Oregon Insurance Bad Faith Lawyers
Insurance companies love to make money. All too often, the thirst for bigger profit margins leads to insurance companies taking advantage of unsuspecting consumers. These corporations and their paid consultants are so clever in what they do, that they can cheat the average person without anyone noticing. For example, insurers know that if they can underpay a claims by $1.00 per claim, most customers won’t even notice. Most of those that do will not bother to do anything about it because it’s just a dollar. But, when the same thing happens to 20 million people, the company makes $20,000,000.00 from the fraud. When one insurance company sees others profiting this way, they will also "cheat to compete." This leads to widespread insurance company "policies and procedures" to underpay claims, or the use of claim software to consistently underpay claims.
Insurers Choose Profits Over People
The only way an individual can stop this type of fraud or unlawful conduct is to file a lawsuit and go to court. This is so because the courtroom is the only place in America where an individual can ask other citizens to stop abuses by the biggest, richest and most powerful insurance companies in the world. We rely upon jurors to stop harmful conduct by the insurer, so that all insurance companies do not cheat to compete.
To stop intentional claim denials or intentional underpayments, you must file an insurance fraud lawsuit, an insurance class action case or an insurance bad faith case.
In insurance fraud cases or an insurance class action case, a lawyer must consider whether one or more insurers, insurance software vendors, or service providers obtain an improper profit at the expense of an insurance policyholder. When an insurer works with other insurers it can also be an antitrust action or civil rackateering case. When an insurer conspires with other vendors or service to underpay a policyholder, it can also be a fraud or rackateering case that could carry triple damages. “The essential elements of a common-law fraud claim are: the defendant made a material misrepresentation that was false; the defendant did so knowing that the representation was false; the defendant intended the plaintiff to rely on the misrepresentation; the plaintiff justifiably relied on the misrepresentation; and the plaintiff was damaged as a result of that reliance.” Strawn v. Farmers Ins. Co. of Oregon, 350 Or 336, __P3d __, 2011 WL 1886283, *8 (2011). Not only is the insurer liable in such cases of fraud, but so is the vendor that enables them to commit fraud. Insurance fraud cases often involve situations in which the insurance company institutes national practices and procedures that the insurer knows will increase its profits by intentionally underpaying claims.
In insurance bad faith cases, a policyholder (the insured) can sue an insurance company for a failure to treat them with the “good faith” claims handling required under Oregon law. This can occur either when the company improperly handles a case with their own insured (such as an uninsured or underinsured motorist case, or a property claim where the insurer improperly refuses to pay), or in a case where the insurer fails to appropriately defend their insured, resulting in an “excess verdict” (a trial verdict against the insured which exceeds the coverage amount of the insurance policy.)
Oregon Insurance Bad Faith Lawyers
Our firm is one of few in the State of Oregon who accept insurance fraud and bad faith claims. Dr. DeShaw is also brought into claims outside the state as co-counsel, or as a consultant, on large bad faith or class action cases. One such case in Oklahoma, evolved into a national class-action case resulting in an outcome of over $150 million to insurance company customers who were fraudulent underpaid on their injury claims. (The company knowingly underpaid what they believed the cases were worth.) Faced with their fraudulent conduct, the insurance company repaid their policyholders, and stopped the fraudulent practice against their own policyholders. After this, our firm was one of four firms involved with Hensley v. CSC - a class action case against over 580 insurance companies. In Hensley, (a case based upon the research Dr. DeShaw had conducted for three years on the Colossus claim software program used by many auto insurance companies). The four firms reviewed millions of documents regarding the insurance company and software vendor's efforts to underpay claims using bodily injury assessment software. Our office reviewed over one million documents alone. Over the course of five years of litigation the four law firms obtained over $1 billion for insurance company policyholders who had been underpaid on their bodily injury claims.
If you are interested in finding the best insurance bad faith lawyer in Oregon, finding a lawyer with history in this area of law will be difficult. The reason why is that despite Oregon law recognizing the Unfair Settlement Practices Act since the early 1970s, Oregon Courts did not allow a person to sue their own insurance company for insurance denials, claim delays, or unreasonable offers. As a result, we've seen insurers regularly provide "low ball" settlement offers between $0 and $5,000 on cases where the final outcomes were $100,000 to over $1,000,000. Insurers who engage in delay tactics, improper defenses, and improper insurance claim denials are acting in bad faith toward their policyholders. Oregon courts finally recognized "first party" insurance bad faith in 2022, in Moody v. Federal Insurance Co., 317 Or App 233 (2022). So, very few lawyers in Oregon have experience handling insurance bad faith claims because such claims were not legally viable until the Oregon Court of Appeals recognized the Unfair Settlement Practices Act as a basis for bad faith litigation (which was the intent of the legislature in 1973 when making passing ORS 742.230.) Since we gained substantial experience in insurance bad faith in insurance class action cases filed outside the State of Oregon, people seeking the best Oregon insurance bad faith lawyer will find our experience in insurance bad faith litigation difficult to find at other law firms. There are a few other lawyers with extensive experience in this field, but not many.
