AVOIDING INSURANCE BAD FAITH CLAIMS UNDER MARYLAND INSURANCE LAW
In virtually all jurisdictions, insurance carriers must act in good faith when evaluating,
settling or otherwise responding to claims submitted by third parties and policyholders. Although states like Maryland do not recognize a separate
cause of action for bad faith toward policyholders, most states impose substantial penalties for punitive damages when insurers act in bad faith
toward third party claimants and many impose similar penalties in "first party" claims submitted by policyholders themselves. For this reason, it
is extremely important that insurers avoid misconduct which may prompt legal action that could jeopardize the welfare of the company.
While most discussions of bad faith liability focus on broad pronouncements of law requiring insurance companies to act with good faith toward policyholders and third parties,
the following examples of misconduct are real-life illustrations of situations subjecting insurers to substantial liability. In short, here's how
to "botch" a claim:
- 1. Tell Plaintiff's Counsel That Your Policy Limits Are Only $20,000/$40,000 Despite The Fact That Your
Insured Has A $100,000/$300,000 Policy [or, better yet, send an
edited-version of your declarations sheet designed to convince your opponent
to settle for far less than your actual exposure --- a great way to save
big bucks!]
When dealing with claimants and others, an insurance
carrier has a special obligation to be honest in all communications and must
refrain from any misrepresentations. Although an insurer may conceal
its "bottom line" in settlement negotiations, it must be careful not to misstate
the facts. This is particularly true in connection with inquiries regarding
the terms of the applicable insurance policy. Indeed, if a carrier
is concerned about disclosing the terms of coverage to third parties prior
to litigation, it would be well advised to respectfully decline to provide
any information regarding coverage than to misstate the terms of coverage.
The latter practice may render carriers liable for far more than the
policy limits -- a devastating punitive damage award.
- 2. Ignore Letters From
Plaintiff's Counsel Regarding Settlement or Other Matters Relating to the
Claim
An insurer must respond promptly to all
communications regarding a claim. Letting letters gather dust without
a response is easy when confronted with a seemingly insurmountable flood
of paperwork and claims. But such inactivity could cause far more
significant paperwork in the form of a lawsuit for bad faith. Thus,
even if additional work is required before evaluating the claim, insurers
should, at the very least, acknowledge all
correspondence.
- 3. Reject Plaintiff's Contentions
Without Investigating the Claim
An insurer may not simply deny a claim on a
whim. Insurers have a duty to thoroughly investigate all claims. Not only
is this important in determining liability and damages and in protecting
the insured, it is essential in avoiding bad faith claims in which disgruntled
claimants charge that the insurer has discriminated against them or otherwise
rejected their claims without a legitimate basis for doing
so.
- 4. Reject Claims Without
Offering Any Explanation For Doing So
In denying claims, it is essential that the
insurer explain the basis for the denial in writing to the claimant. While
carrier should consult with competent coverage counsel regarding the appropriate
language to employ in specific cases, insurers should take care to outline
all bases for denial for two reasons: First, insurers who neglect important
defenses to liability may be held to have waived these defenses in later
litigations. Second, insurers who develop new bases for denial after
litigation arises invite claims that they are acting in bad faith to concoct
illegitimate reasons for denying claims.
- 5. Don't Go Overboard in
Investigating Claims! Play Golf Instead!
This may prove to be a very expensive trip to
the golf course. As every experienced claims person knows, courts
scrutinize the practices of insurance carriers with a microscope that detects
and punishes all miscalculations and errors. Where insurers are charged
with bad faith, all doubts are resolved against the carrier, rendering companies
liable for virtually all gaps in claims investigation and analysis.
Therefore, it is essential that insurers approach the investigation
of claims seriously, diligently, and thoroughly.
- 6. Don't Ever Initiate Settlement
Discussions with Plaintiff's Counsel! [if they can't make the first
move, why should you look anxious to settle?]
In most states, an insurer's duty to act in
good faith requires the extension of reasonable settlement offers regardless
of whether a claimant's attorney has "made the first move." Don't let
the actions of Plaintiff's counsel dictate your handling of a particular
claim. While traditional negotiation strategies suggest otherwise,
the law of bad faith mandates that insurers make reasonable settlement offers
within a reasonable time after evaluating liability and
damages.
- 7. Never Settle a Claim Right
Away!!! If you hold out for unreasonably long periods of time, most
money-grubbing plaintiffs will wear down and accept less in settlement.
Not only is this philosophy dangerous when
considering bad faith liability, it is often poor negotiation strategy as
well. Claims have a tendency to grow in size the longer they hang around.
What may start as a small whiplash injury case may grow to a case of serious
permanent injury when a claimant's attorney refers the claimant to a doctor
who later recommends surgery. To minimize liability, evaluate claims
thoroughly, promptly and -- where appropriate -- attempt settlement
quickly.
- 8. Take Careful Notes on
Your Desire to Save Money, your Suspicions of a Lying, Fraudulent and Greedy
Plaintiff, and Your Utter Disdain for the Plaintiff's Attorney [its
a great way to relieve those everyday frustrations with these pesky little
ambulance chasers and their cheating, money-grubbing clients!]
Progress notes and other correspondence in the
claims file may become "Exhibit A" in a bad faith claim against the insurance
carrier. Be very careful to document what is important in evaluating
a claim, but avoid "extracurricular comments" which may lead to bad faith
claims. Remember, anything you write may be used against you in a court of
law.
- 9. Don't Tell Your Insured
About Potential Excess Exposure [what an insured doesn't know, can't
hurt her!]
Wrong again. If claims are submitted which exceed
an insured's coverage, the insurer has an absolute obligation to inform the
insured and advise her of the possibility of personal liability. In
most states, the insurer must also advise the insured of her right to obtain
counsel at her own expense to protect against such exposure. Failure
to do so may subject the carrier to that excess exposure in the form of a
bad faith claim. Indeed, what an insured doesn't know, can hurt
her and can hurt her carrier as well!
- 10. See If You Can Get the
Insured to Contribute Toward a Settlement within Policy
Limits
Carriers who have tried to "save on the policy"
by tapping into their own insured's pockets have committed serious violations
which have been severely punished by the courts. Do NOT ask your insured
to contribute to a settlement within policy limits. If a settlement
within policy limits is advisable, the insurer must do everything within
reason to protect the insured from excess liability.
- 11. Do Everything Possible
to Save Your Company Money [after all, the most you can lose are
the policy limits of your insured!]
Critics of insurance companies claim that insurers
don't care about their insureds, they only care about saving money on the
policy. While insurers may dispute this criticism, some claims
representatives forget that an insurer's first obligation is to protect the
interests of its insured against excess exposure. It is also obligated
to act in good faith toward third parties who submit claims. While it is
important to keep the company's exposure to a minimum, those who neglect
their duty of good faith and fair dealing may unwittingly increase this exposure
in the form of substantial liability for punitive damages. In these
cases, a carrier may lose far more than the policy limits of its
insured.
The material provided in this section is designed
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