The typical insurance claimant is often at a loss for understanding the legal responsibilities of their insurance company when something happens that generates the need to file a claim. Insurance agents are commonly cordial to all clients at the time of a policy purchase only to become indifferent when it is necessary to request benefits after a damage incident, and our auto accident lawyers understand how they operate. As a matter of law, insurance companies do have to take action quickly when a policyholder has an issue. However, they can also set a policy for compliance that benefits the company more than the policyholder who has suffered a loss of some type. This can happen with any type of claim, but most claims stem from personal injury of some type such as an auto accident or a workers’ compensation claim. And there are also claims that involve third parties such as an employer when a worker is injured on the job. Depending on what has transpired during the claim process, there are a few issues that claimants should evaluate regarding possible bad faith by the insurance provider.
Insurance companies can even act in bad faith on the very first contact they make with a claimant, and it can happen even on the first contact. This especially applies to auto accidents. North Carolina uses the antiquated contributory negligence law that is also used in the District of Columbia and a few eastern states that allows insurance companies to deny claims of injured drivers if they are even 1% at fault for causing an accident that produces their own injuries. This gives the respondent insurance provider ample incentive to deny many claims from drivers based on causation contribution. Claims adjusters look diligently in the initial investigation as state law requires for any slight technicality they can find to use as a legal defense to the claim denial, which is the goal for each and every insurance provider. They are in business for profit and not for client protection.
Ridiculous Documentation Demands
Another tactic insurance providers use is requesting multiple documents as verification of small details involved with claims. This can occur in a variety of claim types and situations, especially in personal injury cases and physical property
damage submissions. Many have even been known to retain a private investigator to “monitor” the activity of claimants while taking photographs in the process to use in support of an embellished injury claim denial. This also happens in workers’ compensation claims as well as standard personal injury situations. There is no depth too low for an insurance claims adjuster to stoop when investigating cases because the industry has influenced many legislators via campaign contributions and private deals to maintain the contributory negligence law in the state. The insurance laws in North Carolina are assuredly largely in favor of the insurance companies, which emboldens company claims evaluation officers.
Purposely Delaying Claim Payment
Another bad faith tactic used by many insurance company adjusters is purposely delaying obvious claims. This is not unusual with claims that can be held over to the next annual payout budget, which is an internal company financial allocation issue that outsiders do not know occurs. Insurance companies have investors as well as clients and making dividend predictions is vital to many just like other corporations. The delay can also be used to entice a claimant to accept a low settlement offer in some cases, especially in cases where think they have an advantage against those in financial straights while waiting on case closure.
Take It or Leave It Offers
Another situation of bad faith can arise when an insurance adjuster makes an offer and tells the claimant it is the final offer. This forces the claimant to accept what is offered or take the case to litigation. This can also be a problem in auto accident or premises liability injury cases because of the strict contributory negligence law that applies in North Carolina courts regarding personal contribution to injury causation. Any claimant who is even 1% at fault for their own injury will be denied a claim payout if the court determines as such, including if the case goes to a jury for a decision. The same can apply in workers’ compensation situations in standard state court. Even though workers’ comp is considered a “no-fault” damages legal matter, cases that are adjudicated in a standard court outside the North Carolina workers’ compensation board determination can result in the injured claimant being denied any financial recovery based on employer negligence.
These are just a few methods of claim defense that insurance companies use when wanting to reduce the value of a claim or deny any compensation whatsoever. The law is largely in their favor, and they know it. It is always vital to have experienced and comprehensive legal counsel when having problems with any respondent insurance provider in North Carolina, especially when there is evidence of bad faith.
Contact Our Law Firm ASAP
Always remember that a bad faith claim is an additional civil claim against a respondent insurance company that should have investigated and paid the claim in a reasonable time format at the level of coverage they were obligated to pay. Additionally, although they have the power to tap dance around the law regarding their responsibilities, deceptive practices in the process could result in a punitive damage award that far exceeds the original claim value. Always consult with our auto accident lawyers when your insurance company is procrastinating your claim payment. Contact Kellum Law Firm Here