Can You Sue Your Insurance Adjuster for Bad Faith

Author

Reads 775

A Woman holding Insurance Policy
Credit: pexels.com, A Woman holding Insurance Policy

Suing your insurance adjuster for bad faith is a serious matter that requires careful consideration. In some cases, you can indeed sue your insurance adjuster for bad faith, but it's not a straightforward process.

Bad faith insurance practices can take many forms, including denying valid claims, delaying payments, or making lowball offers. If your insurance adjuster has engaged in such behavior, you may have grounds for a lawsuit.

To sue your insurance adjuster for bad faith, you'll need to prove that they acted in a way that was unreasonable, unfair, or in bad faith. This can be a challenging task, requiring extensive documentation and evidence of the adjuster's wrongdoing.

If you're considering suing your insurance adjuster, it's essential to consult with an experienced attorney who can guide you through the process and help you build a strong case.

Can You Sue an Insurance Adjuster?

To sue an insurance adjuster, you'll need to gather clear and strong evidence of bad faith. This can be done by reading your insurance policy to understand what's covered and what's not.

People Looking the Insurance Policy
Credit: pexels.com, People Looking the Insurance Policy

You should also keep written records of all communications with the adjuster and insurer, including dates and times. Maintaining an organized file with evidence like medical records and witness statements is crucial.

If the insurance company denies your claim, you can ask them to review their decision. If that's not successful, you may want to consider filing a complaint with TDI.

It's essential to mail a final demand letter to the insurer, giving them one last chance to pay the claim and advising them that you'll file a bad faith lawsuit if they don't.

Here are the steps to take in a clear and organized list:

  • Read your insurance policy to understand what's covered and what's not.
  • Keep written records of all communications with the adjuster and insurer.
  • Maintain an organized file with all evidence.
  • Ask the insurance company to review their denial decision.
  • File a complaint with TDI if necessary.
  • Mail a final demand letter to the insurer.

Insurance Adjuster Liability

Insurance adjuster liability can be a complex issue, but it's essential to understand that adjusters can be held personally liable for their actions. In Texas, for example, the Texas Supreme Court has recognized that insurance adjusters can be individually liable for claims under the Texas Insurance Code, Chapter 541.

Take a look at this: Bad Faith Insurance Claim Texas

A Home Insurance Policy
Credit: pexels.com, A Home Insurance Policy

You can make a claim against an adjuster in their individual capacity, which means they can be held personally responsible for any damages or losses resulting from their actions. This can include cases where the adjuster failed to conduct a proper investigation, made misleading statements, or delayed payments.

To establish liability, you'll need to gather evidence of the adjuster's wrongdoing, such as written records of communications, medical records, and witness statements. If you believe the adjuster acted in bad faith, you may want to consider seeking the help of an attorney who specializes in bad faith insurance cases.

Here are some examples of adjuster liability:

  • Failure to conduct a proper investigation
  • Making misleading statements about policy coverage
  • Delaying payments or denying claims without a valid reason
  • Using biased experts to evaluate claims

What Constitutes Bad Faith

Bad faith insurance adjusters use tactics to deny or delay claims, and it's essential to know what constitutes bad faith. Insurance adjusters act in bad faith by offering extremely low settlements, not conducting proper investigations into accidents, and using stalling tactics to delay the processing of a claim.

An Elderly Man Consulting an Insurance Agent
Credit: pexels.com, An Elderly Man Consulting an Insurance Agent

One key indicator of bad faith is when adjusters don't provide notice in writing as to why your claim was denied. You have the right to be told in writing why your claim was denied. This lack of transparency can be a clear sign that the insurance company is not acting in good faith.

Bad faith adjusters may also use experts who are biased toward the insurer to evaluate claims. This can lead to unfair and inaccurate assessments of your claim. It's crucial to ensure that any experts involved in your case are neutral parties.

Here are some specific examples of bad faith tactics:

  • Offering extremely low settlements
  • Not conducting proper investigations into accidents
  • Using stalling tactics to delay the processing of a claim
  • Delaying the payment of approved claims
  • Using biased experts to evaluate claims
  • Making misleading statements about what is covered in a policy
  • Not providing notice in writing as to why your claim was denied
  • Canceling your policy after you file a claim

If you believe your insurance company is acting in bad faith, it's essential to take action and seek the help of an attorney who handles bad faith insurance cases.

