Suing an Insurance Company

Dealing with an insurance company can be a frustrating experience. Especially when you are trying to fight for a claim that has been wrongfully or mistakenly denied. In times like these, the assistance of a professional who knows how to deal with insurance companies is invaluable. An experienced attorney can not only save you the headache of dealing with insurance company run-around, but may also save you a considerable amount of money.

The attorneys at WylieLaw have had great success over the years standing up to and winning lawsuits against the big insurance companies, recovering thousands of dollars and saving their clients the anguish and frustration of insurance company bureaucracy.

What to Do When Your Claim is Denied
Fighting the Insurance Companies
Legal Remedies
What is Good Faith?
Bad Faith Claims and Recovery
Bad Faith Claims for New Yorkers

What to Do When Your Claim is Denied

When a claim has been denied and subsequently upheld through insurance company appeal and grievance procedures, you may be able to sue based on:

• Breach of Contract: When your insurance company does not adhere to the terms of the contract (your insurance policy).
• Breach of the Implied Covenant of Good Faith and Fair Dealing: When your insurance company makes it too difficult for you to comply with the contract or does not make an honest effort to comply with the terms.
• Bad Faith: The unreasonable denial of a benefit.
• Emotional Distress: While a very difficult claim to prove, if you have suffered emotional harm due to the wrongful conduct of an insurance company, you may be entitled to recover compensation in addition to the policy benefits.

Fighting the Insurance Companies

Even if you can't afford to pay a lawyer, you can fight the big insurance companies. The attorneys at WylieLaw, as well as many other attorneys, may work for you on a contingency fee basis. This arrangement allows you to pursue your case while the attorneys receive a percentage of any settlement from the insurance company.

If you believe that your claim has been unfairly denied or that the insurance company has acted unreasonably in handling the claim, do not simply let it go. Pursue your claim and assert your rights! You can fight and win.

Legal Remedies or What You Can Recover When You Sue

Under Breach of Contract, you may recover:

• The value of the denied benefit or service and any related damages, which may include emotional distress.

Under Bad Faith, you may recover for:

• Emotional distress,
• Interest on out of pocket losses,
• Damages for attorney fees,
• Punitive and exemplary damages (in limited circumstances involving malicious or willful misconduct).

Available legal remedies vary widely from state to state. It is best to consult with an attorney who can advise what remedies may be available for your specific claim.

What is Good Faith?

The duty of good faith and fair dealing means that your insurance company must:

• Adjust your claim (pay it or deny it) within a reasonably prompt period of time.
• Cooperate with you regarding the claim (respond to your letters and phone calls in a timely manner).
• Tell you in writing precisely why it is denying your claim, specifying each contract term or provision upon which it relies.
• Attempt to find a basis to pay the claim rather than find reasons to deny it.
• "Play fair" with you.

Bad Faith Claims — What You Can Recover

Bad faith is the unreasonable denial of insurance policy benefits. If your state law allows you to bring a bad faith claim against your insurance company (New York does not) and if the claim denial can be shown to have been unreasonable, you may be able to recover the following (in addition to what the insurer owes you under the policy, plus interest):

• Consequential or Extra-Contractual Damages: Loss or harm suffered due to the wrongful denial of your claim (may include compensation for mental and emotional distress).
• Compensatory Damages: The benefits to which you are rightly entitled.
• Punitive or Exemplary Damages: Monetary awards designed to punish the insurer and deter it from wrongfully denying similar claims in the future.

Bad Faith Claims for New Yorkers

If you live in New York and your insurance company wrongfully denies your claim, you cannot bring a bad faith claim. However, you may not be restricted solely to the benefits of your policy. Recent case law has held that if a policyholder has been wrongfully denied benefits and has suffered damages in excess of the applicable policy limits, the policyholder may recover monetary damages above and beyond the policy amount. WylieLaw has already fought and won extra-contractual damages for a client under this new law (see Decisions and Press). Our advice is to consult an experienced attorney who can advise you of your rights.