Insurance · Bad Faith and Ethics

Which adjuster behavior is MOST likely to constitute bad faith claims handling?

  1. A Requesting additional medical records before settling a large injury claim
  2. B Deliberately delaying payment of an undisputed, valid claim for 9 months with no legitimate reason, forcing the claimant to accept a lower settlement out of financial desperation
  3. C Negotiating a lower settlement than the claimant demanded
  4. D Denying a claim for a valid coverage exclusion with a written explanation

Why this is the answer

BAD FAITH in insurance claims handling refers to an insurer's breach of its implied covenant of good faith and fair dealing — an obligation all insurers owe to their insureds (and in some states, to third-party claimants). BAD FAITH EXAMPLES — conduct that is clearly actionable: UNREASONABLE DELAY: deliberately stalling payment of a valid, undisputed claim (as in the scenario) without any legitimate reason; claimants often accept reduced settlements out of financial desperation after long delays — using delay as a settlement tactic is a classic bad faith pattern; MISREPRESENTING COVERAGE: telling a claimant a loss isn't covered when it clearly is; FAILING TO INVESTIGATE: settling without reasonable investigation or denying without proper investigation; LOWBALLING: making settlement offers the insurer knows are far below the actual value of the claim without reasonable justification; FAILING TO SETTLE WITHIN POLICY LIMITS: when a case clearly exceeds policy limits and a settlement demand is made within limits, failure to settle can expose the insurer to an excess judgment against the insured (bad faith toward the insured); REFUSING TO COMMUNICATE: ignoring calls and correspondence; THREATS AND COERCION: pressuring claimants to accept inadequate settlements. NOT BAD FAITH: REQUESTING ADDITIONAL RECORDS: legitimate investigation is expected and required; NEGOTIATING: offering less than demanded, if based on reasonable evaluation; DENYING FOR A VALID EXCLUSION: with a clear, written, policy-supported explanation. BAD FAITH CONSEQUENCES: insurance companies can be liable for: the original claim amount; consequential damages (beyond the policy limit in some cases); attorney's fees; PUNITIVE DAMAGES (in egregious cases, potentially multiples of actual damages); regulatory action and license consequences.
Source: Insurance Adjuster, Bad Faith Claims Handling

Practice more questions

This question is from our Insurance License Practice Tests practice test. Take the full practice test to test your knowledge across all Bad Faith and Ethics and other topics.

Take the Insurance Adjuster practice test →

New to this exam? Our Insurance exam guide explains the format, scoring, and how to prepare.

Related questions

State-specific guides

Need information for your state? Our state guides cover local requirements, fees, and what to expect on exam day.