Insurance Bad Faith Lawyer

When you pay your insurance premiums month after month, year after year, you expect your insurance company to hold up its end of the bargain. Every insurance policy carries with it an implied covenant of good faith and fair dealing — a legal obligation that requires insurers to treat their policyholders and claimants honestly, promptly, and fairly. When an insurance company violates that duty by unreasonably denying a valid claim, delaying payment without justification, or offering far less than what a claim is worth, the insurer may be acting in bad faith. Insurance bad faith is not just frustrating — it is actionable under the law. The California Supreme Court’s decision in Gruenberg v. Aetna Ins. Co., 9 Cal.3d 566 (1973), established that an insurer’s unreasonable refusal to pay a covered claim gives rise to tort liability, and it can expose the insurance company to liability far beyond the original value of the claim.

At Maxx Compensation, attorney Charles C. Teale represents policyholders and injury victims who have been mistreated by insurance companies. Whether your own insurer has refused to pay a legitimate claim under your policy or the at-fault party’s insurance company is stonewalling your personal injury claim, we fight to hold insurers accountable for their bad faith conduct. Insurance companies employ armies of adjusters, investigators, and lawyers to protect their bottom line. You deserve an attorney who will fight just as hard to protect yours.

If you believe an insurance company is acting in bad faith on your claim, contact Maxx Compensation today at 877-462-9952 for a free consultation, or visit our Free Case Evaluation page to get started online.

What Is Insurance Bad Faith?

Insurance bad faith refers to an insurance company’s unreasonable or dishonest conduct in handling a claim. The concept is rooted in the implied covenant of good faith and fair dealing, a legal principle recognized across the United States that applies to virtually every insurance contract. This covenant requires both parties to an insurance agreement—a duty recognized in virtually every jurisdiction since the seminal case Comunale v. Traders & General Ins. Co., 50 Cal.2d 654 (1958)— — the insurer and the insured — to act fairly and in good faith toward each other. Because insurance companies hold significant power over their policyholders’ financial well-being, courts have long recognized that insurers owe a heightened duty of good faith when processing, investigating, and paying claims.

Bad faith claims generally fall into two broad categories: first-party bad faith and third-party bad faith. Understanding the distinction between these two categories is important because the legal theories, available remedies, and the parties involved differ significantly.

Statutory Bad Faith vs. Common Law Bad Faith

Insurance bad faith claims can arise under two different legal frameworks. Common law bad faith is a judge-made legal doctrine that has developed through court decisions over many decades. Under common law, courts have recognized that the special relationship between an insurer and its insured gives rise to a duty of good faith, and that a breach of this duty can result in tort liability — meaning the insurer can be sued for damages beyond just the policy benefits owed.

Statutory bad faith arises from specific state legislation that defines and prohibits certain unfair claim settlement practices. Most states have enacted some version of an Unfair Claims Settlement Practices Act, many of which are modeled on the National Association of Insurance Commissioners (NAIC) Model Unfair Claims Settlement Practices Act, first adopted in 1972 and revised periodically. The NAIC Model Act identifies specific practices that constitute unfair claim handling, including misrepresenting policy provisions, failing to acknowledge and act promptly on claims, refusing to pay claims without conducting a reasonable investigation, and not attempting in good faith to effectuate prompt, fair, and equitable settlements when liability is reasonably clear.

Whether an individual policyholder can sue the insurer directly under these statutes — known as a “private right of action” — varies by state. Some states allow direct claims, while others reserve enforcement authority to the state insurance commissioner or attorney general. Where a private right of action exists, statutory bad faith claims may provide additional remedies, including statutory penalties and attorney fee awards.

What Is First-Party Insurance Bad Faith?

First-party bad faith occurs when your own insurance company acts in bad faith toward you — the policyholder who has been paying premiums. In a first-party insurance relationship, you are making a claim directly under your own policy for benefits you are entitled to receive. When your insurer unreasonably refuses to honor that obligation, it constitutes first-party bad faith.

