When filing an insurance claim, you may have encountered a variety of legal terms that are quite unfamiliar to you. In addition, it is not uncommon to feel as if the insurance company, or its representatives, are misrepresenting specific aspects of the claim. While there are many dynamics associated with insurance claims, it is important to understand what your rights may be and when, or if, the insurance company is engaging in an act or omission that can be described as a tort action.
Within the realm of civil law, there is a concept that is familiar the insurance industry, commonly referred to as “tort”. The laws that address tort are established to outline the rights and responsibilities of members in our society and how we related to one another. In the insurance industry, tort refers to the right of an individual to recover damages when another individual has failed to meet their obligations or duty. More specifically, when an insurance company fails to act, or omits specific information, a tort action may have occurred.
If you feel, when facing an insurance claim, that your rights to recover damages are being impeded by the progress of the insurance company, it may be prudent to speak with a legal counsel regarding the possibility of a tort action. To be classified as a tort action, there are three general components that must be present. First, the insurance company must have some type of liability owed to you. If the liability for your claim has not been established, tort action may not be an issue.
In addition to a “duty owed”, you must also show the insurance company, or its representative, has failed to meet the duty owed to you. By this we mean, it may be the failure to offer specific information that is important to your recovery of damages or invading your privacy or rights so as to prevent your recovery of damages.
And, finally, the insurance company, or its representative, must commit the act and then there must be a proximate damage that arises out of that failure. In other words, the mere fact that you sustain damage arising out of your claim is not enough to establish tort. Instead, there must be additional damages that arise and those specific additional damages must be a direct result of the failure of the insurance company to act or the omission of action by the same entity.
Establishing tort by an insurance company can be challenging. However, if you believe that the insurance company has intentionally failed to provide you with benefits or services you are entitled to, and you have sustained additional damages arising out o their action, consult with legal counsel regarding the possibility of filing tort action.