Insurance companies in the state of Ohio are obligated to act in good faith when handling policies, payments and claims. When an insurance carrier fails to provide a policy holder with the coverage stated in their terms as valid and accurate, they may be viewed as “acting in bad faith.” Sometimes, this is a result of a mistake made by the claimant, but most of the time, the insurance carrier is looking for ways to reduce the amounts they should be paying out.
Because the insurance industry is a business, it often takes on characteristics that most businesses possess. While businesses are known to provide products and services consumers need, their ultimate goal is to make money. The trouble with that is, we need insurers who are looking out for our best interest when it comes to our homes and health, and unfortunately, some are more concerned with profiting rather than providing.
How Do Ohio Administrative Codes Protect Policy Holders?
For this reason, there are Ohio Administrative Codes that have been compiled that highlight unacceptable behavior that should be avoided by any insurance agent. The state of Ohio identifies anyone as an agent if they are an “individual, corporation, association partnership or other legal entity authorized to represent an insurer with respect to a claim.”
A claim can be filed for a number of different reasons including car accidents, a natural disaster destroyed part of your home, a medical treatment you had rendered, etc. And if you are working to obtain compensation from a claim filed,
- “No agent shall willfully conceal from first party claimants benefits, coverages or other provisions of any insurance contract when such benefits, coverages or other provisions are pertinent to a claim.”
- “No insurer shall deny a claim based on the first party claimant’s failure to make available for inspection the property which is the subject of the claim unless there is documentation of breach of the policy provisions in the claim file.”
- “An insurer shall fully disclose to first party claimants all pertinent benefits, coverages or other provisions of an insurance contract under which a claim is presented.”
What Sections 3901.041, 3901.19, and 3901.26 specify is that your insurance carrier and the agents assisting you cannot misrepresent the benefits you have nor can they deny you access to pertinent information when trying to get your claim approved. Sometimes it is necessary to hire a nearby denied insurance claims lawyer simply because you may get some push-back from your insurer.
With that in mind, if you believe your agent has provided you with false information or you are under the impression that your claim was left unpaid for illegitimate reasons, you are going to want to consult with a local insurance attorney in Ohio who can assess the details of your matter and determine if your insurer is in fact acting in bad faith. USAttorneys is ready for your call and will gladly place you in touch with some of the most reliable lawyers out in the field.