First-party bad faith claims commonly arise in the following contexts:

• Uninsured and underinsured motorist (UM/UIM) claims: If you are injured by a driver who has no insurance or insufficient insurance, you may file a claim under your own auto policy’s UM/UIM coverage. When your own insurer denies, delays, or lowballs your UM/UIM claim without a reasonable basis, that can constitute bad faith. For more information about these claims, visit our Uninsured Motorist Lawyer page.
• Homeowners insurance claims: After property damage from storms, fires, water damage, or other covered events, homeowners insurance companies sometimes deny valid claims, undervalue the damage, or drag out the claims process for months or years.
• Health insurance claims: Health insurers may deny coverage for medically necessary treatments, impose unreasonable prior authorization requirements, or terminate coverage without proper justification.
• Disability insurance claims: Both short-term and long-term disability insurers are known for denying claims based on their own hired medical reviewers’ opinions, even when the claimant’s treating physicians support the disability.
• Life insurance claims: Life insurers may delay death benefit payments, contest policies based on alleged misrepresentations in the application, or invoke exclusions that do not properly apply.

In first-party bad faith cases, the central question is whether the insurer had a reasonable basis for its conduct. An insurer is not acting in bad faith simply because it denies a claim — denial must be unreasonable under the circumstances. However, when an insurer denies a claim that should have been paid, delays payment without justification, or offers a settlement amount that is far below the actual value of the claim, the policyholder may have grounds to bring a bad faith action.

First-party bad faith is particularly harmful because it strikes at the very purpose of insurance. Policyholders purchase coverage to protect against financial loss, and when their own insurer refuses to honor that protection, the policyholder is left bearing the very burden the insurance was supposed to cover.

What Is Third-Party Insurance Bad Faith?

Third-party bad faith occurs when someone else’s insurance company acts in bad faith. In personal injury cases, this most commonly involves the at-fault party’s liability insurer. The at-fault party’s insurer owes its own policyholder a duty of good faith, which includes a duty to reasonably investigate claims and to settle within policy limits when liability is clear.

Third-party bad faith often manifests in the following ways:

• Failure to settle within policy limits: When an insurer refuses to accept a reasonable settlement demand within its insured’s policy limits, despite clear liability, the insurer exposes its own policyholder to a judgment that exceeds the policy limits. This is one of the most consequential forms of third-party bad faith. If a jury returns a verdict above the policy limits, the insurer may be liable for the entire judgment, as established in Crisci v. Security Ins. Co., 66 Cal.2d 425 (1967) — not just the policy limits — because its unreasonable refusal to settle caused harm to its own insured.
• Failure to properly investigate: Insurers have a duty to conduct a reasonable investigation of claims made against their policyholders. When they fail to investigate, conduct only a superficial investigation, or ignore evidence favorable to the claimant, they may be acting in bad faith.
• Failure to defend: Liability insurers generally have a duty to defend their policyholders against covered claims. Refusing to provide a defense when one is owed can constitute bad faith.
• Unreasonable delay tactics: Some insurers deliberately delay the claims process — failing to respond to correspondence, requesting unnecessary documentation, or reassigning adjusters repeatedly — in hopes that the injured party will accept a lower settlement or simply give up.

Third-party bad faith is especially relevant in personal injury cases where the at-fault party’s insurer is the primary entity responsible for compensating the injured victim. When that insurer engages in bad faith tactics, it can prolong the victim’s suffering and financial hardship while the insurer profits from the delay.

What Are Common Examples of Insurance Bad Faith?

Insurance bad faith can take many forms. While every case is different, the following are among the most common examples of insurance company conduct that may constitute bad faith:

Unreasonable Claim Denial

Denying a claim without a reasonable basis is perhaps the most straightforward form of bad faith. This includes denying a claim that is clearly covered under the policy terms, denying a claim based on a misinterpretation of the policy language, or denying a claim without providing a clear explanation of the reasons for the denial. Insurance companies are generally required to provide written explanations for claim denials, and those explanations must be based on legitimate policy provisions and factual findings.

Failure to Investigate Properly

Insurance companies have a duty to conduct a thorough and fair investigation of every claim. When an insurer fails to interview key witnesses, ignores relevant medical records, refuses to inspect property damage, or relies solely on information that supports denial while ignoring favorable evidence, the insurer may be acting in bad faith.

Unreasonable Delay in Processing Claims

Some insurers deliberately slow-walk the claims process, taking weeks or months to respond to inquiries, repeatedly requesting the same documentation, transferring files between adjusters, or simply sitting on claims without taking action. Many states have specific regulations establishing timeframes within which insurers must acknowledge claims and make decisions. Violations of these timeframes can support a bad faith claim.