Negligence Claims

Insurance adjusters can face negligence claims in Pennsylvania state courts, as ruled by U.S District Judge Thomas N. O'Neill in Kennedy v. Allstate Property and Casualty Insurance.

Businessperson shaking hands with a client while holding a home insurance policy document.
Credit: pexels.com, Businessperson shaking hands with a client while holding a home insurance policy document.

This decision suggests that Pennsylvania courts may allow for negligence claims against individual insurance adjusters, potentially holding them liable for their actions.

In this case, the plaintiffs alleged that the adjuster-defendants made false assurances about investigating their UIM claims.

Pennsylvania law is silent on the issue of adjuster negligence, but Judge O'Neill opined that the Pennsylvania Supreme Court could find that an adjuster does owe a duty of care to an insured.

Multiple Pennsylvania courts have opined that claims against individual adjusters for violation of the UTPCPL are actionable, making it possible for plaintiffs to bring negligence claims against adjusters.

Here are some key points to consider:

In some cases, adjusters may be liable for their actions, and plaintiffs may have grounds to bring negligence claims against them.

CPA Violations

CPA Violations are a serious concern for insurance adjusters.

If an adjuster knowingly or recklessly makes a false or misleading statement, they can be held personally liable for damages.

A single misclassified claim can result in a 10% to 20% increase in premiums for policyholders.

The NAIC requires adjusters to maintain accurate records, including notes and communications with insureds.

Adjusters who fail to do so can be subject to fines and penalties.

Making a Claim

Close-up image of an insurance policy with a magnifying glass, money, and toy car.
Credit: pexels.com, Close-up image of an insurance policy with a magnifying glass, money, and toy car.

Making a claim against your insurance adjuster can be a complex process, but it's an option that's been explored in court cases. The Eastern District of Texas, Sherman Division, has weighed in on this issue in the 2023 opinion Lawrence Family Fund, LLC v. Westchester Surplus Lines Insurance Company, et al.

You can sue your insurance adjuster for violating Texas Insurance Code, Chapter 541, as the Fifth Circuit and the Texas Supreme Court have recognized this is allowed under Texas law. This means you can hold the adjuster personally liable for their actions.

The Texas Supreme Court hasn't specifically addressed the viability of claims against insurance adjusters in their individual capacity. However, the court has found that you have at least one valid cause of action against the adjuster under Texas law.

To determine whether you can make a claim against your insurance adjuster, you'll need to consider the specifics of your case, such as the adjuster's actions and the applicable laws in your state. The court will also look at whether the adjuster's actions were unreasonable, as in the case of Lawrence Family Fund, LLC v. Westchester Surplus Lines Insurance Company, et al. where the adjuster failed to verify a statement through a physical inspection.

See what others are reading: Victoria Texas Insurance Adjuster

Damages and Compensation

People Discussing a Home Insurance Policy
Credit: pexels.com, People Discussing a Home Insurance Policy

If you're considering suing your insurance adjuster, it's essential to understand the potential damages and compensation you could receive. You could get up to three times the money you would have gotten in a properly processed claim.

In a successful bad faith insurance lawsuit, you can also recover compensation for your attorney's fees and court costs. This can help offset the expenses of taking on a big insurance company.

Interest at the rate of 18% annually can be added to the damages if your payment was delayed. This can add up quickly and significantly increase the total amount you're owed.

Punitive damages can be awarded to punish the adjuster and/or insurance company for their actions. This can serve as a deterrent to prevent similar behavior in the future.

Frequently Asked Questions

How do you deal with a bad adjuster?

Deal with a bad adjuster by hitting the reset button, becoming informed about your claims process, and seeking support from a supervisor or the Insurance Commissioner

Alfred Blanda

Senior Writer

Alfred Blanda has carved out a niche for himself in the realm of banking information, offering readers clear, concise, and comprehensive insights into the financial sector. His articles are known for their depth and clarity, making complex financial concepts accessible to a wide audience. With a keen eye for detail and a passion for educating, Blanda continues to be a trusted voice in financial journalism.

Love What You Read? Stay Updated!

Join our community for insights, tips, and more.