Archives: Claims Investigation

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Insurance coverage for water damage

The great American humorist and writer Ambrose Bierce (1842-circa 1914) published a famous work called “The Devil’s Dictionary,” in which he provided astute (if sardonic) definitions of many common terms in the English language. Bierce defined “insurance” for example, as “An ingenious modern game of chance in which the player is permitted to enjoy the … Continue Reading

Bad Faith and Settlement Negotiations

Here’s an interesting question recently confronted by the Ninth Circuit:  Is it bad faith for an insurance company to refuse to initiate settlement discussions in a third-party context when liability has become reasonably clear?  The carrier (Deerbrook, an Allstate company) took the position that bad faith could not exist unless the carrier failed to respond … Continue Reading

More on the ERISA “arbitrary and capricious” standard

To many policyholders, ERISA is a government program that simply backfired (sort of like Prohibition). That’s because ERISA considers an insurance company to be a “fiduciary.” Back in 1974, when ERISA was passed by Congress, the lawmakers figured that since the insurance company is a “fiduciary,” it must have the best interests of the injured … Continue Reading

Insurance claims handling

I’ve been reading Jay Feinman’s excellent book, Delay Deny Defend:  Why Insurance Companies Don’t Pay Claims and What You Can Do About It. The book deals with the games insurance companies play in claims handling, especially in the personal lines arena.  At one point, Feinman quotes from a great movie I haven’t seen in a … Continue Reading