Lowball Settlement Offers

Offering a settlement amount that is far below the reasonable value of a claim can constitute bad faith, particularly when the insurer knows the true value of the claim but hopes the claimant will accept a fraction of that value out of financial desperation. This is especially common in personal injury cases, where medical bills are mounting and the injured person may be unable to work. An insurer that offers $5,000 to settle a claim that its own adjuster has valued at $50,000 is not negotiating in good faith.

Misrepresenting Policy Terms or Coverage

When an insurer misrepresents the terms of a policy — telling a policyholder that a certain type of loss is not covered when it actually is, or mischaracterizing an exclusion to avoid paying a claim — that misrepresentation can form the basis of a bad faith claim. This conduct is specifically identified as an unfair claims settlement practice under the NAIC Model Act.

Failure to Communicate

Insurance companies have a duty to keep policyholders and claimants reasonably informed about claim status. When an insurer goes silent — refusing to return phone calls, failing to respond to correspondence, or not providing updates — that failure to communicate can support a bad faith claim.

Threatening or Intimidating Claimants

Some insurers engage in threatening or intimidating behavior, including suggesting that filing a claim could result in policy cancellation, implying the claimant is committing fraud without evidence, or using aggressive interrogation tactics during recorded statements. This conduct is designed to discourage legitimate claims and can constitute bad faith.

Requiring Unnecessary Documentation

While insurers may request documentation reasonably related to evaluating a claim, some use documentation requests as a delay tactic — repeatedly asking for additional records, requiring the same documents multiple times, or demanding documentation with no reasonable connection to the claim. When these requests are designed to frustrate rather than evaluate, they can support a finding of bad faith.

Refusing to Pay a Valid Claim Without a Reasonable Basis

This is the core of insurance bad faith: an insurer that refuses to pay benefits owed under the policy when there is no legitimate reason for the refusal. The insurer may not formally deny the claim — it may simply refuse to act on it, fail to make a coverage determination, or acknowledge that the claim is valid but still refuse to issue payment.

Failure to Settle Within Policy Limits When Liability Is Clear

When an injured person makes a settlement demand within policy limits and liability is clear, the insurer’s refusal to accept can constitute bad faith. This is significant because a failure to settle within limits exposes the insurer’s own policyholder to personal liability for any excess judgment. Courts have consistently held that when an insurer prioritizes its own financial interests over its duty to protect its insured from excess liability, the insurer acts in bad faith.

How Does Bad Faith Arise in Personal Injury Claims?

Insurance bad faith frequently arises in the context of personal injury claims. When you are injured in a car accident, motorcycle accident, slip and fall, or other incident caused by someone else’s negligence, you will likely need to deal with one or more insurance companies. Each of these interactions presents an opportunity for bad faith conduct.

In a typical personal injury case, you may encounter bad faith from the at-fault party’s liability insurer — which may refuse to accept liability despite clear evidence, drag out the investigation, or make settlement offers that do not come close to covering your damages. You may also encounter bad faith from your own insurer on a UM/UIM, personal injury protection (PIP), or medical payments (MedPay) claim.

Bad faith in personal injury cases is particularly harmful because injured people are often in vulnerable positions — unable to work, facing mounting medical bills, and under pressure from creditors. Insurance companies are well aware of this financial pressure, and some exploit it by delaying claims or offering lowball settlements, knowing the injured person may feel compelled to accept less than their claim is worth.

When bad faith occurs in a personal injury context, the injured person may be able to pursue both the underlying personal injury claim and a separate bad faith claim against the insurer, providing additional compensation including consequential damages, emotional distress damages, and in some states, punitive damages.

If you have been injured in an accident and believe the insurance company is not handling your claim fairly, it is important to consult with an attorney who understands both personal injury law and insurance bad faith. At Maxx Compensation, we handle both types of claims and can advise you on the best strategy for your specific situation. Visit our Practice Areas page to learn more about the types of cases we handle, or contact us at 877-462-9952 to discuss your case.

How Do State Bad Faith Laws Differ Across the Country?

Insurance bad faith laws vary significantly from state to state. There is no single federal bad faith statute that applies nationwide. Instead, each state has developed its own body of law governing how insurance companies must handle claims and what remedies are available when they fail to do so fairly. Understanding the law in your state is critical to evaluating whether you have a viable bad faith claim and what damages you may be able to recover.

