Bad Faith Blog

Summary: The insured filed suit against his insurer for breach of contract and bad faith after repeatedly failing to attend an independent medical examination (“IME”) scheduled by his insurer. On appeal, the Third Circuit held the insured materially breached the insurance contract by failing to appear for the IME. The court further held the insurer had a reasonable basis for the IME and its subsequent denial of the claim. Because there was a reasonable basis for its actions, the insurer did not commit bad faith.

Summary: The insureds filed suit against their insurer for breach of contract and bad faith after their insurer denied their claim for a stolen boat and trailer. On appeal, the court held the policy was void due to a material misrepresentation on the application. Because there was no policy in force, there was no claim for bad faith.

Summary: The plaintiff was injured while operating a vehicle insured by GEICO. The plaintiff obtained the policy limits from the tortfeasor’s insurer and then made a claim under the SUM endorsement of the GEICO policy. GEICO denied the claim, and the plaintiff alleged GEICO unreasonably refused payment.

Summary: The plaintiff healthcare insurance administrator acts in various roles including administering some plans that expressly assume the risk of medical costs and establish their own benefit plans, including employer self-funded plans, state government plans, and claims arising under the BlueCard program allowing out-of-state patients to obtain care in Texas. Plaintiff also services benefit plans for federal employees in Texas under the Federal Employee Health Benefits Program (“FEHBP”).