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Law Pro
Law Pro, Attorney
Category: Business Law
Satisfied Customers: 23443
Experience:  20 years experience in business law - sole proprietor, partnership, and corporations
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My homeowners insurance does not want to reimburse me (about

Customer Question

My homeowner's insurance does not want to reimburse me (about $5000) for subrogating a claim that they chose not to subrogate and closed it. The other insurance is willing to reimburse my insurance company for the $14,000 they paid to repair my home. They want my research and info for free and I don't think that is fa

The last letter from the vice president of my insurance company said the following is in my policy (and it is)- "You may waive in writing before a loss all rights to recovery against any person. If not waived, we may require an assignment of right of recovery for a loss to the extent that payment is made by us.

If an assignment is sought, the person insured must sign and delivery all related papers and cooperate with us".

What does this mean in layman terms? I have not signed anything for them one way or the other and as far as I'm concerned I have a letter stating they were not going to pursue subrogation and that the claim was closed. Do I still have an argument
Submitted: 4 years ago.
Category: Business Law
Expert:  Law Pro replied 4 years ago.

That means that you have to cooperate with you insurance carrier and turn over anything and everything you have in the matter to help them pursue the other party.

 

So, there was damage done to your house - correct?

 

Your insurance company paid so much in damages - correct?

 

The defendant's insurance company paid the balance of your damages - correct?

 

What happened to your house?

Customer: replied 4 years ago.

Yes- neighbor's rotted and neglected tree fell on my rental home.

 

Sort of- they paid up to the policy limits, however would not subrogate or pay for damaged appliances, loss of rent, etc.

 

Yes- I was able to subrogate on my own and win back my losses above the policy limits and my deductible from my neighbor's insurance. Neighbor's insurance would not pay for my time, research and expenses to prove my case. My insurance company doesn't want to reimburse me for this either.

 

House has been repaired. I feel my insurance company failed to throughly and promptly investigate the claim and realize after I advised them several times that the neighbor's tree fell due to neglect and rot, not the wind.

 

So basically I am not entitled to be reimbursed for my efforts which go beyond the duties of the insured in my opinion, in winning a judgement for my insurance company?

 

 

Expert:  Law Pro replied 4 years ago.

That is norm - your non-ability to recover for you time and expenses (sorry about that).

 

 

Yes, it would seem that they investigated your claim in "bad faith". That they found it cheaper to just pay up to your deductible rather than assist you in your legal rights and claim against the neighbor.

 

I understand you disgust with your insurance carrier.

 

Not that you have a particular case - you might want to mention to insurance carrier that your contemplating an insurance "bad faith" case against them under the circumstances and their failure of their duty to investigate and pursue your causes of action. That will get them jumping for you and all around investigating the matter.

 

Insurance bad faith is a legal term of art that describes a tort claim that an insured person may have against an insurance company for its bad acts. Under the law of most jurisdictions in the United States, insurance companies owe a duty of good faith and fair dealing to the persons they insure. This duty is often referred to as the "implied covenant of good faith and fair dealing" which automatically exists by operation of law in every insurance contract. If an insurance company violates that covenant, the insured person (or "policyholder") may sue the company on a tort claim in addition to a standard breach of contract claim. The contract-tort distinction is significant because as a matter of public policy, punitive or exemplary damages are unavailable for contract claims, but are available for tort claims. The end result is that a plaintiff in an insurance bad faith case may be able to recover an amount larger than the original face value of the policy, if the insurance company's conduct was particularly egregious.

 

An insurance company has many duties to its policyholders. The kinds of applicable duties vary depending upon whether the claim is considered to be "first party" or "third party." A common first party context is when an insurance company writes insurance on property that becomes damaged, such as a house or an automobile. In that case, the company is required to investigate the damage, determine whether the damage is covered, and pay the proper value for the damaged property. Bad faith in first party contexts often involves the insurance carrier's improper investigation and valuation of the damaged property (or its refusal to even acknowledge the claim at all). Bad faith can also arise in the context of first party coverage for personal injury such as health insurance or life insurance, but those cases tend to be rare. Most of them are preempted by ERISA.

Third party situations break down into at least two distinct duties, both of which must be fulfilled in good faith. First, the insurance carrier usually has a duty to defend a claim (or lawsuit) even if some or most of the lawsuit is not covered by the insurance policy. Unless the policy is expressly structured so that defense costs "eat away" at the policy limits, the default rule is that the insurer must cover all defense costs regardless of the actual limit of coverage.

Second, the insurer has a duty of indemnification, which is the duty to pay a judgment against the policyholder, up to the limit of coverage, but only if the judgment is for a covered act or omission. As a result, most insurance companies exercise a great deal of control over litigation.

Bad faith can occur in either situation-by improperly refusing to defend a lawsuit or by improperly refusing to pay a judgment or settlement of a covered lawsuit.

In some jurisdictions, like California, third party coverage also contains a third duty, the duty to settle a reasonably clear claim against the policyholder within policy limits, in order to avoid the risk that the policyholder may be hit with a judgment in excess of the value of the policy (which a plaintiff might then attempt to satisfy by writ of execution on the policyholder's assets). If the insurer breaches in bad faith its duties to defend, indemnify, and settle, it may be liable for the entire amount of any judgment obtained by a plaintiff against the policyholder, even if that amount is in excess of policy limits. This was the holding of the landmark Comunale case.

Bad faith is a fluid concept and is defined primarily by court decisions in case law. Examples of bad faith include undue delay in handling claims, inadequate investigation, refusal to defend a lawsuit, threats against an insured, refusing to make a reasonable settlement offer, or making unreasonable interpretations of an insurance policy.

In some cases, the tort or the governing state statute allows punitive damages against insurance companies as a mechanism to prevent future behavior.

In California, the plaintiff in a bad faith action may be able to recover some of its attorneys' fees separately and in addition to the judgment for damages against a defendant insurer, but only up to the extent that those fees were incurred in recovering tort damages (for breach of the implied covenant) as opposed to contractual damages (for breach of the terms of the insurance policy). The allocation of attorneys' fees between those two categories is usually a question of fact (meaning it usually goes to the jury).

 

 

 

 

 

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Law Pro, Attorney
Category: Business Law
Satisfied Customers: 23443
Experience: 20 years experience in business law - sole proprietor, partnership, and corporations
Law Pro and 11 other Business Law Specialists are ready to help you
Customer: replied 4 years ago.

OK thank you.

 

How do I leave your feedback?

DAVE

Expert:  Law Pro replied 4 years ago.
I think once you hit "accept" you can also leave feedback (hopefully good feedback) at the same time.

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