Statutory Frameworks

Most states have enacted some version of an Unfair Claims Settlement Practices Act, many modeled on the NAIC Model Unfair Claims Settlement Practices Act, which provides a framework for regulating insurer conduct. The NAIC Model Act identifies specific unfair practices, including misrepresenting policy provisions, failing to acknowledge and act promptly on claims, failing to implement reasonable investigation standards, and not attempting in good faith to effectuate prompt, fair settlements when liability is reasonably clear.

While most states have adopted some version of this framework, the specifics vary considerably. Critically, not all states provide a private right of action under their unfair claims settlement practices statute. In states without a private right of action, the statute may only be enforceable by the state insurance department or attorney general. In those states, bad faith claims must typically be brought under common law theories.

Common Law Bad Faith

In addition to — or in some cases instead of — statutory bad faith claims, most states recognize some form of common law bad faith. The specifics of common law bad faith vary by state, but the general principle is the same: insurers owe a duty of good faith and fair dealing to their insureds, and a breach of that duty gives rise to a cause of action in tort. The standard of proof, available defenses, and scope of recoverable damages all depend on state law.

Punitive Damages

One of the most significant variations among state bad faith laws is the availability of punitive damages. Punitive damages are designed to punish the insurer for egregious conduct and deter similar behavior. Some states allow punitive damages in bad faith cases, sometimes with statutory caps. Others do not allow them at all, or limit them to cases involving fraud or malice. Where available, punitive damages can dramatically increase the total value of a bad faith claim.

Extracontractual Damages

Extracontractual damages go beyond the insurance policy benefits themselves. While a breach of contract claim typically limits recovery to policy benefits, a bad faith claim may allow recovery of emotional distress, consequential financial losses, and attorney fees. The availability of these damages varies by state.

Because bad faith laws vary so widely from state to state, it is essential to work with an attorney who is familiar with the law in the relevant jurisdiction. Maxx Compensation can help you understand how the bad faith laws in your state apply to your specific situation.

What Compensation Can You Recover in a Bad Faith Case?

One of the most important things to understand about insurance bad faith claims is that the damages available can significantly exceed the value of the original insurance claim. This is what makes bad faith claims such a powerful tool for holding insurance companies accountable. When an insurer acts in bad faith, the policyholder or claimant may be entitled to recover several categories of damages.

The Original Claim Amount

First and foremost, a successful bad faith claim should result in recovery of the benefits that were owed under the original insurance claim. If your insurer wrongfully denied a $100,000 claim, you are entitled to recover that $100,000. This is sometimes referred to as “contract damages” because it represents the amount the insurer was contractually obligated to pay.

Consequential Damages

Consequential damages are the foreseeable financial losses that resulted from the insurer’s bad faith conduct. For example, if a wrongful denial caused you to lose your business, the lost income could be recoverable. If an unreasonable delay caused you to fall behind on mortgage payments and face foreclosure, those financial losses could be recoverable. Consequential damages are often substantial and can significantly increase the overall value of a bad faith case.

Emotional Distress Damages

Dealing with a wrongful claim denial or an unresponsive insurer can cause anxiety, depression, sleeplessness, and other forms of emotional distress. Many states allow policyholders to recover damages for emotional distress caused by bad faith conduct, with the amount depending on the severity of harm and the egregiousness of the insurer’s behavior.

Attorney Fees and Costs

In many states, a policyholder who prevails on a bad faith claim can recover attorney fees and litigation costs. Some state statutes specifically provide for fee awards, and some states allow fee recovery under common law theories as well. These provisions reduce financial risk for policyholders and create additional incentive for insurers to handle claims fairly.

Punitive Damages

As discussed above, punitive damages may be available in states that allow them. The amount is determined by the jury (or judge in a bench trial) and is typically based on factors such as the reprehensibility of the insurer’s conduct, the ratio between punitive and actual damages, and the insurer’s financial condition. In cases involving particularly outrageous conduct, punitive damage awards can be several times the amount of compensatory damages.

The Multiplier Effect

When all categories of damages are considered, a bad faith claim can result in a total recovery that is many times the value of the underlying insurance claim. This multiplier effect is one of the reasons insurance companies take bad faith claims seriously — and why it is so important for policyholders to assert their bad faith rights when an insurer acts unreasonably.

