Welcome back to the concluding piece of our three-part series on insurance companies and their potential acts of bad faith. Our journey began with understanding what “bad faith” means and exploring real-life scenarios highlighting the power imbalance between the insured and the insurers. In the second part, we explored a case study and established the importance of proper documentation and communication. In this final piece, we will consolidate our learnings, offer more insights, and ensure you’re equipped with all the tools you need to navigate the complex world of insurance claims.
If you missed our previous blogs, read them to understand this topic comprehensively. In Part 1, we discussed the inherent conflict of interest between the insured and the insurers and the protections in place in California. We also delved into a gripping real-life example of how racial biases affect claim processes. Part 1 is available here.
In Part 2, we unraveled a story where improper investigation by the insurance company led to increased exposure for the insured. We also stressed the value of consistent written communication with your insurance company to build a record for potential legal recourse.
In today’s edition, expect more actionable advice, stories from the field, and a deeper dive into the nuances of dealing with insurance companies. Remember, understanding the intricate dynamics of insurance claims empowers you and strengthens your position in any negotiations.
The Impact of Lowballing
At the end of our last blog, we stressed the importance of documenting your communication with the insurance company. When insurance companies make these excessively low offers, we will have a paper trail that depicts it. We have had cases when the insurance company will pay more than what they insured the person for because we documented that they were lowballing. When they were aware that their offers were documented, they realized that they were backed into a corner.
One of the tips that we recommend is to do things in writing. Although we have said this before, we encourage you to look at it from a fresh angle. At the same time, you can save anything that the insurance company gives you. It is also essential for you to write a clear and detailed explanation of what you want, what your demands are, the basis for each, and give a deadline to respond. We also highly encourage you to look at your writing tone.
For example, refrain from using emotional language and replace it with factual details. Think about how easy it would be to say that you or someone else was in “great pain.” That won’t resonate as strongly as stating that someone was in the hospital for X number of days, that they received Y treatment, and was then confined to a wheelchair because of it.
When someone gets discharged from the hospital, these factual elements tend to be more powerful, mainly when talking to an insurance company.
When the Insurance Company Isn’t Responsive
Receiving a low offer is frustrating, which is putting it mildly, but it is still a response. There may be scenarios where someone who deals with an insurance company isn’t engaging in correspondence. This may be a prime example of when it is appropriate to go to the California Department of Insurance to file a claim—especially if it is a case that an attorney will typically not get involved in.
We have encountered cases that involved health insurance companies refusing to pay for things they should have because they were banking off the client receiving money from a lawsuit. Whereas the lawsuit was ongoing, the client had health insurance and had been paying premiums. They wanted the bills to go through health insurance, and the medical provider was sending the unpaid bills to collections. This was one case where the California Department of Insurance was notified. They stepped in and got the health insurance company to pay the bills they were obligated to cover.
Howell, LLP
Navigating insurance claims can be daunting, especially when faced with lowball offers or non-responsiveness. Howell, LLP is dedicated to ensuring you have the tools to document, communicate, and effectively deal with insurance companies. Through experience, we’ve seen firsthand the benefits of detailed, factual documentation and the power of intervention by regulatory bodies like the California Department of Insurance. Don’t face these challenges alone. Let us be your guiding hand in navigating these intricate dynamics. Schedule a free consultation with Howell, LLP today.
