You purchase insurance coverage for a variety of reasons. Sometimes because it is mandated by law, sometimes it is to protect your family or assets, and sometimes it is to provide you with peace of mind that you will be taken care of if something goes wrong. In the case of automobile insurance, it’s likely for all three reasons.
Courts have increasingly recognized the role that automobile insurance coverage plays in providing you, the consumer, with peace of mind. You purchase the insurance so that if something goes wrong and you are injured, you and your family are protected. Recently, the courts have re-affirmed that insurance companies have a duty of good faith towards the insured person, especially when dealing with a so called “peace of mind” insurance policy such as your automobile insurance.
This duty of good faith requires that you are treated fairly by the insurance company when they are investigating your claim and when they are making decisions about whether to pay your claim. The insurance adjuster responding to your claim has an obligation to consider all aspects of your claim when making decisions. If there are no reasonable grounds to deny coverage or payment, the claim must be processed and paid on a timely basis. The insurance adjuster is not entitled to take advantage of an insured persons’ financial vulnerability as part of negotiating a settlement of the claim or to unreasonably withhold benefits that an insured person is clearly entitled to.
For example, if you are injured in a car accident, you may be entitled to certain benefits on a no-fault basis. These benefits are referred to as “accident benefits” and are part of every automobile insurance policy. If you are injured and make a claim for accident benefits, the adjuster assigned to your claim has to assess the extent of your injuries and make a determination on classifying your injuries within one of three categories. These categories are the Minor Injury Guideline (“MIG”), Non-Catastrophic, and Catastrophic. The classification of your injury has a significant effect on the types and amounts of benefits that are available to you. Unfortunately, we at McNally Gervan are seeing many people placed into the MIG when they should not be. More alarmingly, many people who come to us have been placed in the MIG despite clear medical evidence which indicates their injuries are not within the MIG, even where this evidence was available to the adjuster at the time they made their decision. Where there is clear medical evidence that your injuries are not within the MIG and you are being kept inside it, the conduct of the insurance company may amount to a breach of their duty of good faith.
If you are denied accident benefits, or any other payment for an insured loss, on the basis of improper considerations or an inadequate handling of your claim, you may be entitled to not only the compensation or benefits that have been denied, but additional compensation arising solely out of your mistreatment. In certain cases, where there has been a significant departure from the standards of good faith, you may be entitled to an award of aggravated or punitive damages.
If you feel that your insurance claim is not being handled properly you should contact the lawyers at McNally Gervan for a no-obligation consultation about your rights. In addition, we strongly urge anyone injured in a car accident to consult with a lawyer, regardless of whether or not you feel that your claim is being handled properly, because of the complicated nature of these claims.