How Do You Prove Insurance Bad Faith?

Proving insurance bad faith requires demonstrating that the insurer’s conduct was unreasonable under the circumstances. While the specific elements vary by state, most bad faith claims require the policyholder to show that the insurer owed a duty of good faith, that the insurer breached that duty through unreasonable conduct, and that the breach caused the policyholder harm. Building a strong bad faith case requires careful documentation and evidence gathering.

Policy Terms and Coverage Analysis

The starting point for any bad faith claim is the insurance policy itself. You must be able to show that your claim was covered under the policy and that the insurer’s conduct was inconsistent with the policy terms. This requires a thorough analysis of coverage provisions, exclusions, conditions, and definitions. An experienced attorney can analyze your policy and determine whether the insurer is misrepresenting or misapplying the policy language.

Claim Documentation

Thorough documentation of your claim and the insurer’s handling of it is essential. This includes claim forms and submissions, medical records and bills, repair estimates, proof of lost wages, the insurer’s claim file and internal notes, and all written communications. Insurance companies are required to maintain claim files, and in litigation, these files can be obtained through discovery. The claim file often contains internal notes and adjuster evaluations that reveal the insurer’s true reasons for its conduct — which may differ from the reasons provided to the policyholder.

Correspondence and Communications

Every communication between you and the insurance company is potentially important evidence. Keep copies of all correspondence, document the date, time, and content of phone conversations, and save emails and voicemails. If the insurer made verbal representations that differ from its written positions, those inconsistencies can be powerful evidence of bad faith.

Timeline of Events

Constructing a detailed timeline of your claim — from the date of loss through the insurer’s various actions and inactions — can reveal patterns of delay that support a bad faith claim. The timeline should document when the claim was reported, when the insurer acknowledged it, when additional information was requested, how long responses took, and when coverage determinations were made. Comparing this timeline to the insurer’s obligations under state regulations can demonstrate a failure to act with reasonable promptness.

Industry Standards and Expert Testimony

Insurance companies are expected to follow accepted industry standards in handling claims. Evidence that an insurer deviated from these standards — established through regulations, professional guidelines, and accepted practices — can support a bad faith claim. In many cases, expert testimony from former insurance adjusters, claims managers, or industry professionals is used to establish how a reasonable insurer would have handled the claim and to demonstrate how the insurer fell short of that standard.

Preserving Evidence

If you believe your insurer is acting in bad faith, begin preserving evidence immediately. Keep copies of all documents and correspondence. Take notes of phone conversations, including the date, time, and name of the person you spoke with. Do not discard any documents related to your claim. The more thoroughly you document the insurer’s conduct, the stronger your bad faith case will be.

Frequently Asked Questions

What is the difference between a denied claim and insurance bad faith?

Not every denied claim constitutes bad faith. Insurance companies have the right to deny claims that are not covered or where the evidence does not support the claim. Bad faith occurs when the denial is unreasonable — the insurer denied a claim that should have been paid, failed to conduct an adequate investigation, or based the denial on a misrepresentation of policy terms. The key distinction is reasonableness: if a reasonable insurer would have paid the claim, the denial may constitute bad faith.

Can I sue an insurance company for bad faith if I am not the policyholder?

In many situations, yes. Third-party bad faith claims can arise when the at-fault party’s insurer acts in bad faith. Some states also allow injured third parties to bring direct bad faith claims against the at-fault party’s insurer, particularly after a judgment has been obtained against the insured. The rules vary by state, and whether you can bring a bad faith claim as a non-policyholder depends on the specific circumstances and jurisdiction.

How long do I have to file an insurance bad faith claim?

The statute of limitations for insurance bad faith claims varies by state and depends on whether the claim is brought under a statutory or common law theory. Statutes of limitations for bad faith claims typically range from one to six years, depending on the state and the legal theory. It is important to consult with an attorney as soon as you suspect bad faith, because the clock may start running from the date of the insurer’s wrongful conduct, and delay can result in the loss of your right to bring a claim.

What should I do if I think my insurance company is acting in bad faith?

