How to sue an insurance company?

by ty_ger88 » Fri Sep 14, 2007 02:20 pm

Many a times you may be unhappy with your insurance company for not paying you your dues or for delaying your payments or for any other reason. Your insurance company does not always have the upper hand. There are laws to protect you if you have a dishonest insurer.

When can you sue your insurance company?

You can sue your insurance company on grounds of:
  • Bad faith and
  • Breach of contract

If your insurer tries to trick you by not paying up a legitimate claim you can put up a civil suit against the company for having acted in bad faith. A company shows bad faith when it unreasonably denies a legitimate claim. This may mean that:
  • The company has failed to carry out proper investigations
  • Undue delay in processing a claim
  • Disregarding the rights of the policyholder
  • Inadequate compensation provided against claim filed

You can sue your insurance company for the full amount of benefits that has been denied to you as well as for any economic loss or emotional distress that you may have had to suffer as a result of the refusal. If your insurance company has been dishonest you may also get punitive damages. This is a means to make the insurance company behave more responsibly in future correspondences.

It is good to keep all paper works organized so that you can find them as soon as you need them. You may think of an old receipt as unimportant but it might hold great importance when you have a case standing against your insurer for bad faith or breach of contract.

Related Readings

I'm confused, please help. Here's my story and question. I'll try to make it short. My car was hit about a month ago. I was not in the car. It was parked on the side street. The driver of the truck that hit me left a note with all of his information. Now, it has been almost a month, and his insurance is not doing much. At first, they promised to have the damage estimated, but then nothing was sent to the car shop where my car located. I ended up going through my own insurance company. The problem is before I went with my insurance company, I had rented a car and had discussed this with the other insurance company. They said they would reimburse me all the fees. Now, they're not answering my calls. They keep on telling me that the agent is busy and will get back to me. It has been 4 days since I faxed in my car rental bill. What can I do? Can I sue them? Would you tell me how to sue an insurance company? The bill was paid for by my credit card, and I don't want to owe interests on it. Please help. Thanks.

Total Comments: 380

Posted: Fri Sep 14, 2007 11:37 pm Post Subject: Sue insurance companies

First have you been talking to an AGENT or an ADJUSTER? Not many AGENTS would have the authority to settle liability claims. If you have been talking with an agent, if you will let this forum know the negligent parties insurance company (not the agent), we will more than likely be able to come up with a phone number for you to report the claim.

If you insurance company has handled your collision claim, they will subrogate the negligent party and include your deductible, and should include your rental (as a service to you). Some companies will not if they did not actually make payment. What does YOUR adjuster have to say about this? Are they trying to assist you? If not, you should know how to sue an insurance company.


I would call this claims handler back, if their voice mail picked up, I would push zero, and should re-route you, if you speak to another person, ask to speak to their supervisor. If they are busy ask for their supervisor and so on. You could also (and this generally gets results quickly) contact your states dept. of insurance and file a complaint. You definitely have grounds!!!!! These complaints must be answered in a strict time line.

I'm so sorry this has happened, all companies do not operate this way.

Please let us know how it turns out.

Posted: Sat Sep 15, 2007 04:29 am Post Subject: suing insurance company

Hi Lori. This is ty_ger88. Thanks for responding to my question. I'm going to give you more details here.

To answer your questions. I've been talking to an AGENT at the National Adjustment Bureau who handles claims for the Seminole casualty insurance Company. Since day one, this AGENT has been promising me this and that when I called in to file a claim. It took her 13 days to tell me that they were having problems with the appraiser (this is the same as the ADJUSTER right?). Initially I didn't want to go through my insurance, which is Statefarm, because it wasn't my fault (and also because my Statefarm agent had suggested me to go with the other insurance company. However, after so many days of waiting and hearing lies from the National Adjust Bureau, I decided to go with Statefarm to handle my claim. Statefarm is doing a very good job so far, and I believe they will take care of the damages for me and then will go after the other insurance company. The problem I have is that I have a $750 car rental bill that occurred before I decided to go with Statefarm (from the 13 days of waiting for Seminole to handle my claim). When I opened a claim with Statefarm, they got me a car rental, and will take care of the bill, so that's not a problem now. It's just the money that I had to put out prior to going with my insurance company, Statefarm. Statefarm will not cover any expenses that I had before a claim was opened with them. I hope I'm not confusing you.

