Examples of Unfair Claim Practices

Here are some examples of such practices:

• Attempting to settle a claim based on an application which the company has changed without the insured's knowledge or permission
• Delaying a claim investigation by requiring unnecessary reports or documents which contain substantially the same information
• Failing to act promptly after receiving information concerning an insurance claim
• Failing to adopt or comply with standards that define what is meant by a prompt claims investigation
• When applicable, failing to pay a claim quickly, fairly and equitably
• Failing to promptly settle claims where liability is reasonably clear under one portion of the policy to influence settlement under any other portion of the insurance policy coverage
• Failing to promptly and clearly explain the basis in the policy or the law for either denying a claim or offering a compromise settlement
• Attempting to persuade insureds not to take advantage of the arbitration process
• Misrepresenting significant facts or insurance policy provisions
• Refusing to tell an insured what is happening with a loss within a reasonable time after receiving a completed proof of loss statement
• Denying claims without a reasonable loss investigation
• Offering very low settlements to encourage insureds to sue
• Settling claims for less than the amounts a reasonable person would expect

Of course a good way to avoid problems is to deal with reputable agents and companies who have a strong commitment to properly serving their insurance customers. Your insurance agent would be happy to discuss your concerns and/or expectations about making an insurance claim. Take advantage of his or her expertise.

For more information on claims handling, please see part 1 of this article.

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