Our goal to make certain you are getting what you paid for with your insurance policy instead of being cheated out of what is owed.
What is Insurance Bad Faith?
Despite what they say, insurance companies don’t always have your best interests at heart. They might claim to be “always by your side” — but the truth is: insurance companies’ top priority is to make money. Paying out on legitimate claims just cuts into their bottom line. Here are a few examples of insurance bad faith in auto cases (the field where we have most experience):
Vehicle Damage Bad Faith
After a car accident, or truck accident, you expect either the at fault driver's insurance or your own insurance to cover the vehicle damage. But, there are multiple procedures in place to underpay vehicle damage claims. Some involve referring you to a "direct referral program" auto body garage that the insurer knows will replace the damaged parts with used parts, or "aftermarket" parts. These aftermarket parts have been the subject of litigation nationally, where the aftermarket parts are demonstrated to fail more than original equipment (OEM) parts. Using imitation parts can also void your car's warranty and damage the resale value. If your car is totalled, insurers often use "comparable vehicle" total loss valuation reports. What we know from both our past experience and research on this issue, is that most of the cars that are used as "comparable" vehicles to your car, don't actually exist. If you do your own research you will almost always find that vehicles that are a direct comparable to your car that actually exist, are valued far higher than the comparable vehicle values that your insurer provides. This is an intentional underpayment of claims because they either know or should know that these comparable vehicles do not exist.
Personal Injury Protection Insurance Bad Faith
After a car accident, truck accident or other catastrophic injury, you might expect the insurer for the at-fault party to pay enough to cover the costs of your medical bills. This is not how Oregon law works. Instead it is your insurance company that pays your medical bills through a special type of insurance in your auto policy called "personal injury protection." Many insurance policies have limits that would more than cover the expected costs of an accident. But, insurance companies have been working together since the early 90s to systematically undervalue and underpay legitimate claims. Insurers use multiple ways to try to underpay many aspects of claims and cutting payments on your medical bills is a very lucrative way for them to improperly profit. Personal Injury Protection bad faith has several aspects to it including "independent medical exam" schemes, "medical bill review" software underpayment schemes, and others.
Bodily Injury Claim Insurance Bad Faith
Dr. DeShaw is the leading author in the United States on the bodily injury claim evaluation software used by most auto insurers to evaluate auto injury cases. We know from non-protected insurance company documents and interviews of many former claims adjustors and claim supervisors (as well as the head of Allstate's Colossus program, Mark Romano) that insurance companies set these programs to underpay what their best adjustors believed cases to be worth. This happens during the set up of these claim software programs at the insurer. These claim software programs then consistently undervalue claims for the adjustors handling the claims. (This fact was the reason for one of the largest class action lawsuits ever to come before a US court - the Hensley v. CSC case discussed above). To this day, your insurance company may be underpaying your legitimate claim to improve their bottom line.
The bad news is: your underpaid insurance claim is not the only case like this. The good news is: you have a right to compensation that allows you to recover medical bills, property damage, job loss, as well as “noneconomic damages” like pain and suffering. In more severe cases including permanent disability, wrongful death, you or your loved ones may be entitled to more if your insurance company made a low ball offer and you ended up getting more at arbitration or trial.
“How do I tell when an insurance company is underpaying my claim?”
After decades of working on insurance bad faith cases — legal cases where an insurance company has been wrongfully delaying or denying their policyholders’ their claims — we have come to understand the nuances of this specialized legal field.
Bad Faith Insurance Practices
What is “insurance bad faith”?
Bad faith describes the actions of an insurance company when they neglect or incompletely fulfill their contractual obligations to their policyholders. This term also applies to third parties: non-policyholders injured in an accident caused by their insured. Any time you take legal action against an insurance company, you may also have an bad faith insurance claim.
