Insurance Litigation

Houston Insurance Lawyers Dedicated to Helping Clients Surpass Insurance Disputes

Insurance coverage issues can be a surprise for policyholders who have never filed a major insurance claim before. Many insurers will take advantage of ambiguous language in the insurance contract and complications (with regard to the facts undergirding your claim) to avoid having to pay. Because insurers are fundamentally against their policyholders it is critical that policyholders understand the nature of their relationship with insurers.

At Berg Plummer Johnson & Raval, LLP, our Houstoninsurance attorneys work closely with our clients throughout the litigation process. We will assess your claims and help you challenge the insurer’s denial or valuation of your benefits, and — in situations where bad faith may be involved — will follow through with a lawsuit to recover damages.

Texas Insurance Laws and Regulations

Unreasonably denied benefits to the policyholder
Misrepresented the terms of the insurance contract
Unreasonably delayed in processing the insurance claim
Failed to properly investigate and assess the insurance claim
Failed to comply with their duty to defend the policyholder against third-party lawsuits
Failed to settle a third-party claim within the coverage limits, thus exposing the policyholder to personal liability
Otherwise misleading the policyholder or interfering with their ability to file a claim and receive benefits in a timely manner

Bad faith litigation can be challenging, as you must show that the insurer violated their duty of good faith (given the circumstances). As such, it’s important that you work with an experienced team of Houston insurance coverage and litigation attorneys who have a track record of success in tackling insurance bad faith issues.

We represent clients in insurance disputes that involve:

Long Term Disability Insurance
Short Term Disability Insurance
Health Insurance
Life Insurance
Accidental Death and Dismemberment Insurance

Disability Insurance Claims

If you are suffering from a disabling condition and are no longer able to work, disability benefits can provide the lifeline you need to support yourself and your family. Whether you have disability insurance coverage through your employer or independently through your own personalized insurance coverage, you are entitled to receive disability benefits if you have a qualifying condition. If you file a disability insurance claim and it’s denied, you will need to file an appeal. That is a very good time to hire an insurance attorney so they can help with your appeal. If the insurer denies your appeal, your lawyer can help you file a lawsuit, as litigation under employer-provided group insurance policies is different from other types of insurance litigation.

Accidental Death and Dismemberment Insurance Claims

Accidental Death and Dismemberment insurance (AD&D) is a category of life insurance that only pays out a benefit when the insured is in a covered accident that causes death or specific serious injuries. It can be purchased as an optional rider to an existing life insurance policy or as a standalone, independent insurance product. AD&D insurance policies only cover accidents. Death or injuries caused by illnesses (and various other non-accidental causes) are not eligible for benefits. If you have filed a claim for AD&D benefits and that claim has been delayed, underpaid, or denied, our insurance attorneys can help.

Health Insurance Claims

When it comes to health insurance, an injured policyholder who requires significant medical treatment may find themselves in a situation where they are held hostage to the whims of their insurer. Berg Plummer Johnson & Raval, LLP is committed to helping policyholders obtain their rightful benefits. We represent clients in Houston and throughout Texas who were wrongfully denied a health insurance claim or whose claims were unjustly delayed.

Life Insurance Claims

At Berg Plummer Johnson & Raval, LLP, our life insurance attorneys are well-positioned to seek a favorable resolution to an insurance dispute, including those that involve life insurance. We understand that having a life insurance claim denied can be an overwhelming experience. After all, an unexpected claim denial can leave you and your family in a vulnerable financial position. We therefore work closely with our clients to ensure that they are fully aware of how their case is progressing.

Contact the Insurance Lawyers at Berg Plummer Today

In Texas, as in other states, policyholders are entitled to sue and recover damages when their insurer has failed to uphold their duty to act in good faith. The duty of good faith applies to a wide range of conduct. At Berg Plummer Johnson & Raval, LLP we are committed to providing a full range of legal services for clients struggling with insurance claims. Our Houston insurance attorneys have decades of experience representing clients in a range of insurance disputes and we are happy to meet with you and your loved ones to discuss your needs.

Insurance Attorney Frequently Asked Questions (FAQ)

Can lawyers sue insurance companies in Texas?

Yes, lawyers can sue insurance companies in Texas for various bad faith practices, including the delay, underpayment, or denial of a valid policyholder claim.

Can you sue an insurance company for denying a claim?

Yes, a policyholder that is current on their premiums can absolutely sue an insurance company for denying a claim.

What can you do when your insurance company refuses to pay?

When an insurance company refuses to pay a claim, the recourse the policyholder has depends upon where the claim is in the process. If it is an initial denial and the policy provides for an administrative appeal, working with an insurance attorney can help you both be more successful at this phase and ensure your evidentiary record for trial is as complete as possible. If you have exhausted your administrative appeals with your insurance provider, a lawyer can also represent you in court in a lawsuit against your insurer.

Health Insurance

Health insurance claim denials can be exceedingly difficult to handle from both a financial and emotional perspective. In health insurance claim disputes, not only are you saddled with the unique challenge of having to recover from your injury or illness, but depending on the circumstances (e.g., if your insurance provider makes a significantly undervalued offer or denies your claim entirely), you could be left with significant bills. Whether your health insurance provider chooses to cover your treatment could spell the difference between bankruptcy and solvency – and in many cases the difference between prompt treatment that can save a patient’s life and an unknown future. The stakes in health insurance disputes are often rather high. If your insurer acts in bad faith, you may therefore be entitled to recover damages for emotional distress, among various other losses.

Life Insurance

It is common for life insurance companies to wrongfully deny a legitimate claim for benefits, or to otherwise interfere with the processing of a legitimate claim through an unreasonable delay. These actions can put serious pressure on the policyholder and/or their beneficiaries.

If a life insurance claim is denied, for example, you may be forced to appeal the denial through an internal administrative process, or, if that does not resolve the issue, to sue the insurer in a court of law. When grieving for a loved one, the prospect of an ongoing legal conflict may seem daunting.

Disability Insurance / ERISA

Whether you have disability insurance coverage through your employer or independently through your own personalized insurance coverage, you are entitled to receive disability benefits if you have a qualifying condition. Insurance policies can vary considerably. A disability insurance lawyer can assess your plan and the language of the contract and determine the obligations that apply to you, the claimant, and those that apply to the insurer. Understanding the provisions and language of your disability insurance policy and how it will be enforced is critical.

Accidental Death

Many people – especially breadwinners – purchase multiple types of insurance to protect their loved ones in the event they are killed or incapacitated and unable to work and provide financially. One of the types of insurance commonly purchased is called Accidental Death and Dismemberment, a category of life insurance that only pays out a benefit when the insured is in a covered accident that causes death or specific serious injuries.