If you believe your insurance company is acting in bad faith, take the following steps: First, document everything. Keep copies of all correspondence, take notes of phone conversations, and maintain a timeline of events. Second, put your concerns in writing. Send a letter to the insurer clearly stating your position and requesting a written explanation for the insurer’s conduct. Third, file a complaint with your state’s department of insurance. While this may not resolve your claim directly, it creates an official record of the insurer’s conduct. Fourth, consult with an attorney who handles insurance bad faith cases. An attorney can evaluate your situation, advise you on your rights, and take legal action if warranted.

Do I need an attorney for an insurance bad faith claim?

While you are not legally required to have an attorney, insurance bad faith cases are complex and are almost always better handled by an experienced lawyer. Insurance companies have teams of adjusters and attorneys working on their behalf, and bad faith cases involve intricate legal issues including policy interpretation, state insurance regulations, and complex damages calculations. An attorney can level the playing field, gather the evidence needed to prove bad faith, negotiate with the insurer from a position of strength, and litigate the case if necessary.

Can I file a bad faith claim while my original insurance claim is still pending?

In many states, yes. You do not necessarily need to wait until your original claim has been formally denied to take action against an insurer that is acting in bad faith. Unreasonable delay in processing a claim is itself a form of bad faith. However, the timing and procedural requirements for filing a bad faith claim depend on state law, and in some jurisdictions, you may need to exhaust certain administrative remedies before filing a lawsuit. An attorney can advise you on the proper timing for a bad faith action in your state.

What types of insurance policies can give rise to bad faith claims?

Bad faith claims can arise under virtually any type of insurance policy, including auto insurance, homeowners insurance, renters insurance, health insurance, life insurance, disability insurance, commercial property insurance, general liability insurance, professional liability insurance, and workers’ compensation insurance. The duty of good faith and fair dealing applies to all insurance contracts, regardless of the type of coverage involved.

Will filing a bad faith claim affect my insurance coverage or rates?

Filing a bad faith claim should not affect your current coverage. Insurance companies are generally prohibited from retaliating against policyholders for asserting their legal rights, and canceling or non-renewing a policy in retaliation for a bad faith claim could itself constitute additional bad faith or a violation of state insurance regulations. If you are concerned about potential retaliation, discuss this with your attorney.

What is the difference between bad faith and breach of contract?

A breach of contract claim asserts that the insurer failed to pay benefits owed under the policy, and the remedy is typically limited to the policy benefits plus interest. A bad faith claim asserts that the insurer acted unreasonably or dishonestly in handling the claim. Because bad faith is a tort claim in most states, remedies can go well beyond the policy benefits to include consequential damages, emotional distress, attorney fees, and punitive damages. Many policyholders assert both claims simultaneously.

How much does it cost to hire an insurance bad faith lawyer?

Many insurance bad faith attorneys, including the attorneys at Maxx Compensation, handle bad faith cases on a contingency fee basis. You pay no upfront attorney fees — the fee is a percentage of the recovery obtained on your behalf. If there is no recovery, you owe no fee. This makes it possible for policyholders to bring bad faith claims against large insurance companies without paying hourly fees out of pocket. Contact us at 877-462-9952 to learn more.

Find a Insurance Bad Faith Lawyer in Your State

Maxx Compensation represents insurance bad faith victims across all 50 states. Select your state to learn about the laws and legal options specific to your location:

• Alabama
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• California
• Colorado
• Connecticut
• Delaware
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• Georgia
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• Illinois
• Indiana
• Iowa
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• Kentucky
• Louisiana
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• Virginia
• Washington
• West Virginia
• Wisconsin
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Contact Maxx Compensation Today

If an insurance company has denied your claim, delayed your claim, offered far less than it is worth, or otherwise failed to treat you fairly, you may have a bad faith claim. Insurance companies count on policyholders giving up or accepting less than they deserve. Do not let that happen to you.

At Maxx Compensation, attorney Charles C. Teale has the knowledge and determination to take on insurance companies that put profits ahead of their obligations to policyholders. We understand the tactics insurers use to avoid paying legitimate claims, and we know how to fight back effectively.

Call us today at 877-462-9952 to speak with a member of our team about your situation. You can also visit our Free Case Evaluation page to submit your information online. There is no cost and no obligation — just honest answers about your rights and your options.

Do not wait. Statutes of limitations apply to bad faith claims, and the sooner you take action, the better positioned you will be to hold the insurance company accountable. Contact Maxx Compensation today and let us fight for the compensation you deserve.