Insurance company policies are sold as contracts; you provide regular premiums with the understanding that your insurer will pay to cover your costs in certain situations. Situations can vary by policy, but most auto insurance claims are car accidents caused by the other driver. While Oregon law requires that your own insurance pay your initial medical bills, that other driver’s insurance eventually covers your medical bills (including the repayment of the amount your insurance company paid), as well as wage loss and personal losses, in accordance with the driver’s insurance policy.
Instructions to insurance companies and their adjustors from the Insurance Institute of America is clear in a book called The Claims Environment - treat your policyholders equally with the interests of the insurance company. That is the way insurance companies should operate in regard to their own policyholders. This is because profitability is built into the economic formula used to run an insurance company. This concept of treating the injured policyholder equal to the insurer is now disregarded by many insurers seeking improper amounts of profit. Billions of dollars of profit isn't enough for them. Insurers know the fewer (and lower) their claims payouts, the higher their profits. Even though you are paying them to protect you, insurance companies are now disregarding their legal obligations and protecting their improper profits when you file a claim. Claims adjusters are highly trained to find any loophole or fine-print policy detail that will keep more money in the insurance company's pockets. Insurers then use this to invest in the stock market, making even more profit.
This business model relies on the fact that most policyholders will not file claims — and those that do will usually take the first offer, even if they are entitled to more. This is why it is critical to involve an insurance bad faith attorney any time you see the following behavior in your insurance company:
Here are a few telltale signs that your insurance company is wrongfully denying, delaying, or defending your claim:
Refusing to pay
It’s written into their business model: insurance companies go from “good hands to boxing gloves” when your claim value gets too high. They will require that you submit documentation to support your claim; always do so exhaustively. If you fail to provide the information they request, they are sometimes entitled to deny your claim outright without offering you a chance to resubmit your claim. But, if you cooperate with them and they still deny your claim with no response or reasoning, you are likely dealing with an insurance bad faith case. Insurance bad faith lawyers will be able to help here.
Offering no reason for claim denial
This is perhaps the most common bad faith tactic: a simple denial letter with no followup explanation or recourse. Insurance companies must provide their reasoning for denying your claim when asked, so always ask! Some insurance companies even have policies that require the denial of all claims upon first submission, in the hopes that their claimant will simply take “no” for an answer.
Inappropriately delaying a payout or claims decision
If you have filed a claim against your insurance company, time is probably of the essence: you have medical bills, car repair bills, lost wages during your medical recovery, and perhaps other costs as well. Or maybe your house has been burnt by a wildfire and you now have nowhere to live until your insurance company starts paying on the claim. If your insurance company stalls in processing your rightful claim, you are seeing bad faith in action (or rather, inaction). The solution is to hire a bad faith lawyer, and preferably an insurance bad faith trial lawyer in your area to force them to take the next step.
Insultingly low settlement offers
Most of us have heard about this, and some will have the misfortune of experiencing it firsthand: an insurance company will “lowball” you by offering far less in payout than what your case’s actual value. This practice has been particularly abusive in Oregon because until early 2022 there was no legal or financial penalty for insurers making little or no offer even on serious injury cases. Insurance companies are known to do this even on legitimate, high-value claims. Many claimants believe that their insurance company knows best, or that they have to “take it or leave it” when it comes to insurance claims payouts. This is not a good idea, because it is leaving money on the table. Our firm has a long history of getting initial offers from insurance companies of $0 - 5,000 and then obtaining outcomes of $100,000 to over $1,000,000. These ridiculous offers on high value injury cases is bad faith and it is widespread in Oregon. Washington has had better insurance bad faith laws than Oregon for many years, but we also see abuses there and have filed Insurance Faith Claim Act cases as well on behalf of clients.
If you choose to accept a lowball offer, that settlement is final; you will not be able to recoup more, or take your insurance company to court, if you agree to their settlement terms. Always talk to an insurance bad faith attorney the moment you suspect bad faith behavior. Insurance companies are known to offer lower amounts to claimants who they know are not represented by an attorney. This is why some insurance companies will suggest you should not get a lawyer.
Incomplete / improper claims investigations
Your insurance company has the right and responsibility to thoroughly investigate your claim. This could mean on-site visits, medical evaluations, and property damage assessments. This must be done within a reasonable time frame, and done to the point of answering every conceivable question about the nature of your case. Insurance claims are complicated, and you want your insurance company to be thorough; if they deny a component of your claim because they didn’t catch it, they have failed to perform their due diligence, as stipulated in their contract. This likely constitutes bad faith. (Pro tip: always document your accident and medical recovery thoroughly. If you have a property loss arising from a forest fire or earthquake document the loss extensively with photographs and video.)
