Insurance Coverage Attorney in South Carolina
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South Carolina Insurance Coverage and Bad Faith Insurance Lawyer
Have you read your insurance policy? Insurance coverage and bad faith insurance cases are complex and require intensive reading of the Policy, the applicable statutes, and the case law in order assess whether coverage applies and if the insurance company has a duty to defend. It seems often times that individuals purchase expensive policies just to not be covered for what is seemingly a coverable incident. This is where we help.
As the Supreme Court so aptly stated the conundrum that often occurs in insurance policy interpretation and bad faith cases:
- “This opinion represents our honest effort to make detailed answers to the conflicting arguments of the parties relative to the construction of an insurance policy. It would be somewhat ludicrous for us to say this policy is not ambiguous. It is. But no more so than most others. Ambiguity and incomprehensibility seem to be the favorite tools of the insurance trade in drafting policies. Most are a virtually impenetrable thicket of incomprehensible verbosity. It seems that insurers generally are attempting to convince the customer when selling the policy that everything is covered and convince the court when a claim is made that nothing is covered. The miracle of it all is that the English language can be subjected to such abuse and still remain an instrument of communication. But, until such time as courts generally weary of the task we have just experienced and strike down the entire practice, we feel that we must run with the pack and attempt to construe that which may well be impossible of construction.”
South Carolina Ins. Co. v. Fidelity & Guar. Ins. Underwriters, 327 S.C. 207, 219, 489 S.E.2d 200, 206 (1997) (quoting Universal Underwriters Ins. Co. v. Amer. Fam. Home Ins. Co., 451 S.W.2d 616, 622-623 (Ky. App. 1970)).
Keibler Law Group has experience representing clients – both individuals and companies – in insurance coverage disputes and bad faith refusal to pay insurance benefits in South Carolina.
What are common types of insurance coverage issues in South Carolina?
Insurance companies are not in the business of paying out claims; quite the opposite. Insurance coverage issues in South Carolina include:
- Who is an insured
- What is the scope of coverage
- Coverage exclusions and limitations
- Are there multiple occurrences
- Does the insurance company have a duty to defend
- Underinsured motorist (UIM) coverage analysis
- Uninsured motorist (UM) coverage analysis
- Stacking coverage
- Accident or occurrence
- Who is a permissive user
- Additional insured
- Intended or expected injury
- Owned property exclusion
- Excess insurance disputes
Coverage disputes typically involve the interactions between the insured (policy holder) and the insurance company or their adjuster. In addition, the involve interpreting the written Policy, South Carolina statutes, and South Carolina case law. We have experience representing insureds – both individuals and companies – in fighting coverage disputes and bad faith refusal to pay insurance benefits.
What are common types of bad faith refusal issues in South Carolina?
There are statutory protections and punishments when an insurance company acts in bad faith such as attorneys fees. An insurance company acts in bad faith when it does the following:
- Denying a claim that is covered under the insurance policy
- Failing to investigate a claim
- Delaying payment of an insurance claim
- Paying out on only part of a claim
- Failing to make a good faith offer of settlement
Under South Carolina law, the named insured in a policy may recover damages and attorney’s fees from their insurance company for a bad faith denial of insurance coverage if that person proves that the insurance company acted unreasonably and without a factual justification to support its decision to deny benefits under the insurance contract. South Carolina Code Annotated § 38-59-20.
What are improper insurance claim practices in South Carolina?
Any of the following acts by an insurer doing accident and health insurance, property insurance, casualty insurance, surety insurance, marine insurance, or title insurance business, if committed without just cause and performed with such frequency as to indicate a general business practice, constitutes improper claim practices:
(1) Knowingly misrepresenting to insureds or third-party claimants pertinent facts or policy provisions relating to coverages at issue or providing deceptive or misleading information with respect to coverages.
(2) Failing to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies, including third-party claims arising under liability insurance policies.
(3) Failing to adopt and implement reasonable standards for the prompt investigation and settlement of claims, including third-party liability claims, arising under its policies.
(4) Not attempting in good faith to effect prompt, fair, and equitable settlement of claims, including third-party liability claims, submitted to it in which liability has become reasonably clear.
(5) Compelling policyholders or claimants, including third-party claimants under liability policies, to institute suits to recover amounts reasonably due or payable with respect to claims arising under its policies by offering substantially less than the amounts ultimately recovered through suits brought by the claimants or through settlements with their attorneys employed as the result of the inability of the claimants to effect reasonable settlements with the insurers.
(6) Offering to settle claims, including third-party liability claims, for an amount less than the amount otherwise reasonably due or payable based upon the possibility or probability that the policyholder or claimant would be required to incur attorneys’ fees to recover the amount reasonably due or payable.
(7) Invoking or threatening to invoke policy defenses or to rescind the policy as of its inception, not in good faith and with a reasonable expectation of prevailing with respect to the policy defense or attempted rescission, but for the primary purpose of discouraging or reducing a claim, including a third-party liability claim.
(8) Any other practice which constitutes an unreasonable delay in paying or an unreasonable failure to pay or settle in full claims, including third-party liability claims, arising under coverages provided by its policies.
How do you prove bad faith?
Under South Carolina Law, an insured is entitled to recover damages caused by an insurer’s breach of contract and the inherent covenant of good faith and fair dealing when the insured shows:
(1) the existence of a mutually binding contract of insurance between the plaintiff and the defendant; (2) a refusal by the insurer to pay benefits due under the contract; (3) resulting from the insurer’s bad faith or unreasonable action in breach of the implied covenant of good faith and fair dealing arising under the contact; (4) causing damage to the insured. ContraVest Inc. v. Mt. Hawley Insurance Company, 273 F. Supp. 3d 607, 614 (D.S.C. 2017) (quoting Founders Ins. Co. v. Richard Ruth’s Bar & Grill LLC, No. 2:13-cv-03005- DCN, 2016 WL 3219538, at *5 (D.S.C. June 8, 2016)).
“[A]n insurer acts in bad faith when there is no reasonable basis to support the insurer’s decision [for contesting a claim].” Helena Chem. Co. v. Allianz Underwriters Ins. Co., 357 S.C. 631, 645, 594 S.E.2d 455, 462 (2004).
Can I sue for an insurance company refusing to pay under the policy? – Yes
If an insurance company wrongful fails to honor its agreement with an insured, policy holder, or someone covered under the policy, then an attorney can sue for breach of contract and for bad faith refusal to pay insurance benefits. Less frequently, attorneys in South Carolina may sue for unfair trade practices, fraud, or negligent misrepresentation, or breach of contract accompanied by fraudulent intent.
An insurance policy is a contract. You pay the premiums for the insurance to cover a loss as described under the policy to a certain limit. If the insurance company fails to honor the policy for whatever reason, this may be a breach of contract if they incorrectly interpreted the contract or applicable South Carolina rules. An experienced South Carolina insurance dispute attorney can help determine if you have a claim.
An insurance company can act in bad faith if it wrongfully refuses to honor a policy by either failing to defend or indemnify an insured or failing to pay benefits afforded under the contract. Importantly, an insurance company’s duty to defend is broad and separate and distinct than a duty to indemnify. A duty to defend is determined based on the allegations in the complaint or claim made against an insured.
Often times, an insurance company will refuse benefits or a defense because the insured/policy holder failed to timely notify the insurance company of the claim. This is why it is important to put your insurance company on notice when there is a possible claim made against you that the policy may cover. You should also contact an insurance coverage and bad faith insurance attorney to assess your policy and the insurance company’s obligations owed to you under the agreement.