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Describing Grounds for the Tort of Bad Faith Unexplained Delays in Communication  

https://zalma.com/blog

When an insured asks a question of his or her insurer an answer is  expected. An insurer should respond to all inquiries promptly, and in no  event later than 15 days. If an insured submits a proof of loss to  which the insurer has agreed and asks \\u201cwhen can I expect to be paid?\\u201d  the insurer should respond with specificity, immediately. Most policies  and state regulations require payment within 30 calendar days of  agreement to the proof of loss. If the question is ignored and payment  is not made, after the insurer agreed to the proof of loss, the insurer  is breaching the contract and if without good cause, the covenant of  good faith and fair dealing. Often, bad faith is merely the difference  between courtesy and lack of courtesy.  An insurance company will not be allowed to deny coverage where all the  relevant facts were known to the insurer at the outset, but it  unreasonably delayed in asserting a basis for disclaimer. An unexplained  delay of two months can be found to be unreasonable in disclaiming  coverage. When the insurer waited an even longer amount of time, with an  unexplained delay of approximately one year, before mentioning two new  reasons for disclaimer the court found the insurer\\u2019s actions to be  unreasonable as a matter of law. [Allstate Ins. Co. v. Gross, 27 NY2d  263, 269-270) and Mendoza v. American Country Ins. Co., 19 A.D.3d 300,  797 N.Y.S.2d 492, 2005 NY Slip Op 5432 (N.Y. App. Div., 2005).]  Insurer\'s Delayed Requests for Information  The insurance adjuster knows better than an insured what is needed to  prove a claim. If, for example, the adjuster fails to ask for a proof of  loss, documentation to support a claim, or the sworn testimony of the  insured at examination under oath, until months after the loss the delay  in the request can upset the insured and lead to charges of breach of  contract and bad faith.  Lack of Settlement Authority Delays in Settlement  \\xa9 2021 \\u2013 Barry Zalma  Barry Zalma, Esq., CFE, now limits his practice to service as an  insurance consultant specializing in insurance coverage, insurance  claims handling, insurance bad faith and insurance fraud almost equally  for insurers and policyholders. He also serves as an arbitrator or  mediator for insurance related disputes. He practiced law in California  for more than 44 years as an insurance coverage and claims handling  lawyer and more than 52 years in the insurance business. He is available  at http://www.zalma.com and zalma@zalma.com.  Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE  Legend Award.  Over the last 53 years Barry Zalma has dedicated his life to insurance,  insurance claims and the need to defeat insurance fraud. He has created  the following library of books and other materials to make it possible  for insurers and their claims staff to become insurance claims  professionals.  Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma;  Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library \\u2013 https://zalma.com/blog/insurance-claims-library/ Read posts from Barry Zalma at https://parler.com/profile/Zalma/posts; and the last two issues of ZIFL at https://zalma.com/zalmas-insurance-fraud-letter-2/  podcast now available at https://podcasts.apple.com/us/podcast/zalma-on-insurance/id1509583809?uo=4