Threatening you or your loved ones
It is hard to believe the lengths some insurance companies go to to make money from your misfortune. After an accident or loss, you are likely already feeling scattered, anxious and in some casees are even medically compromised — but this is frequently the time when insurance companies begin to harass you with claims denial letters or allegations that you are a liar. You may even hear the falsehood that you are to blame for an accident that you know was not your fault, or that your injuries or other losses are not covered under your policy. The odds are good that this is just bluster to get you to take a lowball settlement so they can avoid paying what they owe and moving on the next claim.
Remember: Your insurer promised you peace of mind to induce you to buy insurance from them. You paid premiums, often for years or decades, before you ever filed a claim because your insurer promised you that they would help you if you ever had a claim. You have a right to peace of mind after an accident or loss. If your insurance company has been sending threatening letters or making threatening phone calls, you need an experienced insurance bad faith lawyer to advocate on your behalf. If you can find one who knows their internal claim practices better than the adjustor handling the claim, they will realize they just made a very bad decision by improperly denying, delaying or defending your claim.
Refusing to provide requested documentation
For as prickly as Insurance companies can be about you providing them with corroborative claims information, they can be notoriously slow to provide you with the same courtesy to your own reasonable requests. If you wish to review your policy, see their claims denial reasoning. They are legally obligated to provide that to you. Not all insurance companies readily comply with this requirement. They may be aware that their settlement process is not being undertaken ethically, or that your claims payout has been wrongfully denied, and they are just biding their time. In these frustrating instances, it is time to get an attorney who specializes in bad faith.
You’ve submitted your claim with complete paperwork, you’ve documented your injuries and property damage claims, you wait to hear back … and then the waiting begins. In the event that your claim is approved, your insurance company may delay payout for weeks, months or years. Some will even keep stringing you along so long that you can no longer file a lawsuit against them. You have a right to a prompt payment; in many cases this can be the difference between being able to pay for necessary medical care, repairing or replacing your vehicle and getting back on track after an accident or loss. If your insurance company keeps delaying or is slow in getting your check to you, you may be dealing with bad faith behavior. A competent bad faith insurance lawyer will often be able to get your claim paid quickly.
Misrepresenting the law
It should go without saying, but your insurance claims adjuster is not an attorney, and they are not allowed to offer you legal advice. They may tell you that your injuries are not severe, that your settlement needs to happen within a certain time frame, that you need to give them a recorded statement before you get a lawyer, or that you do not need a lawyer. None of these statements are theirs to make; they do not know the law like an insurance bad faith attorney will. In instances like these it is extremely wise to speak to an insurance bad faith attorney who clear up any confusion they may have caused, and who can set the record straight — with you and with them.
Why do I need an insurance bad faith attorney?
Hiring a personal injury attorney who specializes in bad faith could mean substantially more in settlements or, should your case go to court, trial verdict. While no attorney can guarantee a settlement amout or trial outcome, research from the Insurance Research Council shows that for cases over $15,000, having legal representation results in a 300% increase in case value. In cases where medical bills and other expenses are large, you need an experienced Oregon personal injury attorney who is also an Oregon insurance bad faith attorney to help protect you from insurance bad faith behavior.
FREQUENTLY ASKED QUESTIONS:
Do I have a right to bring a bad faith claim against my insurance company?
Your insurance company may use the tricks above to wrongfully delay or deny your claim. Therefore, both parties have a right to file an insurance bad faith claim against their insurer under certain circumstances.
What is a “first-party” claim?
“First party” claims refer to claims made on the policy of the insured against their own insurance company. If you were to sue your insurance company, that would be a first-party claim.
Oregon Insurance Bad Faith Lawyer for First Party Auto Claims
In auto cases, this could include instances of nonpayment in a variety of capacities:
Vehicle Damage Insurance Bad Faith
As discussed above, most of these cases arise from insurers steering customers to "direct referral Provider" relationships where the garage gets referrals from the insurer in exchange for cutting their labor rate (resulting in negligent repairs of the vehicle), requirements to do the repair with used or aftermarket (imitation non-OEM parts). Garage repair bill averages are tracked by insurers and the ones with the lowest rates generally get the referrals even though the low rates may be the result of negligent vehicle repairs.
Other vehicle damage bad faith cases involve improper total loss valuations based upon non-existant "comparable" vehicles.
