Insurance · Bad Faith and Ethics

What are common examples of insurer 'bad faith' in claim handling?

Correct answer

Unreasonably denying a clearly covered claim, unreasonable delay, inadequate investigation, refusing to settle within policy limits when liability is clear, misrepresenting policy provisions, requiring excessive documentation, threatening or intimidating the insured

  1. A Asking for documentation
  2. B Following policy provisions
  3. C Unreasonably denying a clearly covered claim, unreasonable delay, inadequate investigation, refusing to settle within policy limits when liability is clear, misrepresenting policy provisions, requiring excessive documentation, threatening or intimidating the insured
  4. D Paying promptly

Why this is the answer

Bad faith is conduct breaching the implied covenant of good faith and fair dealing inherent in every insurance contract. Examples of bad faith handling: (1) Denying a clearly covered claim without reasonable basis; (2) Unreasonable delay in investigation, decision, or payment; (3) Inadequate investigation — making decisions without proper fact-finding; (4) Misrepresenting policy provisions or coverages; (5) Requiring documentation not required by the policy or law; (6) Refusing to communicate with the insured; (7) Failing to settle a liability claim within policy limits when liability is clear and damages exceed limits — exposing the insured to personal liability ('Stowers' doctrine); (8) Pressuring the insured into accepting less than full value through threats, intimidation, or misinformation; (9) Failing to acknowledge or respond to a claim within reasonable time; (10) Compelling litigation to recover what is properly owed. Bad faith creates 'extra-contractual' liability — damages beyond the policy limits, often including emotional distress, attorney fees, and (in some states) punitive damages. Adjusters should: be timely and responsive; document their investigation and decision basis; explain coverage decisions clearly in writing; never pressure the insured. Insurers train adjusters specifically on bad-faith avoidance because the liability exposure is significant.
Source: NAIC Adjuster Bad Faith

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About this topic: Bad Faith and Ethics

Bad faith and ethics questions cover the insurer's duty of good faith, the conduct that unfair-claims-practice laws prohibit, and the consequences — extra-contractual damages — when a claim is handled unfairly. This is one of 7 Insurance Adjuster questions on bad faith and ethics, each with a full explanation on a single study page.

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