To give you additional details. Seminole Casualty Insurance Company is located in Florida. As of today, I was told by their AGENT that her management had rejected my reimbursement request because they were waiting for a police report. The funny thing is that when I found the note on my car, it stated that police was NOT notified. However, that driver told his insurance company that he had filed a report. I called him today and he told me he had called 911 when he hit my car, and reported it over the phone. Can people do this? Would this result in a police report? Another funny thing told to me by AGENT was that if the police report showed that another car caused the driver to swerve and hit my car, it would then be a NO FAULT solution. She said that would mean my insurance would have to take care of all my damages. Lastly, I found out from talking to the driver today that he too is having problems getting his car fixed through his insurance company. As for talking to the supervisor, I've tried that with no success. The supervisor is never in it seems.

Again, Statefarm which is my insurance, is handling it from here on, except for the expenses I had before they stepped in. I just want that portion reimbursed, and the AGENT at Seminole had promised me they would, but is now telling me that they may not. At this juncture I must remember the tips on how to sue an insurance company!

Posted: Sat Sep 15, 2007 09:27 am Post Subject: vital information

Hi!
I hope Lori has rightly mentioned that all agents don't have the authority to settle claims. At the same time I'd also like to add that many of these agents don't understand the claims processing procedures that are performed within an insurance company. This is simply because they don't have the access to many of the vital information. So, they don't ever become as knowledgeable as an adjuster. But it is better to know that your insurance carrier has stood beside you so firmly! I'm sure you'd get over a major share of the problem.
Regards, Fatman

Posted: Sat Sep 15, 2007 12:33 pm Post Subject: Suing insurance company

Ok, Ty, I think I have a better grasp of your situation, please correct me if I'm wrong.

Your vehicle was hit by a hit and run driver that DID leave a note on your vehicle. The note stated the police were not called. What exactly did the note say? Did his note mention anything at all about this phantom vehicle forcing him to hit your parked unoccupied car? Or is that simply some wishful thinking on the part of the agent you spoke with? When you spoke with the guy that hit your car did you ask about that (phantom vehicle theory) ?

I would think (especially in front of a judge), that your chances of disproving this phantom vehicle are very good. Think about it, if a reasonable (non-impared) person is forced off the road, and hit a vehicle, (now apparently for sure) has a cell phone with them, they will call 911, (as he now says he did, more than likely his company requires this and that is why he is now saying he did) report this (from the scene) a police officer will be dispatched. I'll insert here, you can in most jurisdiction make a 'call in'' or ''walk in'' police report, but I have never heard of an instance when a person could dial 911, and an officer not respond to an accident that occured on a public road way. Most particularly when there is some nut phantom vehicle driving around forcing people off the road. So I think that is just not true. They either called later and reported it, and gave no information what so ever about your vehicle being hit, or just never called. Minimally this guy would've gotten a hit and run ticket and most certainly the police would've contacted you. I think I would contact the police department myself immediately and ask if a report had been filed, if so get a copy, contact the reporting officer. If not report it now yourself, either way get a report with your information on the record.

Clarify with me again, is it the independent adjusting company (National Adjustment Bureau) who is not returning calls, or is it the actual insurance company, ( Seminole Casualty Insurance Company)? You are talking with the claims dept. at Seminole correct? This appears to be the 'main' claims reporting number, and should be able to route you to the correct adjuster handling and overseeing this claim 1-800-393-LOSS. Make sure you get the name, title, and note all contacts or attempts at contact with these people, documentation is key.

I think it is important to state, that the ulitmate responsibility lies with Seminole, they merely employ this independent adjusting or appraisal company. Seminole would be making the liablity determination and are responsible to the state dept of insurance for their actions or lack of action. Here is the number I found for you for the correct dept. I think.

Office of Insurance Regulation (Tallahassee)
Florida Financial Services Commission
Consumer Helpline: (800) 342-2762
Hours: 8 AM - 7 PM Monday through Friday

I tried to access their complaint registry but it is down for maintence. Not sure but most states will show the number of complaints filed against a particular company.

I think you should call and file a complaint immediately against Seminole. They will HAVE to respond to that, and it is very time sensative. Have all your information (ie contacts attempts etc), with you when you call, more than likely you will need to fill out some forms.

To answer the 'sueing' portion of your question. You will likely need to sue the guy that hit you, and I'd get on that. File a small claims action. If you receive a judgement, (and think you have a real good chance) his company will more than likely pay that judgement. You might have a vexatious refusal to pay claim against Seminole. That you would need to ask an attorney, if you do have, those claims/suits are punitive in nature.

Couple of things, (I know this is random, in a big hurry, sorry).
When was the claim actually reported to them, who did you report it to, were you given a claim number when it was reported? Has there been any attempt at an investigation, (ie statements from you, request for estimates, or this ''appraiser'' inspecting or atleast attempting to set up an appointment for an inspection)?

While this is all fresh, set down with a calender get a cronilogical list of events. Then I think I would ;

1) contact the police (as I said) see if a report was made get a copy of that report, and also ask to file a report yourself, get that copy when ready.