Additionally, some insurer will deny replacement of certain parts that the vehicle manufacturer requires replacement after a crash. A regular problem is insurers who refuse to replace the seatbelt of occupants after a collision even though many manufacturers require this as a safety measure.
Personal Injury Protection Insurance Bad Faith
As discussed above, insurers use a number of ways to cut payments on your health care bills. Often this involves what is commonly referred to as an "Independent Medical Examination" (which is not independent as these doctors work on behalf of insurance companies, not an independent party). Some doctors make most or all of their income from doing examinations that result in the termination of care for injured people, or provide litigation opinions for insurers that the injured person is not hurt. Needless to say, a concerted effort between an insurance company to terminate claims with another person or company when that determination is false, could be the basis for a first party bad faith lawsuit or even justify allegations of fraud and conspiracy between the insurer and the IME company. A longstanding pattern and practice to deny policyholder claims in a high percentage of cases, or an insurer working with an illegally operated clinic could even justify litigation for Civil RICO, which carries triple damages against co-conspirators. In practice, nearly everyone who undergoes an IME either for PIP or in the context of making a bodily injury claim, is deemed to have not been injured, to have received excessive treatment, or to have a personality disorder (thereby providing an alternative explanation for their injury symptoms.) This practice by insurance companies has been habitual in Oregon for decades because Oregon did not have first party bad faith until 2022. Dr. DeShaw has fought these insurance company terminations of health care services since his time as a doctor in the late 1990s, and continued fighting false opinons in IMEs since becoming a lawyer in 2000. What few people know is that the doctors providing these examinations do not have a doctor - patient relationship with the injured person they examine and have zero liability in the event they provide a false diagnosis. The Oregon Medical Board, the Oregon Chiropractic Board of Examiners, and Oregon Board of Psychology have not taken the licenses of doctors involved in this process and so it is left to Oregon juries to send a clear message about doctors who use their degrees to cause harm to the public.
We are presently investigating the operation of several IME Mills - the companies that produce the reports that terminate the payment of policyholder treatment for legitimate injuries sustained in an insured crash. Some of the companies that provide IMEs in Oregon include MedConnect Pro, Oregon Medical Evaluations, Inc., ExamWorks LLC, Integrity Medical Evaluations, Inc., Medical Consultants Network / Mitchell International, Inc. (Formerly Medical Consultants Northwest), MES Solutions, Objective Medical Assessments Corporation (“OMAC”), Sunrise Medical Consultants LLC, Impartial Medical Opinions, Medical Examinations of Oregon / Washington ("MEOW") and others.
Other insurance bad faith in the PIP context can involve "paper reviews" by doctors not qualified to cut off care of another provider type. As one example, we've seen Psychologists with no medical training and no radiology training denying necessary medical care or advanced medical imaging. We have also seen companies who use doctors (who are providing diagnoses and treatment opinions) in Oregon cases, who are not licensed in Oregon, and therefore are practicing medicine without a license. In the past, litigation cases such as Robinson v. State Farm 45 P.3d 829 (2002), have uncovered non-doctors writing "medical" reports that terminated an insurance policyholder's right to receive necessary medical care. Insurers try to get confidentiality clauses to keep the public from finding out about the pattern of abusive insurance denials. See Foltz v. State Farm, 331 F.3d 1122 (2003).
Uninsured Motorist Cases Insurance Bad Faith
Oregon law requires that an insurer provide its policyholder with Uninsured and Underinsured Motorist coverage equal to your liability coverage.
If you are hit by an uninsured driver, or are hit in a hit and run crash where the driver is never identified, you will have an Uninsured Motorist case against your own insurance company. In this type of claim your insurer is supposed to treat you with equal consideration to their own profitability. But, we know that many insurers will make offers that are not reasonable in any way - $0-$5,000 offers on cases that are worth $100,000 to over $1,000,000. This is insurance bad faith.
Dr. DeShaw's 20+ years of research and litigation on Colossus and other bodily injury software (Liability Navigator, ClaimIQ and others) also suggests that insurers intentionally undervalue claims evaluated by claim software, even in first party cases. An insurer should not be collecting 100% of your premiums and then only pay 80% of what it believes your case is worth by using software known to undervalue claims.
Underinsured Motorist Insurance Bad Faith
Oregon law requires that an insurer provide its policyholder with Uninsured and Underinsured Motorist coverage equal to your liability coverage. But, unlike Uninsured Motorist, some insurers will claim this only requires uninsured motorist coverage and not under-insured motorist coverage. That is not correct.
