Regarding insurance claims, navigating the legal landscape can be complex and confusing. If you need to take legal action against your insurance company, you may wonder,
This article aims to comprehensively understand your rights and the factors involved in such a scenario.
The Policyholder-Insurer Relationship
As a policyholder, you enter into a contractual agreement with your insurance company. This agreement, often called the insurance policy, outlines the terms and conditions under which the insurer agrees to provide coverage for specified events or damages. While insurance policies typically cover various situations, disputes can arise when the insurer denies a claim or fails to fulfill its obligations.
Circumstances for Suing Your Own Insurance Company
While each case is unique and subject to specific circumstances, there are certain situations in which you may have grounds to sue your own insurance company. Let’s explore some of these scenarios:
1. Coverage Denial or Delay
You may consider legal action if your insurance company denies your claim without valid reasons or unreasonably delays the claims process. Insurance companies must act in good faith and handle claims promptly and fairly.
2. Breach of Contract
If your insurance company does not honor the terms outlined in your insurance policy, it may be deemed a breach of contract. Failing to act under the agreement could include refusing to provide coverage for legitimate claims or failing to fulfill their obligations as stated in the policy.
3. Bad Faith Practices
Insurance companies must legally act in good faith when dealing with policyholders. If your insurance company engages in deceptive practices, intentionally undervalues your claim, or unreasonably denies coverage, you might have grounds for a bad faith lawsuit.
Steps to Take if Considering Legal Action
If you believe you have valid reasons to sue your own insurance company, it is crucial to take the following steps to protect your rights and increase your chances of success:
Review Your Insurance Policy
Thoroughly examine your insurance policy to understand the terms and conditions, coverage limits, and any exclusions that may apply to your situation. This knowledge will help you assess whether the insurance company has breached the contract.
Maintain a detailed record of all communication with your insurance company. A written record includes correspondence, emails, phone conversations, and claim-related documents. These records will serve as evidence in your case and help establish a pattern of misconduct, if applicable.
Seek Legal Counsel
Consult with an experienced insurance litigation attorney who specializes in insurance disputes. An auto insurance lawyer in Houston can evaluate the merits of your case, guide you through the process, and represent your interests in negotiations or court proceedings.
Exhaust Negotiation Remedies
You may want to exhaust all internal remedies, such as negotiating, providing reasonably requested information, and cooperating with the adjuster. Failure to comply with these requirements could weaken your case.
Initiate Legal Proceedings
If negotiations fail to settle the dispute or the insurance company continues to act in bad faith, your attorney may recommend filing a lawsuit against your insurance company. Your attorney will guide you through the legal procedures and advocate for your rights throughout the litigation process.
Coverage to Look for After a Car Crash
Some of the coverage you may benefit from after a car wreck includes:
Underinsured Motorist Coverage / Uninsured Motorist Coverage
UM / UIM coverage protects you if you are in an accident where another driver is at fault and either has no insurance or the minimum insurance, and you are seriously hurt. This is the main type of coverage where a lawsuit may be necessary.
Insurance companies routinely value human damages like pain and suffering for as little as possible.
Personal Injury Protection
PIP coverage reimburses you for medical expenses incurred because of the wreck. Also, PIP can collect lost wages for work missed due to the accident. PIP pays up to the limits of the PIP coverage.
Med Pay is similar to PIP except that it does not cover lost wages, and with Med Pay, if you collect from the other driver’s insurance company for personal injury, you might have to reimburse your insurance company for bills paid.
Uninsured and Underinsured Motorist Coverage in Texas
If you have uninsured or underinsured motorist coverage, and in an accident with an at-fault driver who has no insurance or who had a minimum policy and you have serious injuries, the odds of you needing to sue your auto insurance company go up quickly. Many people in Texas get auto coverage but let it lapse for one reason or another.
Adjusters routinely take the lowball approach and challenge you to sue the company for fair compensation for personal injury damages.
In Texas, the state is very “pro-insurance” and anti-consumer, which is reflected in the remedies available against your insurance company.
A Few Examples of Bad Faith Acts
- Unreasonable delays
- Failing to acknowledge receipt of your claim.
