Insurance Dispute Questions

I have been mistreated by my insurance company, do I have a case?

This depends on exactly what happened. In most circumstances, you have a contractual agreement with your insurance company – in exchange for policy payments they agree to compensate you for losses. If they act fraudulently or in bad faith, you can sue.

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What is "bad faith?"

"Bad faith" refers to an unreasonable or unfair conduct by an insurance company. To reach the legal standard, their actions must be more than just rude or unethical. You have to demonstrate they caused you harm (usually financial harm) and acted willfully to do so.

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What Are Some Examples of Bad Faith Conduct?

• Unreasonable denial or termination of an insurance claim that should have been paid
• Unreasonable delay in making payments to the policyholder
• Unreasonable failure to defend a policyholder who has been sued under a policy containing a liability provision
• Unreasonably attempting to under-settle or lowball the payment of a claim.

The use of "unreasonable" above means unreasonable in the eyes of a jury or judge. Please ask us to evaluate your particular situation to advise you on whether it meets that standard.

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What does "subrogate" mean?

Subrogation is the right to pursue someone else's claim. Most insurance policies have this clause. For instance, if your insurance policy pays for damages they can then try to collect from a third party who was at fault.

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How can subrogation lead to a lawsuit?

Your insurance company has a fiduciary duty to you as well as contractual obligations. Good faith applies to both and may be violated. They may, for instance, settle a claim for the amount they have paid you, even when you could get more if you acted on your own behalf. Whether or not this falls afoul of Montana law depends on the circumstances.

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What if my claim has already been closed by the insurance company?

If you have suffered damages and the statutes of limitation haven't expired, the case may be reopened. Your attorney can advise you best on this matter.

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What is a "public adjuster?"

A public adjuster is someone who isn't employed by an insurance company and works directly for clients. These may be employed by your lawyer to get an independent evaluation of your damages. This independent estimate will be justified by documentation and used to discover if you have been "low-balled" by your insurance company.

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How is a medical insurance dispute different?

Medical insurance carriers are required to have their own, in-house dispute process. This must be completed and you must be declined before the case can proceed. A medical insurance dispute attorney will then make the case to get you coverage if warranted. You may also be allowed to collect damages that resulted from an unreasonable delay or for "bad faith."

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Do I have to accept the offer from an adjuster?

No, you do not. Insurance companies have a financial incentive to pay out as little as possible on claims. For this reason, adjusters may seek the lowest award they can get away with. Before you agree to the adjuster's evaluation, you should clearly understand what they are paying for and where the amount came from. If part of, or your entire claim is denied, you may wish to contact an attorney for advice.

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