Underinsured Motorist claims occur when you are hit by someone with too little insurance for your injuries. Buying underinsured motorist coverage (and bumping it up from the rest of your insurance policy) is a way to protect you and your family from being injured by a person with too little insurance.
There is a special procedure that you must use when settling the first case (against the at fault driver) or you will waive your additional Underinsured Motorist case against your own insurer. Underinsured Motorist claims are also first party claims, and again your insurer is supposed to be treating your claim with equal regard as their own financial interest. Instead, they try to figure out how to pay as little as possible to maximize profits.
Since Underinsured Motorist claims are stacked on top of insurance from the at fault party, there are more denials, $0 offers, and lowball offers that occur in Underinsured Motorist claims. Our experience is that these denials and low offers are not supported by the end outcome. In some cases we've even had defense lawyers admit that the insurer faced them to try an underinsured motorist case against us even though they knew the value was above the policy limit. This demonstrates the insurer never had a good faith basis to deny the claim or make an unreasonable offer. They simply denied the claim to hold onto their money as long as possible to collect the benefit of investment and interest on the money, while their policyholder suffered for years waiting for a positive outcome.
Since one or more UIM policies can stack in complex crash situations, insurers will often use these situations to make little or no offer. But, if the injuries are serious you need a lawyer willing to take the case to fight the insurance claim denials and take the case either to binding arbitration or trial. If an insurer denies coverage under your UIM insurance policy and you get coverage or get a case outcome higher than the offer you may have a viable insurance bad faith case.
Oregon Insurance Bad Faith Lawyer for Health Insurance Claims
Health Insurance Insurance Bad Faith
Health insurance companies love getting massive premiums from you and your employer. The premiums keep going up every year at most insurers or employee health plans. Then when you need care, or your life depends upon receiving care, they deny coverage. This can create incredible personal stress and financial devastation. In fact, according to medical research, over 62% of all bankruptcies in the United States are caused by medical issues. Himmelstein, et al, "Medical Bankruptcy in the United States," The American Journal of Medicine, Vol 122, No 8, August 2009. At the same time health insurers were driving Americans into bankruptcy their CEOs have been making shocking amounts of money. Cigna CEO David Cordani took home more than $91 million in 2021, and overall, health insurance CEO pay at several of the top health insurers has averaged $11,000,000 to $36,000,000 per year for the past ten years.
If you've ever seen the Disney / Pixar movie "The Incredibles" you might remember a part where Mr. Incredible works at an insurance company denying claims all day. We wish this were a joke, but it isn't. Health insurers expect you to fill out a myriad of forms to appeal a claim denial while you are sick or dying, when the denial is improper in the first place. By denying care improperly they jeopardize your health or your life, while also disregarding the financial impact on you if you go forward with the necessary treatment.
A common denial of payment is that the care isn't necessary for your diagnosis. Due to Dr. DeShaw's background with billing codes (ICD Codes) and billing codes (CPT codes) this can be easily checked.
But, often the care is denied because the health insurer deems the care unnecessary, or that the "treatment hasn’t been proven effective or is considered experimental for your condition." Some health insurers do not care what your doctor says about your need for the care. They also negligently, recklessly or intentionally ignore medical or scientific literature that proves the efficacy of the care you need to receive. They deny coverage anyway.
In some cases this can lead to a short term or permanent worsening of your condition. In other cases it can kill the patient. If a health insurer denies coverage despite there being sufficient evidence supporting the prescribed care, you may have a viable insurance bad faith case.
Oregon Insurance Bad Faith Lawyer for Home Insurance Claims, Including Natural Disasters (Fire or Earthquake Damage Claims)
With increasing wildfirest in Oregon and Washington, insurers are being called upon to pay on homeowner policies. Some are paying claims correctly. Others are trying to avoid paying and deny claims improperly or try to make lowball offers to the policyholder who has already lost everything. We know certain insurers are refusing to pay these wildfire claims properly, or are offering a fraction of what the replacement value of the claim is worth, knowing that their policyholder is stuck in a difficult living and financial situation.
We have had involvement (behind the scenes) in large scale natural disaster claims where insurers use property damage assessment software called Xactimate that intentionally undervalues claims in a way somewhat similar to the way Colossus (and similar bodily injury claim software) works to consistently undervalue bodily injury cases. We've also seen cases such as Hurricane Katrina, where insurers destroy documents that support them having financial liability, and instead push financial liability on taxpayers. Instead of losing money by paying wind damage claims correctly, the insurers would profit by referring claims to the taxpayer funded National Flood Insurance Program, and then profit from handling the claims. Claims where something like this could happen in Oregon and Washington is in the case of the Cascadia Fault Earthquake insurance claims, that is anticipated off the west coast.
