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Insurance Bad Faith and Fraud Defense

Walsworth is uniquely positioned to represent insurance companies against lawsuits that allege “bad faith” in the handling of insurance claims and claimed unreasonable withholding of policy benefits.

Our decades of litigation and insurance defense experience provides us with the perspective to critically analyze insurance policies, allegations, facts as investigated and claimed, and applicable law, and develop strong and creative recommendations, defenses, and arguments. We frequently minimize or conclude cases through demurrers, motions for summary judgment, or very reasonable settlement. We also efficiently prepare cases for trial through well-designed discovery plans. If a trial does prove to be necessary, our trial attorneys are seasoned and successful.

Walsworth’s team includes a specialist in the investigations of suspected fraudulent insurance claims, who has conducted countless examinations under oath for numerous national insurance carriers and their SIU units. Our team can assist with assessing NICB indicators, investigating SIU claims, resolving coverage issues, providing coverage opinions, and resolving and litigating suspected fraudulent claims.

We have represented insurance companies in a wide range of suits arising from homeowners, automobile, travel and commercial policies. Our expertise extends to handling bad faith cases arising out of water losses, theft, arson, fraud, suspect uninsured motorist claims and duty-to-defend matters. Our breadth of background and experience in this area enables us to honestly evaluate a matter and recommend the right course in a variety of case scenarios. We are proud to be known for consistently providing exceptional client service and thoughtful and tailored  representation.

Representative Successes:

  • Obtained a judgment of dismissal for a large insurance company in a bad faith case after the client’s demurrer to the plaintiff’s complaint was sustained without leave to amend-a rare win early in litigation given the strict rules for demurrers. The action was barred by the doctrine of res judicata, as the insured had already filed a small claims action for the same loss, which resulted in a minimal judgment in her favor. The plaintiff’s case was contractually time-barred because she failed to file the complaint within one year of the date of loss as specifically required by the insurance policy.
  • Obtained summary judgment in federal matter after successfully proving that the insured had not proven that personal property was present at the residence when an alleged theft occurred, which was a requirement to demonstrate there was a covered loss. Without demonstration of a covered loss, the Court agreed that there was no breach of contract and therefore no bad faith on behalf of the insurer.
  • Successfully drafted and argued a successful motion for summary judgment in an insurance bad faith case. The client was sued for breach of contract, breach of the implied covenant of good faith and fair dealing and declaratory relief following the denial of a claim made by the plaintiff for property damage to a truck under a commercial automobile policy. The plaintiff argued that the denial of their claim was incorrect based on representations allegedly made by the firm’s client when the policy was purchased. The Court found that there was no coverage for the damage to the truck as it did not qualify as a covered vehicle under any interpretation of the policy. Further, the Court agreed that, because the insurance policy was fully integrated, any alleged oral agreements were excluded.
  • Prepared and argued multiple successful motions for summary judgment/adjudication including one eliminating bad faith as well as punitive damages in an action against an agent and insurer for allegations of misrepresentation or negligence regarding the sale of a policy. This ruling reduced the value of the case to limited jurisdiction by eliminating the potential for punitive damages, emotional distress and attorney fees.
  • Successfully assisted in the SIU investigation of a large arson fire, wherein the named insureds’ cell phone records, not only impeached their testimony but placed them at the location, when the fire was set. Based upon the results, the insured were indicted and faced criminal prosecution for arson.
  • Obtained a dismissal with prejudice, on the second day of jury trial, in a bad faith, large water loss litigation alleging punitive damages against the insurance carrier, when defendant prevailed on all motions in limine, which gutted the plaintiff’s case.
  • Obtained summary judgment for a large insurance carrier where the insured plaintiff committed material misrepresentations about multiple large theft losses of multiple business locations, which resulted in the denial of the claim. The federal court found the carrier acted reasonably in the investigation and denial of the claim; therefore, granted the summary judgment in its entirety.
  • Successfully argued the subsequent counsel rule in mediation to establish that client was not the cause of any damages and obtained a favorable settlement within policy limits for a multimillion real estate deal where incorrect valuations were used.
  • Eliminated plaintiff’s claims for negligence and punitive damages in a bad faith matter in which plaintiff had alleged that the insurance policy was wrongfully cancelled and that the subject property was deliberately underinsured.