In Illinois, and elsewhere, health insurers often act in such an unreasonable manner (that controverts with the expectations of legitimate claimants) that it puts the policyholder-claimant in a particularly difficult, vulnerable position. Health insurers are always looking to minimize their liabilities, and they do so in a number of different ways: sometimes by denying coverage altogether, and sometimes by undervaluing the claim. Depending on the circumstances, a health insurer may even choose to delay a payout owed to the policyholder.
Importantly, statutory and common law in Illinois protects those whose health insurance claims have been wrongfully handled by their insurer. For example, if you believe that your health insurance claim has been incorrectly denied, then you can go through the appeals process with your insurer, and failing to secure a favorable resolution, you can sue the insurer on the basis of a breach of the insurance contract.
Bad faith claims are rather unique, however. In Illinois, bad faith claims are exclusively statutory in nature, and provide policyholders access to extra-contractual remedies when the insurer has acted unreasonably.
All this legalese can be overwhelming, so let’s begin with a simple analysis of how bad faith claims actually work in Illinois. If you’re looking for further guidance, we encourage you to contact a Chicago bad faith insurance lawyer here at Bryant Legal Group, P.C. Our attorneys will assess your bad faith claims and help you secure full and adequate compensation.
How Bad Faith in Illinois Works
In the state of Illinois, most insurance disputes are governed by common law, but bad faith insurance disputes are governed by statutory law. Section 155 of the Illinois Insurance Code gives policyholders a cause of action for bad faith conduct. Specifically, when an insurer — in the health insurance context or otherwise — acts in a manner that is vexatious and unreasonable, then the policyholder may recover substantial damages for such bad faith conduct.
Health insurers may act unreasonably in:
- Denying a legitimate claim without basis
- Failing to properly investigate the facts surrounding a claim
- Delaying the processing of a claim, or the payout of amounts due
- Deliberately undervaluing a claim
- And more
The critical consideration is whether the insurer has acted in a vexatious and unreasonable manner. In other words, the court must determine whether the insurer has acted with an attitude that is particularly intended to frustrate, irritate, exhaust, provoke, or otherwise interfere with the ability of the policyholder to recover.
In Illinois, the “vexatious and unreasonable” determination is based on the totality of the circumstances. A variety of factors are relevant, but prime amongst them is that of the attitude of the insurer. If the insurer’s words and conduct demonstrate an attitude towards the policyholder that could be construed as vexatious and unreasonable, then the policyholder may be entitled to recover pursuant to the Illinois Insurance Code.
- Related Article: 5 FAQs About Private Disability Insurance Claims
Consult a Skilled Chicago Bad Faith Insurance Lawyer Today
If you have had your health insurance claim wrongfully denied, delayed, or otherwise handled in a manner that is unreasonable, then you may be entitled to damages for the bad faith actions of the insurer. Litigating bad faith claims in Illinois is no simple task, however. Effective litigation demands a team of insurance attorneys who have experience representing health insurance policyholders in similar disputes.
Here at Bryant Legal Group, P.C., our attorneys have spent decades advocating on behalf of health insurance policyholders in a range of disputes, bad faith included. Call (312) 561-3010 to get connected to an experienced Chicago bad faith insurance lawyer today.