Bad faith-bad news
| Author | David Frangiamore |
| Pages | 605-692 |
BAD FAITH-BAD
NEWS
15-1
CHAPTER 15
BAD FAITHBAD NEWS
§1500 GENERAL PRINCIPLES AND DEFINITIONS
§1500.1 Scope of Coverage
§1500.2 Origins of Bad Faith Actions
§1501 Bad Faith
§1501.1 Non Insurance Companies—HMO
§1502 Extra-Contractual Damages
§1503 Assignment of Bad Faith
§1504 Lien Rather than Assignment
§1505 A Working Definition of Bad Faith
§1505.1 The Unreasonable
§1505.2 Withholding
§1505.3 Policy Benefits
§1505.4 Without Proper Cause—Excuse
§1505.5 Equitable Subrogation by an Excess Insurer against a Primary Insurer—Is It Permitted?
§1506 Alter Ego: Parent and Subsidiary Corporations
§1510 THE FOUR MAJOR AREAS OF BAD FAITH
§1511 Wrongful Denial of Coverage
§1511.1 Failure to Indemnify the Insured for Property First Party Claims
§1511.2 Failure to Defend the Insured and Pay Settlements and
Judgments on the Insureds Behalf in Third-Party Claims and Suits
§1511.3 To the Claimant
§1512 Unreasonable Delay of Benefits
§1513 Underpayment of Claimed Benefits (Lowballing)
§1513.1 Intentionally
§1513.2 Negligently Underpaying Policy Benefits
§1514 Failure to Process Claim
§1520 FIRST PARTY BAD FAITH
§1521 Implied-in-Law Covenant
§1521.1 Use of Unfair Claims Practices Statutes
§1522 Fiduciary Duties Owed the Insured
§1523 ERISA
§1524 Premature Arbitration by Insurer
§1524.1 Bad Faith Arbitration
§1525 Third Party Beneficiaries—When Can They Claim Insured Status?
§1526 Additional Insureds
BAD FAITH-BAD
NEWS
How Insurance Companies Settle Cases 15-2
§1530 BAD FAITH WRONGFUL DEATH
§1540 THEORIES OF EXTRACONTRACTUAL DAMAGES FOR FIRST PARTY CLAIMANTS
§1541 Common Law Bad Faith
§1541.1 Bad Faith Based on Violation of Statute: Employee Compensation and Bonus Plans
§1542 Examples of Unreasonable Withholding
§1542.1 Deceptive Claims Practices
§1542.2 Intimidation Claims Practices
§1542.3 Failure to Communicate
§1542.4 Failure to Educate
§1542.5 Capricious Cut-Off of Benefits
§1542.6 Arbitrary Declaratory Relief
§1542.7 Failure to Be Objective
§1542.8 Distorted Policy Interpretation
§1542.9 Unreasonable Delay of Payment
§1542.10 Failure to Thoroughly Investigate
§1542.11 Failure to Reconsider Denial
§1542.12 Breaches of Unreasonableness During Litigation
§1542.13 Failure to Settle When Liability Is Reasonably Clear
§1542.14 Incompetence of Insurer’s Investigator
§1542.15 Extortion
§1542.16 Encouraging Adjusters to Practice Lowballing Insurance Claims
§1542.17 Failure to Defend
§1542.18 Bad Faith/Negligent Defense
§1542.19 Interference With the Insured’s Representation
§1542.20 Forcing Claimant Into Arbitration
§1542.21 Withdrawing From the Defense Without Reason or Just Cause
§1543 Breach of Fiduciary Duty
§1543.1 Service
§1543.2 Peace of Mind
§1543.3 Trust
§1544 Statutory Bad Faith
§1545 Exception to the “Fairly Debatable Rule”
§1546 Denial of Claim Based on Void Exclusion
§1547 Fraud
§1548 Insurer’s Negligent Release of the Insured’s Claim Against a Third Party
§1549 Negligent Referrals
§1550 THEORIES OF EXTRACONTRACTUAL DAMAGES FOR THIRD PARTY CLAIMANTS
§1550.1 Fraud, Deceit, Misrepresentations
§1550.2 Intentional Infliction of Emotional Distress
§1550.3 Excess Judgments
§1550.3.1 Excess Insurer’s Bad Faith Claim Against Primary Insurer
§1550.4 Trial of Bad Faith Claim Before Coverage Issue
§1550.5 Third Party Beneficiary
§1550.6 Statute
§1550.7 Case Law
§1550.8 Lack of Coverage Under Policy
§1550.9 Reserved
§1550.10 Strict Liability
§1551 Coaching the IME Doctor
§1552 Information Sharing by SIUs
§1553 Chart: Each State’s Position on Third Party Private Right or Direct Action for Bad Faith
BAD FAITH-BAD
NEWS
15-3 Bad Faith—Bad News
§1560 DEFENSES TO BAD FAITH ACTIONS
§1561 Statutory Privilege
§1562 No Unreasonable Withholding
§1563 Release of Bad Faith
§1564 Mandatory Arbitration
§1565 Claims Representative’s Reliance on Advice of Counsel
§1566 Statute of Limitations
§1566.1 “Time to Sue” Policy Provision
§1566.2 Chart: Statute of Limitations for Insurance Breach
of Contract and Bad Faith Actions in All States
§1567 Comparative Bad Faith
§1568 Federal Pre-Emption
§1568.1 Exceptions
§1569 Workers’ Compensation Exclusive Remedy
§1569.1 Exceptions
§1570 DAMAGES
§1571 Tort or Extra-Contractual Damages
§1572 Contractual Damages
§1572.1 Non Adjunct Bad Faith Cases
§1573 Punitive Damages
§1574 Warning Signs of Punitive Damages
§1575 Emotional Damage Need Not Flow From Economic Loss
§1576 Treble Damages Under RICO.
§1580 BAD FAITH LIABILITY WHEN THERE IS NO COVERAGE
§1590 PUBLIC BAD FAITH FINES
§1591 Defendant—Independent Adjusting Firms
§1592 Tort Reform Has No Effect on Insurance Premiums
KEY POINTS TO REMEMBER
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