You are required by law, in most circumstances, to have insurance. You pay your premiums and try your best to drive safely. When you finally get unlucky and have a car accident, like most people do in their life, you expect your insurance company to be there for you. Unfortunately, insurance companies look out for themselves first.
Insurance companies will do everything that they can to deny your claim or reduce the amount of money that they have to pay you by as much as possible. If you are being strung along by your insurance company, you need “the Strong Arm” to fight back. Contact John Foy and Associates for a free consultation.
Why Do Insurance Companies Deny Claims?
Your insurance company, at the end of the day, is a business. This means that their only goal is to maximize their profit. Unfortunately, because of the nature of the insurance business, this means that their customers will be the victims of their practices far more often than not.
How Does the Law Protect Me from Bad Insurance Practices?
If an insurance company denies your claim in violation of your policy agreement, you can sue them for breach of contract. However, breach of contract is not truly good enough because the most you can recover as damages under breach of contract is the amount that you lost out on. Because lawsuits can take years, this means that you would have to wait far longer than is fair to get the money that you deserved in the first place.
For this reason, every state legislature in the country, including Georgia, has created a new cause of action that you can sue insurance companies under Insurance Bad Faith. Insurance bad faith claims compensate you for the money that you should have received initially and extra damages. A good insurance claims lawyer in Macon will be able to advise you on your rights under the law.
Damages in Insurance Bad Faith Claims
If you successfully prove that your insurer acted in bad faith while denying your claims, you are entitled to special, statutory damages. These damages are:
- The money you were initially owed
- Either 50% of the money you were owed, or $5,000, whichever is greater
- Your attorney’s fees
So, for example, if your insurance company should have paid you $100,000, but did not, in bad faith, you would be entitled to $150,000 plus your attorney’s fees. The extra damages create an incentive for insurance companies to only deny coverage if they are completely sure that they are correct, which protects you from bad faith insurance practices. A skilled Macon insurance claims attorney can help maximize your recovery.
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How to Prove Insurance Bad Faith
Insurance bad faith is not difficult to prove as the only evidence that you need to show the Court is your policy contract, and what happened in the accident that you are claiming your insurer should have covered. There are two elements to insurance bad faith: (1) your insurance company did not pay what it should have paid within 60 days, and (2) the denial of coverage was in bad faith.
“Bad faith” only means that your insurance company’s denial of coverage was not reasonably given the policy contract between you. While this might sound like insurance companies can escape liability by simply showing they had a decent argument for denying coverage, this is not really how it works. In fact, almost every single wrongful denial of coverage will be determined to be in bad faith.
When Can My Insurer Legally Deny Coverage?
There are three situations in which your insurer can deny coverage to you. First, if your injury or loss is not within what your insurance coverage was designed to cover, that insurance company will not have to pay. Second, if you made a “material misrepresentation,” (you lied to them), they can deny coverage. Third, if your loss comes within an “exclusion,” they can deny coverage.
Not Covered Losses
The first, and most obvious reason why your insurance company would not have to cover your loss is because they never agreed to. Insurance contracts are quite broad with what constitutes a “loss,” so this does not come up very often. Obviously, your life insurance policy does not have to cover your car accident if you did not die.
A material misrepresentation is an intentional lie that you tell your insurance company that is so important that it affects their ability to properly determine their risk. For example, if you told your insurance company that you had a perfect driving record, but in fact, you had 3 DUIs, this would be a material misrepresentation.
Most of the time, material misrepresentations arise when people lie about the facts of their accident or loss to attempt to have their insurance company cover accidents that they otherwise would not have. For example, telling your insurance company that you were rear-ended when in fact, you backed into a brick wall would also be a material misrepresentation.
Material misrepresentations, if serious enough, can be a crime called insurance fraud. This is why it is important to be honest with your insurance company.
Finally, a reason why your insurance company might deny coverage to you is because of an exclusion. An exclusion is a clause in your insurance contract that provides certain situations under which your insurance company does not have to cover your loss or injury. Most exclusions have to be set by state law, so your insurance company cannot just have a litany of random exclusions.
The most common exclusions are:
- You were injured while under the influence of alcohol or drugs
- You were injured while committing a crime
- You were injured by an enemy combatant in a warzone (yes, really)
- For life insurance policies, your death was the result of suicide
Contact a Macon Insurance Claims Lawyer Today
If your insurance company is trying to give you the runaround, you should fight back with the help of a skilled insurance claims attorney in Macon. When you need to go head-to-head with your insurance company, contact “the Strong Arm” John Foy and Associates for a skilled insurance claims lawyer in Macon today.