Determining When Insurance Company Tactics Rise to the Level of Bad Faith

J.P. Gonzalez-Sirgo
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Founder of J.P. Gonzalez-Sirgo, P.A.

Insurance is a somewhat unique product because the purchase of insurance constitutes one of the few transactions where the parties will have adversarial interests after they enter into the service provider-customer relationship.  The insured pays premiums for financial security against covered perils.  While the insurance company accepts premium payments while providing no other product or service beyond the payment of claims if disaster strikes, the insurance carrier has a financial incentive to deny legitimate claims or minimize any settlement.  Predictably, policyholders often find that routine claims are anything but routine. 

Although there are many frustrating practices that an insurance company can engage in, it is not the case that every annoying act amounts to insurance bad faith.  Based on my background assisting policyholders in thousands of claims disputes, I have provided an overview of the types of conduct that might justify an insurance bad faith claim.  Florida Statute Section 624.144 provides the civil remedy for compensating policyholders who are victimized by insurance company bad faith practices in Florida.  Because the question of whether conduct rises to the level of bad faith can be an extremely contentious issue, you need an experienced Miami-Dade insurance claims attorney to identify bad faith practices and advocate for your interests.

There are many forms of conduct that can provide a justifiable basis for pursuing bad faith remedies under Section 624.144 that include:

  • A material misrepresentation by the insurance company with the objective of settling the claim on less favorable terms than those contemplated by the policy
  • Endeavoring to settle the claim based on a relevant document that has been modified without the approval or knowledge of the insured
  • Failing to conduct an investigation of a claim based on reasonably available information
  • Failure to provide an explanation based on policy language, applicable law and facts that justify denial of a compromised offer to settle a claim
  • Lack of implementation of compliant implementation procedures which includes maintaining a complete record of complaints since the last examination
  • Requesting information that is not relevant or failing to provide a reason that the information is needed
  • Lack of prompt response and communication with an insured in resolving a claim or answering questions
  • Not providing prompt notice to an insured regarding additional documents or information required to process a claim
  • Failure to confirm partial or full coverage, as well as the amount of partial coverage in writing, or failure to indicate in writing that an investigation is underway within 30 days of receiving a sworn proof of loss

When you are victimized by bad faith insurance company actions, the financial pressure created by your loss can motivate you to accept a lowball offer.  However, you should never accept any offer from your insurance company without professional advice to determine that you are receiving the full value of your claim.  If you have questions about Miami-Dade insurance claims, you are welcome to contact my Florida insurance claims dispute law firm.  My law firm represents policyholders in claims disputes in Miami and throughout Florida.  The Law Firm of J.P. Gonzalez-Sirgo, P.A. offers free consultations and case evaluations.  No Recovery, No Lawyer Fees.  Call 305-461-1095 or Toll Free 1-866-71-CLAIM.

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