Do you believe your insurance provider is acting in bad faith? Do you think they’re intentionally denying your claim, failing to perform a proper investigation, or limiting your payout for their own gain? You need an attorney to help you prove your insurance provider’s bad-faith actions.
What Is a Bad-Faith Insurance Claim?
A bad-faith insurance claim is a claim filed against your insurance provider for their failure to act according to their policies or in a way that unfairly impacts your initial insurance claim.
It doesn’t matter what insurance provider or policy you’re dealing with. It could be health insurance, life insurance, auto insurance, or homeowner’s insurance. If the provider acts in bad faith and attempts to take advantage of you, an attorney can assist you in seeking compensation by filing a new claim against them.
Insurance Provider Bad-Faith Practices
The good news for South Dakotans is that the state’s laws specifically lay out what insurance provider practices it considers unfair or deceptive. Examples of bad-faith insurance practices include:
- Failing to investigate your insurance claim to a reasonable standard within 30 days of its filing
- Making payments without a statement outlining what policy and under what coverage the payment is for
- Failing to provide a prompt, reasonable, and legal explanation for why they denied your claim or limited your payout
- Failing to settle claims where liability is reasonably clear under the insurance policy’s coverage within a reasonable period
- Requiring claimants to seek repairs to treatment from specific contractors or providers as a condition of receiving payment
- Failing to assign the degree of contributory negligence in a claim properly
- Refusing to settle a claim because the insurance provider believes others should assume the responsibility instead.
These are tactics that insurance providers will sometimes use to “pull one over” those to whom they owe money.
Failing to investigate your claim promptly means they may no longer have access to evidence that would have supported your claim. Making payments without telling you what the coverage was for allows them to hide the true extent of what they owed you. And claiming that you were more responsible for the accident that caused your claim is their excuse for paying you less.
They hope that you won’t fight back against these bad-faith practices. Don’t let insurance providers increase their profits by refusing to pay you the money you deserve.
Health Insurance Provider Denial Requirements
Has your health insurance provider denied your compensation claim? When rejecting a claim, health insurers must include the following information:
- The specific reasons for the denial, including the provisions of your insurance plan that the provider based your denial on
- A description of additional evidence or information that could support your claim for compensation and why it’s necessary
- The rule or law that the provider used to back up their denial of your claim
- A clinical or scientific basis for their denial of your claim if they believe a particular treatment wasn’t necessary
- Notice of your right to appeal the provider’s decision, details about the appeal process, and the time limit within which you must file your appeal
If your health insurance provider failed to present the above information when denying your claim, you may have an insurance bad-faith claim.
Proving Your Provider Acted in Bad Faith
To prove that your insurance provider acted in bad faith, you must show that they intentionally engaged in behaviors that negatively impacted your claim. One way to do this is by documenting your interactions with your provider.
Keep emails, letters, voicemails, and other documentation showing how you and your provider handled your case. Your attorney may be able to use these pieces of evidence to show that your provider did not act according to their policies.
Additionally, this evidence can prove that your provider spent a needlessly long time “investigating” your claim or intentionally caused delays that negatively impacted your payout.
You should also keep copies of all bills and records regarding medical treatments you have undergone or repairs made concerning your initial insurance claim. Your attorney can use these bills and records to fight back against your insurance provider’s low settlement offers and prove the value of your claim in court.
The Role of an Insurance Bad-Faith Lawyer
Why do you need an attorney with experience fighting against insurance providers who engage in bad-faith tactics? The most important reason is so you fully understand your rights.
Your insurance provider will have a team of attorneys trying to get you to drop your claim or accept less compensation than you legally deserve. When you hire a knowledgeable attorney, you gain access to their comprehensive understanding of South Dakota’s laws and the insured’s rights (that’s you).
Your attorney can also review your contract with your insurance provider. What terms did you and the provider agree to when you signed up with them? You’re holding up your end of the agreement by paying for your insurance. Are they holding up theirs?
Settlement negotiations, mediation, and trial litigation can all go much smoother with an experienced attorney on your side. The simple fact that you have an attorney may be enough to prevent the insurance company from attempting to give you a lowball settlement offer. And if your claim goes to trial, your attorney can present the full extent of the case they’ve built against the insurer.
Watertown, South Dakota Insurance Bad-Faith Attorney
Has your insurance provider used bad-faith tactics to cheat you out of the compensation you deserve? Contact Turbak Law Office, P.C. online or at 605-886-8361 for a free consultation about your case.
One of our experienced insurance claim attorneys will evaluate your claim, help you understand your legal rights, and walk you through our process of holding insurance companies accountable to their clients.