What Can be Done About Abusive or Negligent Adjusters in Texas?

“You have the right to be treated fairly and honestly when you make a claim.”

Consumer Bill of Rights, Personal Automobile Insurance

Dealing with insurance companies can be a stressful and unpleasant experience. If you encounter an abusive or negligent insurance adjuster during the claims process, it’s important to understand your options for holding them accountable.

A solid first step is to document all correspondence with the adjuster. This evidence is important to successfully prove you have been treated unfairly. The next step is to lodge a complaint with the insurance adjuster’s supervisor or manager, since the insurance company is not aware of the adjuster’s conduct. This can be done by contacting the insurance company’s customer service department.  If you continue to receive abuse or neglect from the insurance company, you can file a complaint with the Texas Department of Insurance.

A key function of the Texas Department of Insurance (TDI) is to help “resolve complaints against insurance companies, health maintenance organization (HMOs), insurance agents, and adjusters.”  TDI can help with the following types of complaints:

• “Poor customer service late or slow payment of claims;
• Policy cancellations and nonrenewals;
• Improper claim denials;
• Health care treatment or service denials
• Poor customer service;
• Misrepresentation about what a policy covers;
• Discriminatory rate increases;
• False or misleading advertising; and
• Suspected insurance fraud.”

If you need assistance with filing a complaint you can call the TDI Consumer Help Line at 1-800-252-3439. You can also file a complaint online. After you file a complaint with TDI, they will contact the implicated company and attempt to remedy the problem. You will receive a letter from TDI letting you know they are working on the complaint. Typically, after 60 days you will receive a letter detailing the outcome of the complaint. If the adjuster broke state insurance laws enforcement action will be taken.

The Texas Department of Insurance is limited in certain ways. It can’t assign fault in an accident, make medical judgements, give legal advice, or settle disputes based on your word alone. If you are unhappy with the complaint’s outcome, then seeking out an attorney is a viable next step. An attorney can advise on whether litigation is an option, and outline any other legal recourse you can take. Many attorneys offer free consultations and offer their services on a contingency basis. This means you do not pay an up-front fee for legal services. The attorneys’ fees are taken from any financial sum resulting from a settlement or judgement.  In some instances, when bad faith can be shown, you might be able to seek a penalty against the insurance company and recover your attorneys’ fees.

You have a right for be treated fairly and honestly by adjusters. If you encounter an abusive or negligent adjuster take action to make sure they are held accountable.

References

1. http://www.tdi.texas.gov/rules/2012/documents/Consumer_Bill_o1.pdf
2. http://www.tdi.texas.gov/consumer/complfrm.html