When you buy insurance and pay your premiums, you expect the insurance to take effect and provide you with security in a time of need. Unfortunately, insurers are driven by profit, and sometimes they may deny valid claims for benefits just when they are most needed. Fort Worth insurance attorney Mark Humphreys handles first-party insurance claims, bad faith claims, life insurance denial claims, and deceptive trade practices claims. Whether your life insurance benefits were denied after a loved one died, or the liability coverage that you paid to receive has been refused, we can bring a claim against your insurance company on your behalf.
First-Party Insurance ClaimsFirst-party insurance claims are made by an insured person against their own insurance company. For example, if your basement was damaged by a flood, you might submit a first-party insurance claim to your flood insurance carrier for the damage to your house. Insurers owe duties to their policyholders under Chapters 541 and 542 of the Texas Insurance Code. Among other things, insurers are required by Chapter 541 not to engage in unfair or deceptive practices. They must provide reasonable explanations related to why a claim was denied and conduct a reasonable investigation when deciding whether to pay a claim. Chapter 542 requires insurers to take specific actions and act in good faith.
Some reasons that an insurer may give you for denying a first-party claim are a failure to make a timely payment, a misrepresentation on your application, a failure to promptly update your information, or a belief that you are committing fraud. Our firm can evaluate the reasons that the insurer is giving for denying your claim or push the insurer to give you a reason, if that is the problem. If the reason is illegitimate, we can file suit or use other tactics to pursue payment.
Bad Faith ClaimsAs noted above, your insurer owes you statutory duties as well as a common-law duty of good faith and fair dealing. Insurers are considered to have a special relationship with policyholders and owe them a duty to act in good faith. Unfortunately, many insurers put their interest in profits over a policyholder's interest in getting claims properly paid out. When filing a bad faith lawsuit, you will need to show that your insurer failed to try in good faith to effectuate a fair, prompt, and equitable settlement with respect to which its liability had become reasonably clear. The insurer must have known or should have known that a claim was covered. You may recover punitive damages if an insurer not only acts in bad faith but also acts maliciously, intentionally, fraudulently, or with gross negligence.
Life Insurance Denial ClaimsA life insurance policy is a contract between an insurer and a policyholder. Insurers often look for reasons to deny a life insurance claim so that the company is more profitable. For example, an insurer might deny benefits if an insured person failed to include information in the application that the insurer believes adds to the risk of death, such as being a smoker. However, refusing to pay a valid claim constitutes a breach of contract. It may be helpful to have an experienced attorney on your side who can review your policy and determine whether the supposed violation claimed by the insurer was a violation of the contract terms. For an insurer to rescind a policy or void coverage, an alleged misrepresentation must be material and meet other requirements.
Deceptive Trade Practices ClaimsThe Texas Deceptive Trade Practices Act protects many different types of consumers who are victims of unconscionable, deceptive, misleading, or false business practices. Section 17.46(b) lists 27 practices and acts that are considered deceptive, false, or misleading. In order to recover damages, you will need to prove that a defendant engaged in one of these practices or acts and that you relied to your detriment on the deception.
Consult an Insurance Attorney in the Fort Worth AreaMr. Humphreys is an experienced and knowledgeable Fort Worth insurance lawyer. If you are dealing with a first-party insurance claim or want to bring a claim for bad faith, let our firm help you. We can handle claims within a 300-mile radius of Dallas and Fort Worth, including in Dallas, Garland, Irving, Richardson, Plano, Arlington, Grapevine, Decatur, and Granbury, as well as other cities in Dallas, Collin, Tarrant, Parker, and Hood Counties. Call us at 972-263-3722 or 817-944-1016, or use our online form to set up an appointment.