There is an old saying that insurance is good to have until you need it. It is no secret that insurance companies resist paying claims, whether brought by a third party injured person, or their own customer or policyholder. The law permits an insurance company to fight a claim, but it must be honest about it. An insurance company cannot lie, or deceive, or misrepresent any material issue like coverage amounts, policy provisions, exclusions, nor can an insurance company lie about the results or information flowing from any investigation it may have done on the claim. Claims are occasionally denied, particularly in claims for Accidental Death Disability benefits, or as to whether a medical procedure is covered based solely upon the insurance company’s conclusion as to whether it is obligated to pay a claim. The law prohibits the insurance company from engaging in any dishonest act that would possibly relieve it from the obligation to pay for damages, known as Wrongful Denial of Claim.
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Reust v. State Automobile Mutual Insurance Co. - 2006 Cross-Claimant Reust had a State Auto homeowner's policy with $100,000 liability coverage. Reust's dog dog bit off girlfriend's lip. State Auto denied his girlfriend's claim, refused to indemnify Reust and refused to provide him with a defense when he was sued by his girlfriend. A judgement was rendered against Reust by his girlfriend, and Reust sued his own insurance company for failing to honor their contractual obligations and bad faith. Settlement: $2,400,000.00 insurance bad faith