Insurance Coverage Disputes


During our representation of current clients in personal injury, malpractice and business litigation, we sometimes represent insured business owners or individuals who have (1) had a valid insurance policy in place (or are covered under someone else’s policy; (2) suffered a substantial loss; (3) have properly reported the loss to the insurance company; and (4) their claim has been wrongfully denied.

The wrongful denial of an insurance claim can take many forms. Often, the insurance company attempts to deny the claims and asserts that the policy under which the claim was made had been previously cancelled. In this type of situation, the burden is on the insurance company to prove that the law regarding notice of cancellation has been strictly complied with. Other times, insurance adjusters unreasonably delay the process and drag things out (many times this tactic is used in order to place the insured into a time crunch, as the time deadline to sue may be fast approaching and the insured is not aware of this).

Insurance coverage disputes often involve the following types of insurance policies:

  • Homeowner's Insurance
  • Life Insurance Claims
  • Long Term Disability Claims
  • Car Insurance
  • Health Insurance
  • Home Fire Insurance
  • Professional Malpractice Insurance such as Errors and Omissions Policies
  • Malpractice Insurance
  • Commercial General Liability Policies
  • Corporate Officers and Directors Policies

Insurance claims that repeatedly spur bad faith denials by the insurance companies are:

  • House fires
  • Apartment Fires and thefts
  • Burglary claims from houses and apartments
  • water damage
  • flood damages
  • vandalism
  • mold
  • automobile theft
  • stolen autos

One of the most commonly litigated insurance coverage issues is the bad faith failure to settle claim. This arises when the insurance company had the opportunity to settle the claim against the insured and fails to do so. By failing to settle in this situation, the insurance company fails to protect the insured form a judgment that may exceed the insurance policy limits. If this failure is in bad faith, the insured can sue the insurance company for breach of contract and bad faith. If successful, the insured may be entitled to up to 150% of the value of the denied claim, plus reasonable attorneys' fees. Although, state laws such as the Georgia Civil Practice Act govern most insurance issues, litigation of these matters is conducted in either state or federal court. There are strict requirements that must be met in order to bring a bad faith insurance lawsuit in Georgia and if you don’t meet this satisfy each and every requirement, your right to sue may be forever lost.

Insurance companies involved in claim disputes in Georgia are, among others:

  • State Farm
  • Allstate
  • Travelers
  • Progressive
  • Liberty Mutual
  • Farmers
  • Nationwide

Insurance companies often try the following in order to wear their claimants down in hopes that they don’t have to pay the claim:

  • Requesting an Examination Under Oath (“EUO”) or multiple EUO’s without proper justification
  • Denying the claim without performing a full and complete investigation
  • Delaying, discounting, or denying payments
  • Hiring “experts” whose sole purpose is to support denial of the claim instead of fairly gathering information to accurately adjust the claim
  • Endlessly seeking more documents and other information from the insured in order to wear them down so that they abandon the claim
  • Misrepresenting the true value of the claim to low-ball the insured and pressuring them to settle for a fraction of the true claim amount
  • Requesting information not required by the policy
  • Harassment
  • Rude behavior during in-person visits by insurance company adjusters and investigators that is meant to intimidate the claimant into settling the claim for less than fair value or dropping the claim altogether
  • Conducting an investigation in a biased or intimidating manner
  • Intentionally withholding claims information which helps the insured
  • Failing to inform an insured of provisions and coverage benefits associated with the policy when it is clear that the insured is not aware of it
  • Lying about coverages and exclusions contained in the policy to avoid payment of a valid insurance claim
  • Threats to criminally prosecute the insured if they continue to pursue the claim
  • Advising the insured that they do not need an attorney and/or that hiring an attorney will actually hurt their claim
  • Unreasonably interpreting policy language to avoid coverage or payment

Don’t let an insurance company harass or intimidate you into settling your insurance claim for less than it is worth or dropping the claim altogether. We are experienced insurance litigation lawyers who handle a variety of claims in this area for our existing clients, such as bad faith litigation and coverage disputes.

If you suspect that your insurance company has denied your coverage in bad faith or is unreasonably delaying your claim in order to deny it and would like to discuss your case confidence, call (404) 525-5150 or contact us online.

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