Insurance Coverage & Litigation
Insurance coverage issues can be a surprise for policyholders who have yet to file a significant insurance claim. Once you have filed an insurance claim, it will be assessed and processed by an insurance claim adjuster (alongside a team of support specialists), and you will either receive an offer of benefits, have your claim denied, or in some cases, there may be an administrative issue that forces a delay in processing.
Many insurers will take advantage of ambiguous language in the insurance contract and complications (with regard to the facts undergirding your claim) to avoid having to pay. Insurers are fundamentally arrayed against their policyholders. It’s therefore critical that policyholders understand the nature of their relationship with insurers so that they are better prepared for the prospect of litigation, if necessary.
Here at Berg Plummer Johnson & Raval, LLP, our Houston insurance coverage and litigation attorneys closely engage with clients throughout the litigation process. We will assess your claims and help you challenge the insurer’s denial or valuation of your benefits, and — in situations where bad faith may be involved — will follow through with a lawsuit to recover damages.
We represent clients in insurance disputes that involve:
Houston Insurance Coverage and Litigation Attorneys Helping With Bad Faith Litigation
In Texas, as in other states, policyholders are entitled to sue and recover damages when their insurer has failed to uphold their duty to act in good faith. The duty of good faith applies to a wide range of conduct. Policyholders may have a legitimate bad faith insurance claim when the insurer has:
- Unreasonably denied benefits to the policyholder
- Misrepresented the terms of the insurance contract
- Unreasonably delayed in processing the insurance claim
- Failed to properly investigate and assess the insurance claim
- Failed to comply with their duty to defend the policyholder against third-party lawsuits
- Failed to settle a third-party claim within the coverage limits, thus exposing the policyholder to personal liability
- Otherwise misleading the policyholder or interfering with their ability to file a claim and receive benefits in a timely manner
Bad faith litigation can be challenging, as you must show that the insurer violated their duty of good faith (given the circumstances). As such, it’s important that you work with an experienced team of Houston insurance coverage and litigation attorneys who have a track record of success in tackling insurance bad faith issues.
Health Insurance Claims
Health insurance claim denials can be exceedingly difficult to handle from both a financial and emotional perspective. In health insurance claim disputes, not only are you saddled with the unique challenge of having to recover from your injury or illness, but depending on the circumstances (i.e., if your insurance provider makes a significantly undervalued offer or denies your claim entirely), you could be left with significant bills. Whether your health insurance provider chooses to cover your treatment could spell the difference between bankruptcy and solvency. The stakes in health insurance disputes are often rather high. If your insurer acts in bad faith, you may therefore be entitled to recover damages for emotional distress, among various other losses.
As a general rule, insurers are incentivized to avoid or minimize their potential liabilities, even when their policyholder clearly qualifies for benefits under their coverage contract. By ramping up the administrative cost for the policyholder, insurers can effectively reduce their benefits liabilities and undermine the ability of policyholders to challenge the legitimacy of their actions.
Successful insurance litigation requires client-oriented legal representation from beginning-to-end of the process. At Berg Plummer Johnson & Raval, LLP, our Houston insurance coverage and litigation attorneys have decades of combined experience in representing policyholders against their insurers for wrongful denial, delay, missed payments, underpayment, and other issues entitling the claimant to challenge the decision of the insurer.
We understand that every client has different needs and limitations, and to that end, here at Berg Plummer Johnson & Raval, LLP, we work with our clients to develop a customized strategic roadmap and budget that empowers them accomplish their legal objectives without excessive spending.