000, provided that we do not sue them or take any other actions. We believe we have an legitimate civil suit. We plan to sue for Pain and Suffering, Bad faith, Breach of contract, not paying legitimate claim,bribary and punitive damages. Do you believe that the church has a case...
Posted: Sat May 21, 2011 07:24 am Post Subject:
The engineer explained to us that the church was a total lose because of the roof having damage do to hell
Mmmmmmm.....and offering us by letter $10,000, provided that we do not sue them or take any other actions
They won't pay you until you sign a release? It's the churches policy, correct? If so, they cannot require you to sign a release... they owe the money under the terms of the contract (policy). If they are trying to get you to sign a release ask them where in the policy it states that you need to sign one. Then point out the opening remarks that state they will pay when you have a loss. Explain that they have 30 days to issue payment or they will then be in bad faith (if they are not already). Put this in writing.We plan to sue for Pain and Suffering, Bad faith, Breach of contract
Then you better hire an attorney who understand what those mean... as they don't all apply.Do you believe that the church has a case
You never fully mention why the reduction in payment. I'm guessing the insurance company is stating some of the damage occurred before the policy or that this is several different losses.If it's a question of cost to repair the covered damages then you can invoke the appraisal clause. If it's a question of coverage under the policy then the clause won't help.
Also, please read my sig.
Posted: Sun May 22, 2011 12:54 am Post Subject: Insurance Claim
Well the first $10,000.00 was offered a conference call, and then a $10,000.00 was made known to start the moving of the contents. It was stated that she was only a small adjuster, so the work had to be turned over to a high claim adjuster. After the Conference call and they were made aware that we were going to get paid for all of it. The first adjuster was going to start procedures of rectifying the whole problem, until she was informed that she was a small claims and not a high claim. This is exactly how the $10,000.00 came about. Yes it is the church's policy, but as a Board Member I was trying to figure out why we are being done this way, going through such chaos of receiving relief from this settlement. The Insurance Company is stating that some of the damages occurred before the policy, but we had no way of knowing that damage was done to the building because the Insurance Company did not come and inspect as they should have. Yes, the appraisal clauses of the Insurance Policy was $545,000.00, this amount is in the policy and was told verbally to the Board of Directors. This battle with the company has been ongoing since October 18, 2010. We were flat out told that they were not going to pay the policy. We also have an engineer who told us what the problem was and there were four witness who understood what his response was.
Posted: Sun May 22, 2011 01:05 am Post Subject:
The Insurance Company is stating that some of the damages occurred before the policy, but we had no way of knowing that damage was done to the building because the Insurance Company did not come and inspect as they should have
You are loosing me... if the damage occurred before the policy started how could this have been caused by a delay in their inspection?I'm guessing there is an indication that the damage had been ongoing, such as rot? Do you disagree that some of the damage happened before the policy started? Did the church have a prior policy? Is so, report the damage to that company as well. If it's an occurrenced based policy then the prior carrier should address the loss as well.
Posted: Sun May 22, 2011 10:25 pm Post Subject: insurance company
I would first like to thank you for responding. Yes, their was a prior insurance company. Neither insurance company did an inspection of the inside of the church, before accepting to insure our property. We had no idea that our church was in such bad conditions until we addressed the ceiling tile. The insurance company sent their engineer out to inspect and it has been down hill every since. We have no other place to worship and it is like where do we turn. No other insurance company will insure us do to the damage of our church. We sent the insurance company two payments and they returned both payments telling us they will drop the claim and they did just that. Do you think we have a claim for bad faith and breach of contract. None of this was do to any fault of the church, we just want to get this resolved and keep the members of our church safe.
Posted: Mon May 23, 2011 12:28 am Post Subject:
We sent the insurance company two payments and they returned both payments telling us they will drop the claim and they did just that.
Then they are not denying the claim... they are rescinding the policy. there is a big difference. What they are saying is that there was material misrepresentation when you obtained the insurance (most likely what was filled out on your application was in error). As such, they are "cancelling" the policy as never in-force. This is why they returned the premium.You need to find out why they rescinded the policy (what the misrepresentation was). I suspect you already know but have not posted this information.
I'm going to guess that you stated the roof was in good condition when indeed it was not. You may not have known but it's not up to the insurance company to confirm everything you wrote on the application was indeed correct. If you feel that the info was correct, then you can file suit if you want. You will need to prove your case.
Posted: Tue May 24, 2011 01:57 am Post Subject: insurance claim
The insurance was obtained by a broker. We did not fill out an application. The broker filled out all the paper work. The broker then moved us from a prior insurance company to the one in question. They only returned the last two payments after being insured by them for over a year. Even in the mist of the claim the insurance company renewed the policy,even added terroist protection to the policy.If there were any misrepresentation done it had to be through the broker. The insurance was done through the broker. We don't know what the misrepresentation could have been, we had no idea that there was anything wrong with the roof until a small portion of the ceiling tile fell in the inside of the church.
Posted: Tue May 24, 2011 03:36 am Post Subject:
We did not fill out an application.
Someone from the church signed the application regardless of who completed the document. Who ever signed it agreed to the conditions in the application.The broker then moved us from a prior insurance company to the one in question.
For a reason... and the church went along with it of their own accord.They only returned the last two payments after being insured by them for over a year.
An insurance policy is going to be for a year... so perhaps after being insured a year and two months. Regardless, I'm betting the entire premium for that policy period was returned.Even in the mist of the claim the insurance company renewed the policy,even added terroist protection to the policy
I'm only working with the limited details that you are providing. To be more clear you only need to find out _exactly_ what took place. I'm betting if you find out the details you will find out that the policy was recinded.. We don't know what the misrepresentation could have been
Then you need to ask/find out. As I mentioned, I'm only guessing at certain things based on what you've posted. I think part of the problem is that you have not found out what took place. You really need to find out. The insurance company would have told someone all of this info and I have no doubt that it was all put in writing as well.Posted: Tue May 24, 2011 12:15 pm Post Subject:
"If you are willing to sue the car insurance company, there are a couple of steps to take.
1. First call your insurance company and get the manager on the phone. Make sure you get the person at the top of the chain. If you have to leave them a message. Let them know that you are fed up and the reasons why. Tell them that you will be immediately filing a complaint with the Department of Insurance (DOI) for your State.
2. Second, call the DOI and file your complaint. You can give the information over the phone. DOI's take complaints very seriously. DOI companies will investigate a car insurance company if there are too many DOI complaints and possibly fine them. Car insurance companies know this and therefore hate DOI complaints and will usually do what they need to in order to avoid them."
Posted: Thu Jun 02, 2011 02:31 pm Post Subject: roof damage denied
we had a hail storm and my roof was l6 days old. The hail dented our metal truck and broke through the skylight but yet the adjustor said "we don't have damage and the claim will close based on his decision at that time". Lots of people are getting new roofs in the area due to damage. I aked for a second opinion and they are sending the same adjustor for it. Can I sue them in small claims court if they deny my claim again?
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