Common claim myths

• Author: David Frangiamore
• Pages: 719-728

COMMON CLAIM

MYTHS

15B-1

CHAPTER 15B

COMMON CLAIM MYTHS

By Kevin M. Quinley, CPCU, AIC, ARM, Senior Vice President, Medmarc

Insurance Group, Chantilly, VA. and updated by David Frangiamore, Esq.

§1500B IN GENERAL

§1501B Myth #1: “Threatening to File Suit Will Soften Adjuster’s Position”

§1502B Myth #2: “Insurers and Adjusters Use ‘Three-Times-Specials’ Formula”

§1503B Myth #3: “It’ll Be More Expensive to Defend Than to Settle”

§1504B Myth #4: “Time Limit Demands Usually Expedite Adjuster Responses”

§1505B Myth #5: “Adjusters Receive Bonuses Based on What They ‘Save’ Off a Claim”

§1506B Myth #6: “Adjusters Cannot Evaluate Cases as Well as Attorneys”

§1507B Myth #7: “The Insurer Denied My Claim; However, I am Conf‌ident That the Claim Is Covered.

If I Ask the Insurer to Reconsider, I Probably Will Not Have to Sue to Get Coverage”

§1508B My th #8: “A Wrongful Denial of a Claim Will Automatically Subject the Insurer to Punitive Damages”

§1509B Myth #9: “The Insurer Must Have a Reasonable Basis for Denying the Claim Because It

Issued a Long Letter Explaining That the Claim Is Denied”

§1510B Myth #10: “I Was Treated so Badly by the Insurance Company That I am Certain a Lawyer

Will Take My Case on Contingency”

§1511B Myth #11: “If I Sue the Insurance Company, It Will Teach Them a Lesson and They Will Not

Do the Same Thing to Other People”

§1512B Myth #12: “I Lost the Insurance Policy Copies That Prove I Have Been Insured by This

Insurance Company for the Last Twenty Years, and the Insurer Is Required

to Have Saved Copies”

§1513B My th#13: “ The Adjuster Working on May Claim Is Probably Well Trained and the Insurer

Would Not Use the Adjuster if the Adjuster Did Not Know What He/She Was Doing”

§1514B Myth #14: “The Adjuster Working on the Claim Is Directly Employed by My Insurance Company”

§1515B Myth #15: “My Claim Is Clearly Covered and the Insurer Has Not Asserted Any Policy

Limitations, Defenses or Exclusions; Therefore, I Should Expect the Claim to Be

Paid Within the 30-Day Period Prescribed by Most Insurance Regulations”

§1516B Myth #16: “The Insurer Says the Policyholder’s Misconduct Related to the Claim Was

Intentional and Therefore They Are Justif‌ied in Denying My Claim”

§1517B Myth #17: “ The Bigger and Richer an Insurance Company Is, the Higher the Likelihood that It

Will Promptly and Fully Pay My Insurance Claim”

§1518B Myth #18: “The Insurance Company Admits That It Made a Mistake When It Did Not Pay My

Claim; However, the Insurance Company Claims It Will Never Be Held Liable for

Bad Faith Due to a Mistake”