12/10/2012
Pro-Insurance Company Bad Faith Decisions
In Millennium Inorganic Chemicals v. National Union Fire Ins. Co. of Pittsburgh, PA, the policyholder suffered business interruption after an explosion at its facility in Australia. Millennium argued that National Union made its coverage decision prematurely and clearly did “not understand how [its] own policies work.” Rejecting the bad faith claim, the U.S. District Court for the District of Maryland, applying New Jersey law, found that the coverage question was “fairly debatable” and thus bad faith could not be shown.
Interestingly, the court held that if National Union were required to cede to its policyholder, it “would never be entitled to test through litigation the merits of a reasonably debatable coverage position.” That would require not good faith but rather “rote acquiescence to any [non-frivolous] claim.”
In Palmisano v. State Farm Fire and Cas. Co., the policyholders discovered structural issues in their home and determined they were caused by a ruptured sewer main under the house. Plaintiffs alleged, among other things, that State Farm violated its fiduciary duty to them, engaged in an adversarial relationship with them, and failed to fairly and properly investigate the claim.
The U.S. District Court for the Western District of Pennsylvania endorsed a prior court’s statement that bad faith claims must show the “who, what, when, why or how” of the insurance company’s bad faith. The policyholder’s “bare bones” and “conclusory” allegations were insufficient to survive the insurance company’s motion to dismiss the bad faith claim.
Lessons Learned from Recent Bad Faith Decisions
Bad faith claims handling does occur, and courts and juries will punish the insurance company that commits it. However, policyholders must carefully document the bad faith conduct and plead it in sufficient detail to meet the legal thresholds courts use to determine whether the cause of action survives a motion to dismiss.
The pro-policyholder cases above also show that the policyholder must be persistent in pursuing its original claim and fighting for its rights. The policyholder should respond to the insurance company’s reasonable request for information and build a record of its cooperation in contrast to the insurance company’s delay. Most importantly, the policyholder needs to be aware of its rights and pursue them aggressively.
Following best practices in pursuit of any claim will not only expedite and maximize coverage when claims are honored, but also establish credibility for a bad faith claim when insurance company behavior justifies it. A short checklist:
• Provide immediate notice. Late notice can result in the forfeiture of coverage. Immediate notice to any potentially involved insurance company is essential.
• Fulfill your duty to cooperate. Often, in the aftermath of a catastrophe, the insurance company is the last person that the policyholder has time for. However, the policyholder has a duty to cooperate that the courts take seriously. Do not put the insurance company off until everything else is done. Responding to the insurance company must be a priority. Moreover, the insurance company cannot analyze your claim without the necessary information. Delaying a response to the insurance company will delay the resolution of your claim.
• Be sensitive to delays. Most insurance companies handle most claims in good faith. Some delay in the process may be unavoidable, and as noted earlier, the insurance company may need a lot of information from you. However, when the delay goes on for too long, or the requests for information become oppressive, think bad faith.
• Engage an insurance professional. Property insurance claims are highly technical, and require substantial analysis.