You have been in a car accident, the other driver is clearly at fault and you require medical attention. You call the other driver’s insurance carrier and they ask you to give a recorded statement about what happened. A few days later you receive a letter saying, “after a careful review of the circumstances the Acme Insurance Company has determined that our insured driver is not at fault.” The letter ends with a polite, but irritating closing sentence, “Thank you for your inquiry.”
In Texas in order to collect from a driver after he has caused an accident and caused property damage or physical injury it must be proved that the driver was negligent, grossly negligent, or acted intentionally. Generally, car accidents involve simple negligence. The definition of negligence that Texas Courts use is as follows:
The failure to use the degree of care that a person of ordinary prudence would use under the same or similar circumstances. Negligence may consist of doing something that a person of ordinary prudence would not have done, or in failing to do something that a person of ordinary prudence would have done, under the same or similar circumstances.
To prevail in a claim for damages caused by negligence, the person bringing the action must typically show: (1) that the person causing the injury had a duty to the injured person or to the general public, (2) the actions of the person who caused the injury were not what a reasonably prudent person would have done, and (3) that damages were caused by the negligent actions.
If a jury or judge finds that the accident was indeed the fault of the other driver then damages need to be proven-up. Depending on the circumstances, an injured party may be able to collect for pain and suffering, mental anguish, medical bills, lost wages, and property damage. The preceding definitions and considerations sound fairly straightforward, but often become complicated by facts specific to the situation. If you have been in an accident and have had no luck dealing with the insurance company, or just don’t want to try to resolve the situation by yourself contacting a lawyer is an option.
The Law Office of Julie Johnson is dedicated to the protection of client rights. This blog is not intended to be specific legal advice; rather each situation must be reviewed to determine the rights and duties that may be presented by each unique set of circumstances. If you believe you have been injured through the negligence of others please feel free to contact us through our website, www.juliejohnsonlaw.com
Hope for the best but prepare for the worst. This is why you purchase insurance. You research the different policies, comparing the features and the companies’ promises, and you purchase a policy. You make your payments on time, giving the insurance company thousands of dollars for a policy you may never even use. But then the worst happens. You’re in a car accident. Or you’re diagnosed with cancer. You’re lucky to have had the forethought and the discipline to purchase insurance for this very event, right? Now you can continue having a roof over your head. Or you can pay for those life-saving medical treatments you could never afford on your own. You submit a claim, only to receive a generic form letter telling you that your claim has been denied. Even though you diligently upheld your end of the bargain with the insurance company, and it happily accepted your premium payments, you have been abandoned under the direst of circumstances.
Left-wing propaganda? Isolated cases of a few bad apples? Think again. These practices happen all day, every day, by some of the most popular and powerful insurance companies around. Companies, like Allstate, which promise that you will be “in good hands.” Companies like State Farm, which compares itself to a “good neighbour.” Farmers, too, promises to “get you back where you belong.” In reality, these three companies have been rated among the top ten worst insurance companies in America, in terms of refusal to pay claims, delayed claims, and paying only part of what you are owed under the policy. Other companies enjoying this dubious distinction include Unum, AIG, Conseco, WellPoint, UnitedHealth, Torchmark, and Liberty Mutual.
These companies have one thing in common. They care more about profits than they do about policyholders. Allstate CEO Thomas Wilson once admitted that Allstate’s “obligation is to earn a return for our shareholders.” Allstate’s shareholders may be in good hands, but where does that leave you? A senior executive at the National Association of Insurance Commissioners (NAIC), a group representing those charged with overseeing the insurance industry, admitted, “the bottom line is that insurance companies make money when they don’t pay claims.” This tension, between profits and policyholders, is the root of the problem. Insurers’ greed for profits saturates the entire field and filters down to its claims handling employees. Claims adjusters are rewarded for denying claims.
So what will you do when your claim is denied? Thankfully, even though the insurance companies literally have your life in their hands, you have an ace in the hole. Texas law imposes on insurers a duty to deal with its insured with a high standard of care. If an insurance company breaches its contract with a policyholder, the policyholder may have a cause of action which in Texas is called “First Party Bad Faith Litigation.” This is an action against an insurance company where the insurance company has without proper cause failed to compensate the insured for a loss covered under the policy, unreasonably delayed in making payments, failed to adequately pay a claim, or failed to fully investigate whether a claim is covered under the policy. By instituting this kind of lawsuit you finally exert the kind of pressure that insurers respond to – pressure on their bottom line. Insurance bad faith lawsuits cost insurers money to defend, and if they lose, not only do they have to pay the amounts due under the policy, but under some circumstances, they have to pay three times the amount due under the policy to punish the company for its bad conduct.
If you’ve been forced to battle your insurance company in your hour of need, contact an attorney well-versed in consumer and bad faith insurance law. Julie Johnson regularly represents individuals in first-party bad faith litigation and has the expertise and resources to fight for what you are owed.