Oregon Business Insurance Bad Faith or Commercial Insurance Bad Faith Claims
Business owners plan ahead by insuring their businesses against possible losses in the future. The purpose of insurance is to spread the potential financial consequences of a loss, by collecting premiums from many businesses that may never have a loss. Business insurance or Commercial Property Insurance can cover a number of business and property losses. Advertisements by the insurance company, and the promises of your insurance agency promise you will have peace of mind and that the insurance company will restore your business and your financial situation to pre-loss condition.
When you experience a business loss or commercia property loss, your business will rely upon a prompt insurance payment or you will be out of business. So, delays or improper denials of claims can destroy your future earnings, result in the layoff of your employees, and result in economic devastation for the business and its owners. Despite this, some insurers commonly deny business loss claims or attempt to underpay commercial property claims.
Claims made by a business against their insurer are first party claims because the claim is between the policyholder and its own insurer, rather than another person or insurer. The contract between the business and its insurer create a requirement for the insurer to treat that business in "good faith" to restore the business to its pre-loss condition. Business insurance denials comprise many of the bad faith cases in Oregon case law, and because of recent changes in Oregon law, the old case law finding no bad faith in business policy denials, is no longer good law.
One thing that few business owners know, and few business lawyers consider, is that many of the contracts used by insurers are written by one entity (Insurance Services Office or "ISO") with the same or similar language, and are potentially used by many insurers throughout the United States. Adverse rulings on an issue in that insurance contract language, could be used in other cases where the same language is used under the legal concept of res judicata.
In all of these first party claims, your insurance company is responsible for paying properly on your claims. If they don’t you may have a first party insurance bad faith claim.
What is a third-party bad faith claim?
A third party claim refers to filing a claim against another person’s insurance company. Usually these arise when an insurer fails to make a sufficient settlement offer in a case to protect its policyholder from an excess verdict. In nearly every case, we make an offer to settle a claim for the policy limit of the defendant's insurance company. In the event they refuse that offer (as is very common) and force our client to file a lawsuit against the at fault party, the insurer either agrees to pay the entire verdict, or faces a bad faith claim from their own policyholder. Often, we hear of insurers attempting to get their policyholder to file bankruptcy after subjecting them to financial ruin because they refused to simply pay the insurance policy.
A policyholder that finds themselves in the stressful situation of having a large verdict against them, can assign the third party bad faith claim to the plaintiff instead of paying the verdict. So, you only get to file a third party bad faith claim if you have been injured in an accident where you were found to be not at fault, and the at fault driver’s insurance should cover your costs, but refuses to do so.
If you end up with an excess verdict and the insurer refuses to pay, you will need to hire an insurance bad faith attorney to go to bat for you. Our office has significant experience, particularly in auto bad faith litigation to dig deep into the insurance companies national claim handling policies and provide a jury an explanation why the insurer made a bad faith offer on your claim and refused to indemnify their policyholder. An experienced bad faith attorney will be able to negotiate with the third party insurer on your behalf if your claim was denied or a lowball offer was made, and will represent you in an insurance bad faith trial should the insurance company fail to offer you a fair settlement.
What does an insurance bad faith attorney do?
An insurance bad faith attorney has extensive knowledge of the insurance claim practices and a history of litigating against insurance companies (and related entities). Through the Hensley v. CSC insurance bad faith class action case (lasting from 2005-2010), our firm has experience litigating against over 580 insurance companies and reviewed over 1,000,000 insurance documents. In addition, we have filed individual bad faith and fraud claims against a variety of insurance companies including State Farm Insurance, GEICO, Allstate Insurance, Farmers Insurance, USAA (and its review company Auto Injury Solutions owned by CCC), Lyft (Indian Harbor), Grange Insurance Association, Hertz, American National (ANPAC), and more. DeShaw also has extensive background in the field of insurance bad faith from his 20+ years in this field including years of research writing three books on auto insurance claim practices. DeShaw also served as editor of the book From Good Hands to Boxing Gloves which publicly revealed the involvement of McKinsey & Co.'s involvement in Allstate's auto insurance claim practices (called CCPR), which changed the way auto insurance claims were handled since the mid-1990s. This led to financial sanctions against Allstate and a suspension in Florida from writing insurance, for refusing to turn over the McKinsey Documents to insurance regulators. Eventually this led to the public disclosure of these documents in which Allstate and McKinsey decided to quit treating its policyholders with "good hands" and chose to treat them with "boxing gloves" once they filed a claim. Aaron DeShaw is mentioned in Allstate's Wikipedia page for the controversy surrounding Allstate's bad faith claim denials. DeShaw has also been an anonymous source for major media on the topic of insurance claim practices, but has also been quoted by leading insurance journals A.M. Best regarding insurers underpayment of claims through the use of bodily injury software like Colossus.
