Can I sue insurance company for delaying claim?
Asked by: Mireille Adams | Last update: December 3, 2025Score: 4.4/5 (68 votes)
Can you sue an insurance company for taking too long?
The answer to this question is complex, but California health insurance providers are bound by state law to respond to claims within a specific amount of time. If they fail to do so, you may have the basis for a lawsuit against your insurer due to bad faith.
What is a valid reason for delay in submission of a claim?
A delayed insurance claim can occur for a number of reasons – delays in informing the insurer, submitting an incomplete claim form, delays from the insurer's side, etc. Overall, your insurer needs conclusive proof of what you say happened to move forward with your claim. Otherwise, you cannot get your claim settled.
What to do if an insurance claim is taking too long?
- Call your insurance company. First and foremost you should give the insurance company every opportunity to fulfill your claim. ...
- Review your policy with a different agent. ...
- Request a formal denial letter. ...
- Call an experienced lawyer to sue the insurance company.
When should you sue an insurance company?
You may be able to sue your insurance company for bad faith if they intentionally neglect to perform the duties necessary according to your policy. If the insurance company knows that the claim is valid but they deny it anyway, you may be able to sue for bad faith.
What To Expect When You Sue An Insurance Company
How likely is an insurance company to sue you?
While subrogation allows insurance providers to pursue third parties, an insurer usually cannot sue their policyholders. However, there are certain situations where an insurer may take legal action against its policyholder.
What is an example of negligence in insurance?
Negligence is an insurance term that is tied to various types of liability insurance, such as home, life, health, business, and auto. For example, perhaps a retail shop owner was negligent by leaving their water hose out after cleaning the sidewalk, causing a passerby to trip.
What can I do if my claim is taking too long?
Let your insurance professional know that you are unhappy.
If the agent or representative is unable to solve your problem, get the name and phone number of the head of the insurer's claims department. Your insurance company may also have a consumer complaint department that can help.
Do insurance companies have a time limit?
All states except South Carolina have rules requiring insurers to pay or deny claims within a certain time frame, usually 30, 45, or 60 days.
Why do insurance companies drag out claims?
Insurance companies may purposely drag out the claims process, hoping that policyholders will grow frustrated and accept a lower settlement or even drop the claim entirely. This may include excessive paperwork requests, slow response times, or frequent requests for additional documentation.
What is an excusable cause of delay?
Excusable vs. Non-excusable Delays: Excusable delays are caused by unforeseen events beyond the contractor's control, such as inclement weather or changes in the project's scope. Inexcusable delays are due to contractor's actions or inactions, like poor project management or inadequate staffing etc.
How long is a delay before you can claim?
You are legally entitled to claim for a flight delay if your flight arrives more than three hours late, and the delay was the airline's responsibility. The official delay time can be recorded once one of the cabin doors has been opened, not when you land or taxiing to the terminal.
What is a major reason why a claims payment is delayed?
Major reasons that payers reject or delay payment on a claim include: The health plan didn't receive the claim. A CPT code is missing or incorrect. Provider and/or patient identifiers are not included.
Can I sue an insurance company for wasting my time?
The law requires insurance companies to acknowledge receipt of a claim within 15 days after they receive it. They must communicate their decision on the claim within 15 business days after receiving all necessary information related to the claim. If they fail to do so, policyholders have the right to sue for delay.
Why would someone sue an insurance company?
Third-Party Lawsuits
This proposition allows an individual or a business to file a third-party lawsuit against an insurance company for unfair claims practices in handling liability claims. (Liability insurance provides financial protection to individuals and businesses for harm that occurs to others.)
How long after an accident can you sue insurance company?
The California statute of limitations sets specific deadlines for filing lawsuits. For personal injury cases like car accident lawsuits, you have two years from the date of the accident. If you're dealing with damage to your vehicle but no injuries, you have three years to file.
What is a bad faith claim?
Looking for evidence that supports the insurance company's basis for denying a claim and ignoring evidence that supports the policyholder's basis for making a claim is considered bad faith. If an insurer fails to promptly reply to a policyholder's claim, that act of negligence, willful or not, is considered bad faith.
How long do most states allow an insurance company to delay?
The amount of time that most states allow an insurance company to delay the payment of a cash surrender under the Delayed Payment provision can vary. However, a common timeframe is around 30 days.
Why is my insurance claim taking so long?
Your insurance company will investigate who's responsible for the accident, as well as whether there's coverage for the injuries, damage, or other loss you filed the claim for. A coverage investigation can take just as long or even longer than an investigation to determine liability.
How long should a claim take to settle?
Time limits may be extended in certain circumstances. Claims handled through the portal usually take around 4-9 months to settle – based on clients' accepting the first settlement offer. Clinical Negligence: Clinical negligence cases can take anything from 18 months to even 2-3 years to settle.
How do you prove negligence in insurance?
To succeed in a negligence case in California, you must establish four key elements: duty, breach of duty, causation, and damages. Negligence Per Se allows the automatic establishment of duty and breach when a law is violated, making it essential in cases like dog attacks.
What are the 4 types of negligence?
While seemingly straightforward, the concept of negligence itself can also be broken down into four types of negligence: gross negligence, comparative negligence, contributory negligence, and vicarious negligence or vicarious liability.
What does 100% negligence mean?
The pure comparative negligence rule in California allows injured parties to recover damages no matter how much they were at fault, except if they were 100% responsible. This approach is intended to reflect a more precise measure of each party's contribution to the accident.