- Failing to conduct a speedy and thorough investigation of your claim.
- Not offering a settlement when liability is clear.
- Lowball Insurance offers for your damages.
- Repeatedly asking for unneeded documentation.
Negotiation with Your Adjuster on Your Claim
Here are a few articles on negotiation that you may find helpful:
How to Find the Best Attorney for Your Auto Insurance Case
When dealing with an auto insurance claim, finding a reputable lawyer can make all the difference in the outcome of your case. Insurance claims can be complex and often involve intricate legal processes, so having an experienced lawyer by your side can help you navigate the complexities and increase your chances of success.
To find a reputable lawyer for your insurance claim, conducting thorough research and considering several key factors is essential. Start by seeking recommendations from trusted sources, such as friends, family, or colleagues, who may have had positive experiences with insurance lawyers. Personal referrals can provide valuable insights into a lawyer’s competence, professionalism, and overall satisfaction.
Another reliable approach is to consult legal directories or bar association websites. These resources typically provide comprehensive listings of lawyers near you, their areas of expertise, and client reviews. Focusing on lawyers who specialize in insurance law or have significant experience handling insurance claims is essential. This specialization ensures they possess the knowledge and expertise to navigate the intricacies of insurance-related legal matters effectively.
Once you’ve identified potential lawyers, schedule initial consultations to gauge their interest and fit with working on your case.
Finally, consider the lawyer’s fee structure and whether it aligns with your budget and expectations. Reputable lawyers will be transparent about their fees and billing practices. Some lawyers may work on a contingency fee basis, where they only get paid if they win your case, while others may charge an hourly rate or a flat fee. Discussing the fee arrangement upfront will avoid any surprises or misunderstandings down the line.
What Damages Can a Victim Receive for a Car Accident Lawsuit?
In a car accident lawsuit, victims can potentially receive compensation for both economic and non-economic damages. Unlike some states, Texas does not impose a cap on the amount of compensation that can be awarded for these damages in a car accident claim, unless it involves a government entity.
Economic damages refer to the financial losses incurred by the victim as a result of the car accident and their injuries. This includes expenses such as damage to the vehicle and personal property, medical treatments and care (including surgeries, emergency room visits, medication, therapy, etc.), loss of income and benefits (including potential decreases in earning capacity due to permanent impairments), and any other financial burdens caused by the accident.
Non-economic damages are meant to address the pain and suffering experienced by the victim after the car accident. These damages encompass both physical and emotional aspects, such as mental anguish, physical pain, emotional distress, scarring, permanent disabilities or impairments (such as amputations, paralysis, brain damage), disfigurement, loss of enjoyment of life, and even psychological injuries like depression, anxiety, or post-traumatic stress disorder (PTSD).
The amount awarded for damages in a car accident lawsuit can vary greatly depending on the severity of the injuries and other factors. In some cases, the jury may deem it necessary to award a substantial amount of compensation to adequately address the damages suffered by the victim.
In addition to economic and non-economic damages, Texas also allows the possibility of punitive damages in car accident cases. These damages serve to punish the defendant for acts of gross negligence or intentional wrongdoing. A situation where personal injury lawyers seek exemplary damages would be if you were hit by a drunk driver.
However, it’s important to note that punitive damages are generally capped in personal injury cases in Texas, which means the liability of the defendant may be limited in this regard. Furthermore, it’s relatively rare for punitive damages to be awarded in car accident lawsuits, with an example being cases involving drunk driving accidents.
Working with an Experienced Insurance Claims Lawyer Improves Your Chances of Success
While it is possible to sue your own insurance company under specific circumstances, it is essential to understand your rights, review your policy, and seek legal advice before acting. Remember, each case is unique, and the outcome will depend on the specific facts and applicable laws.
By being well-informed and working with a knowledgeable Houston auto accident attorney, you can navigate the complexities of insurance disputes and protect your interests.
Call a Car Accident Insurance Claims Lawyer at Baumgartner Law Firm
Our personal injury attorneys in Houston have represented folks in Houston against their own auto insurance companies for over 35 years. Contact us for a free consultation!
6711 Cypress Creek Pkwy, Houston, TX, 77069