Fort Worth, Texas (PressExposure) April 22, 2009 -- Because "insurance is essentially a bet and, when you make a claim, the insurance company is losing, and they don't like to lose their bet," insurance claimants need to exercise extreme caution during the insurer's investigation and settlement proposal process, according to Fort Worth attorney Mark Humphreys.
"Insurance companies have lots of lawyers working for them to try to protect their rights, and individual agents and insurance adjusters often do everything they can to prevent from paying a claim," Humphreys observed. "When an insurance company isn't paying your claim, that's when you need to be talking to an attorney to make sure they're not doing something that's wrong.
Bad Faith & Remedies "When they do things they're not supposed to do to one of their insureds, that's called bad faith insurance, and there are many ways to make them stand up and do the things they're supposed to do under their contract of insurance and the laws of Texas."
Humphreys said insurance companies often deny claims that should not be turned down. Typical methods include, under the guise of an investigation, to take statements that can be used against the claimant to justify denying a claim, or using repeated requests for documents to delay the process in hopes the claimant will become frustrated and give up.
"When they do that, they're probably violating some of the laws in Texas, including the Prompt Payment of Claims Act," Humphreys argued.
Forgery & Deception "Another tactic is to actually forge documents," he noted. "We routinely catch adjusters or agents forging documents. They will also cite portions of an insurance contract as the reason for denying payment when they're actually taking that language out of context or relying on a contract provision that's not legally binding in the state of Texas. These are reasons you should be talking with an insurance attorney to help you with your claims."
"Any time an insurance company wants to take your statement, or starts asking you for a bunch of documents, something's not right," according to Humphreys. "They should be able to do an investigation on their own, asking the claimant a few short questions. And if they start to ask for documents or statements, particularly if they follow-up with repeated requests for additional information, they're playing games with you, and you need to talk to an attorney."