Insurance Disputes

Pivotal Law Group represents policyholders in insurance coverage and payment disputes. Individuals and small business faithfully pay insurance premiums on the premise the insurer will hold up its end of the bargain if there is a future loss. When a loss occurs and the policyholder makes a claim, insurers often minimize their liability by refusing to pay the full amount of the claim, performing an inadequate investigation, or denying coverage entirely. Because most individuals and small businesses lack the resources of a large insurance company, wrongful claim denials or underpayments can pressure policyholders to forgo their rights under the insurance policy rather than dispute the company’s denial.

Washington law seeks to level the playing field between policyholders and insurers. Washington’s Insurance Fair Conduct Act (“IFCA”), Consumer Protection Act (“CPA”), and other provisions of Washington law impose a duty on insurers to act in “good faith.” Among other things, the insurer’s duty to act in good faith requires:

• Insurers must treat the policyholder honestly, made claims decisions based on adequate information, and never put the company’s interests over the policyholder’s.
• Insurers must promptly disclose to the policyholder whether or not they will pay the claim, and cannot string the policyholder along indefinitely without a concrete statement of whether the loss is covered.
• Insurers must fully and fairly investigate claims, and cannot rely solely on facts supporting a claim denial while ignoring facts showing the loss might be covered.
• Insurers must adhere to the written terms of the insurance policy and cannot ignore or re- write the policy after the fact to justify denying claims. Importantly, policyholders who successfully dispute a wrongful claim denial are entitled to recover from the insurer the policyholder’s attorney’s fees and court costs incurred in litigating the dispute.

Pivotal Law Group has repeatedly obtained successful results for policyholders whose insurers have failed to live up to their policy obligations. They represents policyholders regarding diverse forms of insurance including homeowner’s, disability, life, long term care, and auto.

If you have questions about insurance issues or suspect your insurer has acted improperly, contact Pivotal Law Group today for a free consultation. Policyholders concerned about insurance issues may also find the following resources helpful:

• What to Expect When You’re Expecting To Make An Insurance Claim – A Cheat Sheet;
• Does My Insurer Need to Tell Me When They Change My Policy?;
• United Policyholders – a non-profit organization advocating for insurance policyholders nationwide;
• The Washington Office of the Insurance Commissioner – the Washington state regulatory agency responsible for protecting insurance policyholders and regulating the insurance industry.