Topic

Insurance dispute guides

How to organize a problem with an insurer, and where to take it next.

4 guides
Sources listed in each

Insurance disputes often turn on paperwork: which policy applies, what it says, and what the insurer decided in writing. The guide below walks through sorting that out and using a state complaint process, with Texas as the worked example.

Each state runs its own insurance complaint process, so the route outside Texas will differ.

The guides

Insurance disputes: how to organize and escalate a claim problem

When an insurer delays, underpays or denies a claim, a clear record and the right escalation path matter more than a strongly worded letter. A state complaint can prompt a second look, but it is not a lawsuit.

General organizing steps. The complaint process described is the Texas Department of Insurance’s and applies to Texas; its auto-specific limits apply to Texas auto insurance complaints. Other states run their own processes. California court guidance and federal court guidance are cited only for the points they cover.

Insurance bad faith: first-party and third-party claims

A denied or slow claim is not automatically bad faith. The question is whether the insurer handled the claim unreasonably, and the answer depends on whose claim it is and which state’s law applies.

General principles, with Texas statutes and California’s official civil jury instructions as the labeled examples. Whether a person can sue under a state’s unfair claims statute, and the remedies and deadlines, differ by state. This guide does not cover health plans governed by federal law.

Uninsured and underinsured motorist coverage: how it works after a crash

When the driver who hit you has no insurance, too little insurance, or cannot be found, your own auto policy may be where the money comes from. That claim is against your own insurer, and it can still turn into a dispute.

General principles, with the Texas Insurance Code and Texas Department of Insurance guidance as the labeled example. Florida and Pennsylvania regulator guidance is cited only for stacking. Whether insurers must offer this coverage, what it pays for, and how it can be rejected differ by state.

Insurance subrogation: when your insurer pursues the other side

When your insurer pays for a loss someone else caused, it may go after that person to get its money back. That process can affect your deductible, your settlement and what you are allowed to sign.

General principles, with Washington regulator guidance (deductible recovery and settlement notice) and the Texas statute on health plan subrogation as labeled examples, plus one federal ERISA decision. Other states set their own rules for deductible recovery, health plan reimbursement and the made-whole doctrine. No 50-state survey.