2) contact your states dept of insurance, talk with a consumer advocate, and get a complaint started.

3) after receiving their advise (also talk with your state farm adjuster), file a small claims action for your rental bill (only).

4) contact an attorney that will do a first consult free, and see if you have a claim against Seminole.

Again I am so sorry, this is NOT how things are supposed to work! Please let us know how this turns out. I'm glad state farm is helping you and they are correct they cannot take care of these prior thirteen days.

This might be a good time to mention (not for you but for anyone who might read this post later). This is EXACTLY why you should promptly report ALL claims to your own carrier, even if you are not at fault, so they can oversee your claim with the claimant carrier....

Please let us know what happens Ty, sorry, I'm in a rush, and this reply is somewhat disorganized.

lori

Posted: Mon Sep 17, 2007 01:07 am Post Subject: how to sue insurance company

I am not a lawyer or anything like that, but I think I can help a bit. Have you kept all your reciepts from whatever you have paid on your car and the car rental? If so, that's a good start. Now, for the other insurance company. There are two possibilities with your situation.

1. You can sue the other driver. This is because he was the one who hit your car in the first place. A judge may tell you that he was the one to sue.

2. You can sue the other insurance company IF you have a written contract saying that the other insurance told you they were going to reimburse you. If you don't have a written contract, do you have proof of the verbal contract between you? Once they told you they promised to reimburse you, they are under a legal verbal contract. So, do you have a recording of your phone conversation or a message they may have left on your answering machine?

3.You should contact the insurance boss and if nothing happening contact that man, if nothing futher else contact the police headquaters nearby in you local.

Without either of these, the judge may dismiss the case because it would be your word against the insurance company's word. The reciepts may help, and maybe having the other driver as a witness or something.

Posted: Tue Sep 18, 2007 03:42 pm Post Subject: Suing insurance company

Seminole Casualty is a reputable Florida based insurance carrier. They like many companies use outside adjusters to handle claims. They cannot judge the validity of a claim without the proper information which would be a report from their insured and a police report. State Farm on the other hand had all the information from you and should have handled the entire damages ( If you had rental reimbursement coverages ) and then subroigated against Seminole. Meaning they would handle recoverin the money paid out to you.

Posted: Tue Sep 18, 2007 11:36 pm Post Subject: Can you sue an insurance company

State Farm on the other hand had all the information from you and should have handled the entire damages ( If you had rental reimbursement coverages )

He does, and they did but if you'd read the entire post, the problem is the thirteen days he waited on Seminole to handle the claim (as promised) prior to reporting to State Farm. They will not reimburse him (state farm), therefore unable to subrogate on his behalf for thirteen days prior to him reporting the claim to them...The problem (again) is Seminole not keeping their word or moving the claim forward, which caused him eventually to look to his own carrier.

Posted: Wed Sep 19, 2007 04:02 pm Post Subject: how to sue insurance company

Hello Lori, DDH, and everyone. Thank you all for responding.

As of yesterday, my car is still in the shop, I'm still with the car rental bill for the first 13 days, and I have not heard anything from Seminole.

However, there was one new update. I had a conversation with the driver who hit my car. He told me he had gone to the police station and had requested for a police report. I asked him to clarify it a little because he had stated on the note left on my car that day that no police were notified. He said when the accident occurred, he and a passenger in his car decided to call the police and reported it over the phone. Anyway, he gave me the officer's name and his badge number in addition the case number. He also said that the officer was on vacation and that nothing was done on paper - that everything was in the computer system. Since then, I've reported this case number to Statefarm for records.

DDH, to answer your question regarding proof of reimbursement claims. I do not have anything recorded, unfortunately, but the lady at Seminole (Yvette) had promised me almost EVERY SINGLE DAY until about a week ago when I faxed in the car rental bill, that the reimbursement would happen. Again, I have nothing but a verbal promise from Yvette. I've asked to speak to her supervisor, but have been told that he's not in everytime. Yvette also said that her management was the one who had rejected the reimbursement request.

Lori, below is what I've documented in chronological order.

