Most North Carolinians are insured under numerous insurance policies, including health, automobile, home owners, long term disability, fire, and life. If you have complied with all of your obligations under the policy, such as paying your premiums on time, and the insurance company wrongfully denies coverage, you are entitled to bring suit to enforce your rights. Our Raleigh insurance claim handling attorneys can help you enforce those rights.
Insurance Coverage Declaratory Judgment Suit
The insurance industry is a strange business; the insurer can actually benefit and make more money by not giving you what you’ve paid for under the policy. Insurers will often rely upon exclusions to the policy to issue you a denial of coverage for claims which should be covered under your policy. Insurers also may issue you a reservation of rights regarding coverage, essentially delaying the claims process. It’s important to not allow the insurer to have the final word on whether they have to pay the policy holder money or not. Insurance claim attorneys request a Court, rather than the insurer, to make a final decision and issue a declaratory judgment as to whether the act is a covered act under the policy.
Duty to Defend and Third Party Claims
Insurance companies owe policy holders like you a duty to defend against a lawsuit brought against their insurers and must pay covered claims brought that are asserted against their policy holders on behalf of their insured. Our firm can bring a third party insurance claim against the insurance company for their failure to properly handle claims against the policy holder for covered claims under the policy.
Insurance Bad Faith
In particularly egregious cases of wrongfully denied coverage, your insurer may be liable for punitive damages. A policy holder is entitled to punitive damages for bad faith refusal to settle when there is (1) a refusal to pay after recognition of a valid claim; (2) bad faith; and (3) aggravating or outrageous conduct. Punitive damages allow a jury to award up to $250,000 or three times your actual damages, whichever is higher.
Unfair Claims Handling
North Carolina also has a statute defining certain unfair claims handling acts. If an insurance adjuster has engaged in any of these acts, you may be able to recover under a claim known as “unfair and deceptive trade practices.” If a jury determines that the insurer engaged in unfair and deceptive trade practices, your actual damages directly caused by those unscrupulous practices are automatically tripled. You may also recover your attorneys’ fees. Examples of unfair claims handling acts include:
(1) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue;
(2) Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies;
(3) Refusing to pay claims without conducting a reasonable investigation based upon all available information;
(4) Failing to affirm or deny coverage of claims within a reasonable time after proof‑of‑loss statements have been completed;
(5) Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear;
(6) Compelling [the] insured to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insured;
(7) Attempting to settle an insurance claim for less than the amount to which a reasonable man would have believed he was entitled; and
(8) Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement.
Free Consultation and Fee Structure
Our insurance claim attorneys offer free consultations for insurance coverage and bad faith matters. We can handle your case under a number of fee structures, including hourly, flat rate, and contingency. We will work with you to determine the fee structure best for your particular situation. If your insurance company has unlawfully denied coverage or acted in bad faith, we may be able to help you.
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