While some personal injury lawyers will accept an insurance bad faith case, the best insurance bad faith lawyers have extensive background on the claim methods of insurance companies and understand the ways they cut claims to make improper profits. An insurance bad faith lawyer then makes claims against insurance companies for inappropriates practices like the ones listed above. Lawyers may write demand letters on your behalf, coordinate your care and/or medical evaluation, and represent you in depositions. In some cases, when a fair settlement cannot be reached through negotiation or mediation, your insurance bad faith attorney will represent you before the court. Dr. DeShaw has over twenty years of extensive experience and research in this field of legal practice, and we love educating jurors how insurance companies deny and underpay legitimate claims.
How do I file a bad faith insurance claim?
Your bad faith insurance claim starts with talking to a qualified insurance bad faith attorney in your area. They will be able to evaluate your claim, review your insurance company’s behavior, and consider that based upon state bad faith protection laws to determine if your case is viable. If it is, your bad faith attorney will gather the evidence and submit all documentation supporting your bad faith case to your insurance company. If they continue to delay or deny your claim, your attorney will file suit against them and your case will go before a court.
How does the State of Oregon handle bad faith claims?
By the early 1970s stories of improper claim denials were reaching Oregon legislators, who would step in on behalf of their constituents. The Oregon Insurance Commissioner was also facing increasing calls about outrageous insurance claim denials. At the Oregon Insurance Commissioner, Lester Rawl's, request to the Oregon Legislature a model set of rules for insurance companies was passed into Oregon law in 1973. These model rules, created by the National Association of Insurance Commissioners was passed into law as ORS 742.230 - also called the Unfair Claims Settlement Practices Act.
As is made clear in the recordings from that session, the Oregon legislature's intent was to allow insurance policyholders to bring litigation against their insurance company when there was a violation of one or more sections of the Unfair Claims Settlement Practices Act. But, for reasons that are unclear, Oregon's Courts apparently did not listen to those tapes and thereafter misconstrued the purpose of ORS 742.230. It was only with the improper denial of a life insurance claim, that lawyer Travis Eiva of Eugene argued that the statute was always intended to provide a right to sue an insurer for a violation of the statute. In 2022, the Oregon Court of Appeals agreed, and found that Oregon insurance policyholders are entitled to recover damages for emotional distress on insurance claims for violation of the statute or what is called "negligence per se" in insurance claim handling. In plain language: if the insurer is found to have violated the Oregon Unfair Claims Settlement Practices Act, ORS 746.230, policyholders are entitled to extra-contractual damages (beyond the insurance policy limits) when the insurance company fail to act within as required by the statute. This requires prompt and fair settlement offers, and creates legal liability for the insurer if they make unreasonable settlement offers, engage in improper claim denials, and for other violations.
Your insurance bad faith attorney should know about the Moody v. Federal Insurance Co., ruling and understand how to use it in your bad faith case.
Need an Oregon insurance bad faith attorney? Call us.
Bad faith insurance tactics are a violation of Oregon law. It is our mission to expose the myths about insurance companies’ motivations, and to ensure people who pay 100% of their insurance premiums get promptly paid 100% of what is owed for their losses.
Where your insurance company may claim to be “always on your side” — your insurance bad faith attorney actually is. The Oregon bad faith insurance attorneys at the law office of Dr. Aaron Deshaw, Esq., P.C., believe in stopping insurance bad faith practices so that people get paid promptly and fully in the first place without the need of a lawyer.
Don’t let insurance companies deny your claim, delay payment, or lie to you. You are entitled to honesty in your interactions with your insurer, and the fair value of your insurance claim. Insurance companies acting in bad faith should be brought to justice. With extensive history in insurance fraud class action cases, and insurance bad faith law, our law firm is here to help you stop improper claim denials, settlement or litigation delays, and improper defenses to legitimate insurance claims.
Contact us today at (503) 227-1233 for a free consultation.