8/19 - I came out from a friend's house in Lorton, Virginia, and found my car damaged with 2 notes on the windshield. One note stated that the driver had hit my car. Another note was an accident form from Seminole filled out by the driver with all his information on it.
8/20 - I called the toll free number 1-866-693-4393 listed on the accident form and was told that someone would get back to me in 48 hours. A claim number was given to me. I proceeded by calling my agent at Statefarm and he took notes, gave me my options (to go with Statefarm or to go with Seminole), and told me to get back to him with my decision. He gave me pros and cons about each. At the time, I said I would go with Seminole.
8/21 - A representative from Seminole (through National Adjustment Bureau) by the name of Lorenzo Hensen, called and said that an appraiser would come out to do an estimate on my car. I then towed my car to Precision Collision, a shop that was recommended by my Statefarm agent. I asked Lorenzo about getting a car rental, and he said that they would reimburse "loss of use" expenses. I also went to Enterprise next to my house and rented a car.
8/22 - The appraiser by the name of Dan Gosnell called and asked for the location of my car. I told him it was at Precision and he went there to do an estimate.
8/23 - I called Precision and they said that the appraiser had promised to fax the estimate to them, but had not seen anything.
8/24 - I called National Adjustment Bureau to get a status and was told that Yvette would be taking over for Lorenzo. I talked to Yvette and she said the appraiser was going out of town and would be back in two or three days. I was annoyed by this stage, but hung in there. I told Yvette about the car rental I had and she asked for the agreement from Enterprise. I proceeded by faxing her the car rental agreement. I told her that I was going on vacation from 9/1 to 9/8, and that I would like everything resolved before going. She said okay.
8/25 - 8/29 - I called everyday to get a status, but was told that no estimate was sent in. Also, Yvette said they were having problems with the appraiser and that a new appraiser was going to do another estimate. I was annoyed and said that I was going to go with Statefarm. Yvette said it would be faster going through Statefarm, and that it was my choice.
8/29 - I called my agent at Statefarm and he said he would help me. He opened a case for me, and while he was doing this, I got a call from another lady (didn't get her name) from National Adjustment Bureau saying that they were having a backlog of estimates and that my estimate would be in the system by close of business 8/30. I went back to my agent and told him what had just happened, and he said he would leave the claim opened with Statefarm and that if I didn't hear anything from Seminole that I should go with Statefarm. I said ok.
8/30 - I called Yvette in late afternoon, and she said nothing was going to happen, and that I should just go with Statefarm for faster service, and since I was going to leave town for vacation. I was really annoyed, and called Statefarm and proceeded with the claim. I asked Yvette about my car rental, and she said for me to fax in the invoice once I get it and she'll reimburse it for me in time so that I wouldn't have to pay interests on my credit card. I was planning to return the car rental on Friday, because I was leaving on Saturday morning.
8/31 - I called Precision and told them that I would go with Statefarm. They were very happy to get started on my car. I returned my car rental to Enterprise and got the bill. I tried to fax it to Yvette but the fax machine at my work was broken. Plus, I was very busy that day trying to finish up some stuff at work and also packing for the trip.
9/10 - I came back from vacation and today, I went to Enterprise and got another car rental. This time, everything was set up by Statefarm, so the rental agreement was covered by Statefarm. I asked Enterprise to fax Yvette the bill from my last car rental. I called Yvette and confirmed that she had received my fax. She said she would get back to me.
9/11 - 9/13 - I called Yvette but couldn't get in touch with her. She was always busy on the phone. I asked to speak to a supervisor and was told he was not in. I left several messages on Yvette's answering machine and also to the receptionist, but didn't hear anything back.
9/14 - I finally got in touch with Yvette and she said her management had rejected the reimbursement request because their insured had told them that another car had caused him to swerve to hit my car. Yvette said she had sent out a letter by mail requesting for a police report. Again, this company is located in Florida, and the accident occured in Virginia where I live. I told Yvette that the note I had had stated that no police were reported, but she said that their insured had told them that he had reported it. Yvette then said that they would review the reimbursement request again once they've received the police report. I then called their insured driver and asked for more details, and that was when he said he had reported it over the phone. He said he would go down to the police station to get the report for his insurance company as well as for me, and that he would call me back on 9/15. Another strange thing the guy said (in broken English) was that he was also having problems with Seminole, and that his car was still sitting there not fixed yet. He said that they kept on promising him that an estimate was going to be done on his damages, but then he had seen three different appraisers, but no estimate was done. I'm not so sure if I understood everything he said, but that was how I understood him.
9/15 - The guy who hit my car called me and told me he had gone down to the police station, but the officer in charge of the case was on vacation. He was able to get the case number, the officer's name and badge number. I recorded this information and forwarded to Statefarm.
9/16 - Present - Nothing new.

Again, thank you everyone for responding. If I could provide any additional details, please let me know.

Ty

Posted: Fri Sep 28, 2007 06:09 am Post Subject: suing insurance company

One instance of how to sue an insurance company
is to file a lawsuit when the company is not giving you those facilities which are in your contract with them.

Posted: Mon Oct 29, 2007 06:04 am Post Subject:

Hi Lanewbear, your post has been shifted over here >> http://www.ampminsure.org/claims/about3298.html

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