Austin Personal Injury ClaimsInsurance Company Disputes

Austin Bad Faith Insurance Lawyer

When an accident leaves you injured or disabled, you may assume that once you file a claim with your insurer, you will receive your settlement promptly. But that’s not always the case.

Insurance companies may deny your claim, offer you less than you expected, or delay your payment. There are legitimate reasons insurers may take these actions, but if they fail to explain their decisions or act in a manner that seems unfair, they may be guilty of “bad faith” practices. The Evans/Reilley Law Firm has handled many bad-faith insurance cases, so if you believe your insurer has treated you unfairly, call us today at 855-414-1012.

Texas ‘Bad Faith’ Laws

According to Texas Insurance Code Section 541.060, unfair settlement practices regarding first-party claims include:

• Failing to attempt in good faith to offer a fair, prompt and equitable settlement
• Failing to approve or deny a claim within a reasonable timeframe
• Failing to provide a reasonable explanation for a denial of claim, or to offer a settlement
• Refusing, failing, or unreasonably delaying a settlement on the basis that other insurance may be available, or that a third party is liable for damages.

These are just some of the provisions governing insurance carrier treatment of first-party claims. The Texas Insurance Code is in place to protect the rights of consumers, but many people are unaware of their rights when it comes to injury and disability claims. An insurer may make a low settlement offer, hoping the injured party will accept it. But if the offer is unreasonably low, the insured may be able to make a counter-offer. the Evans/Reilley Law Firm can advise clients about the best approach for their claim.

The Insurer’s Perspective

In 2012, fraudulent and inflated personal injury auto insurance claims resulted in $7.7 billion in claims overpayment. As such, it’s easy to understand why insurance companies use adjusters and investigators to determine whether a claim is legitimate. Sometimes, though, insurers reach incorrect conclusions and wrongly terminate benefits to an injured party.

The Evans/Reilley Law Firm represented a man who had been receiving disability benefits for several years, when his insurer suddenly terminated those benefits with no explanation. A neighbor had reported the man for being outside in his yard, which the insurer felt was evidence disproving his disability. The Evans/Reilley Law Firm successfully settled the matter with the insurer, to the client’s full satisfaction.

Challenges for the Insured

Proving a case of bad faith can be difficult, because there are many variables at play, such as the benefit limits established via an insurance policy. With health insurance claims, in particular, the insured may have to present a good deal of evidence to indicate that a specific treatment was medically necessary.

The Texas Department of Insurance reports most health insurer disputes involve either a denial of claim or unsatisfactory settlement/offer. According to the Center for Advancing Health, a non-partisan Washington-based research organization, insurers may deny payment for a medical test or treatment because they believe a less expensive alternative exists. When that happens, an attorney can help collect the records and evidence needed to prove the necessity of a test or treatment.

How We Can Help

An vehicle accident or personal injury can result in hospital bills, lost wages, and ongoing expenses associated with rehabilitation. And when an insurer delays or denies payment of legitimate claims, the insured may experience further financial hardship, such as falling behind on bills and mortgage payments.

If you think you may have a case against your insurer, call us today at 855-414-1012. We can help you understand your rights and whether your insurance company may be acting in bad faith.