In the realm of insurance, the relationship between policyholders and insurance companies is founded on trust. Policyholders expect their insurers to act in good faith, promptly handling claims and providing the coverage promised in their policies. However, what happens when this trust is violated? In Oregon insurance bad faith can leave individuals grappling with denied claims, delayed payments, and unfair treatment.
One area where this often comes to the forefront is when an insurer unlawfully denies or cuts off personal injury protection (PIP) benefits. This usually occurs when there is a “file review” or an “insurance medical exam” by a medical provider that is hired by the insurer and concludes future medical treatment is not necessary or related to the crash. Bad faith conduct also arises when the insurer does not process bills in time or the insurer makes your medical providers jump through unnecessary hoops. This may result in teh providers passing the bills on to you.
What is Insurance Bad Faith?
Insurance bad faith occurs when an insurance company fails to uphold its contractual obligations to its policyholders. This can manifest in various forms, including unjustified claim denials, unreasonable delays in claim processing, inadequate investigations, and deceptive practices. When an insurer acts in bad faith, it undermines the fundamental purpose of insurance, which is to provide financial protection and peace of mind to policyholders in times of need. In Oregon bad faith is written into the law in the Unfair Claims Settlement Practices Act found in ORS 746.230. The recent court decision in Moody v. Federal Insurance Company, has provided persons insured by an Oregon policy a legal remedy to obtain financial compensation when an insurer violates Oregon’s Unfair Claims Settlement Practices Act.
Understanding Personal Injury Protection (PIP) Benefits
Personal Injury Protection (PIP) is a type of coverage that is mandated in some states, including Oregon, as part of auto insurance policies. PIP benefits are designed to provide prompt payment for medical expenses and lost wages resulting from injuries sustained in a car accident, regardless of who was at fault. In Oregon, drivers are required to carry a minimum of $15,000.00 of PIP coverage that pays crash related medical expenses as part of their auto insurance policies.
The Tools Insurance Companies Use to Wrongfully Deny PIP Benefits:
While PIP coverage is intended to provide swift and efficient compensation for accident-related injuries, navigating the claims process can sometimes be fraught with challenges. Insurance companies may engage in tactics aimed at minimizing their financial exposure, including:
Unjustified Claim Denials: Insurers may wrongfully deny valid PIP claims, citing vague policy language or alleging that the injuries are not covered under the policy.
Delaying Claim Processing: Delays in processing PIP claims can exacerbate financial strain for injured individuals who rely on timely reimbursement for medical expenses and lost wages.
Undervaluing Claims: Insurance companies may offer settlements that do not adequately compensate injured parties for their medical costs, lost income, and pain and suffering.
Inadequate Investigations: Insurers have a duty to conduct thorough and fair investigations into PIP claims. However, they may cut corners or overlook crucial evidence to justify denying or undervaluing claims.
Protecting Your Rights
If you believe that your insurer is acting in bad faith regarding your PIP claim, it is essential to take proactive steps to protect your rights:
Document Everything: Keep detailed records of all communication with your insurance company, including emails, letters, and phone calls. Document your medical expenses, treatments, and any correspondence related to your claim.
Know Your Policy: Familiarize yourself with the terms and conditions of your insurance policy, including the extent of your PIP coverage and any limitations or exclusions that may apply.
Seek Legal Guidance: If you encounter difficulties with your PIP claim, consider consulting with an experienced personal injury attorney, such as Jeremiah Ross, who can advocate on your behalf. Ross Law can review your case, negotiate with the insurance company, and, if necessary, pursue legal action to enforce your rights.
Conclusion
Insurance bad faith can have devastating consequences for individuals seeking compensation for injuries sustained in car accidents. Understanding your rights under Oregon's PIP coverage and recognizing the signs of insurer misconduct are crucial steps in safeguarding your interests. By staying informed, documenting your expenses, and seeking legal guidance when needed, you can assert your rights and pursue fair treatment from your insurance company. Remember, you deserve prompt and equitable compensation for your injuries, and insurance bad faith should never stand in the way of justice.
Please remember this blog post is for informational purposes only and is not considered to be legal advice. Please contact an Oregon Personal Injury lawyer such as Jeremiah Ross at 503.224.1658 to discuss your insurance denial. Please remember the law is constanty changing, and this blog post is not updated regularly.