Insurance policies are designed to ensure that there is financial coverage in the case of serious property damage or injuries. Many insurance policies protect against accidental injuries, such as the policies used in auto insurance, homeowners insurance, and business liability insurance. If you were injured and need to file a claim against an insurance company, you may be entitled to a payout under your policy or someone else’s policy. If the insurance company denies your claim or refuses to pay, you should turn to one of our Houston lawyers for suing insurance companies.
The Queenan Law Firm’s Houston attorneys represent injury victims and other individuals seeking compensation from an insurance company, and we sue auto insurance, homeowners insurance, medical care insurance, and other insurance companies to get you the payments you deserve. For a free legal consultation, call our lawyers today at (817) 476-1797.
What Constitutes “Bad Faith” in an Insurance Claim in Houston?
Whether you are filing a claim with your car insurance company, your homeowners insurance, or some other insurance company, the insurance company has a legal duty of “good faith.” This requirement comes from old common law and requires an insurer to make an honest effort to investigate the claim and pay damages if the claim meets the policy’s requirements. If your claim is for damages that are not covered under the policy or the policy truly does not exist, they do not have to follow this standard.
Unfortunately for many people with valid insurance policies, the insurance company will deny their claim based on completely invalid reasons or made-up technicalities. This often violates the “covenant of good faith and fair dealing” and can lead to a lawsuit against the insurance company. This is distinct from a breach of contract case – which could also come up in an insurance claim if the insurance company refuses to follow the terms of the insurance policy.
Bad faith insurance cases are often more extreme than mere breach of contract cases and often involve the following kinds of underhanded or unfair actions:
- Denying that the policyholder has a policy
- Indefinitely delaying a claim without reason
- “Losing” records that show the policy exists, that premiums were paid properly, that a claim was filed, or that the claim was accepted
- Cancelling a policy while the claim is pending
- Dodging communications and failing to respond to the policyholder’s calls and claims
- Denial of a claim without attempting to investigate
- Changing the terms of the agreement without notice or after the claim has already been filed
- Obvious undervaluing
- Threatening you with violence or frivolous legal action
If any of these things occurred in the course of your insurance claim, you should speak with our Houston bad faith insurance attorneys right away to get help with your case.
Suing an Insurance Company After an Injury in Houston
Insurance usually covers first-party claims, third-party claims, or both first- and third-party claims. In a first-party claim, the insurance policyholder files a claim against their own insurance policy to have the insurance cover the cost of an injury, medical care, property damage, or some other harm. In a third-party claim, someone that the policyholder injured or harmed files the claim against the policy instead.
In first-party claims, the terms of the insurance policy will be vital. Your insurance company is contractually obligated to follow the insurance policy, and if they refuse to pay for something covered under the policy, you may be entitled to take them to court to enforce the policy. Sometimes, initial denials can be resolved by appealing the claim, but this can often be a difficult and confusing situation. Having an attorney guide you through the process and help you understand what you are entitled to can be vital to getting you the payments you need.
In third-party claims, the insurance policy is between the insurance company and the person who injured you. This means that you are not a party to the contract, but you can still often file a lawsuit to get the damages you need. The first part of a claim like this will be proving that the policyholder was responsible for your injuries. Most insurance policies cover accidental injuries, which means that you need to prove that the policyholder caused your injuries through negligence or inattention. Once you prove this, the court can order the at-fault party to pay your damages. The insurance policy will then be required to cover the costs under their contract with the policyholder.
In some cases, the details of insurance policies and liability coverage can be extremely complex, and you may need a lawyer to represent your needs and interests against the insurance company.
Should I File an Insurance Claim or a Lawsuit?
In many cases, filing an insurance claim might be the simplest way to get your damages covered. If you faced mild injuries or property damage, an insurance claim with the proper insurance company might cover these costs without much fuss.
However, if the injuries are severe or the property damage is extensive, an insurance claim might not be enough to pay for the full costs. Some insurance policies cover only a portion of the damages, or they refuse to cover unnecessary costs or damages brought about by intentional harm. In these cases, you will likely need to file a lawsuit instead of an insurance claim.
A lawsuit might also be better in some injury cases. While insurance coverage might pay for damages after a car accident or truck accident, the injuries you face might include additional damages that insurance policies simply do not cover. “Pain and suffering” is considered a type of noneconomic damages, and most insurance policies do not pay these damages. That means that an insurance claim might automatically fall short of the damages you deserve.
Some insurance claims might also have strings attached to the payments that make it impractical to file an insurance claim. For instance, workers’ compensation insurance at your job might require you to use a doctor that your employer chooses. If you can opt out of this system, it might be better to sue instead of filing an insurance claim.
In most cases, you must choose one or the other: you cannot typically get paid through an insurance claim then sue on top of that. An insurance payout will usually be considered a settlement that blocks any additional claims for the same damages.
Insurance Bad Faith vs. Breach of Contract Cases in Houston
As mentioned, an insurance policy is technically a contract between the insurance company and the policyholder. This creates certain legal duties between these parties – such as the policyholder’s requirement that they have to pay monthly premiums and the insurance company’s requirement that they will pay damages under the terms of the policy. The duty of good faith is separate from the actual terms of the agreement and is instead a legal duty about how the insurance company needs to act when approaching claims.
If the insurance company gives reasons for denying a case and uses arguments based on the terms of the agreement to support why they denied a claim, the case might not constitute bad faith. Still, you could be entitled to sue the insurance company for breach of contract and ask a judge to enforce your policy. If you need damages from your insurance claim, your lawyer can help determine which type of claim is appropriate and pursue your case either way.
Appealing Denials from Insurance Companies in Houston
If you live in or around the Houston area, our attorneys may be able to help you fight denials from your insurance company. If you are entitled to payments for medical coverage, mental healthcare costs, damage to your home, damage to your car, or other insurance payouts, our lawyers will help you fight to get the coverage you need.
Some insurance policies can be tricky, but many instances of bad-faith insurance coverage or intentional attempts by insurance companies to dodge their obligations can leave people without the money they deserve. Our lawyers may be able to help you appeal a denial with your insurance company and sue to ensure that the claim is paid as it should be.
Call Our Houston Lawyers for Help Suing Your Insurance Company
If you or a loved one was injured or needed to file a claim with your insurance company, there is a chance that an insurance company may resist paying your claim, unfairly deny your claim, or refuse to accept their policyholder was at fault. If you need help getting the insurance payments you deserve, call The Queenan Law Firm today for help filing a lawsuit and seeking damages against an insurance company. Call our Houston attorneys at (817) 476-1797 to set up a free legal consultation today.