This is a question, unfortunately, that has come up over the years for some of my clients. When dealing with a delayed personal injury claim, or a denied claim, particularly where protracted litigation has become necessary, frustration and anxiety can mount quickly. Where an injured individual has incurred medical expenses and has been forced to miss time at work, the financial pressures involved can seem to overwhelm many people. I've seen a few situations where people have literally been reduced to tears due to the financial pressures they feel as a result of having their claim improperly or wrongfully denied. It's a tense time. However, the reality is insurance companies delay and deny claims every day.
I've handled countless claims that have been denied by an insurance company, but ultimately, we won the case, and the injured individual received vindication in court after trial.
Unfortunately the process to get from a delayed or denied claim to a trial can often be lengthy. I've discussed in other guides the timeframes involved in personal injury litigation and workers compensation matters. A frustrated, anxious individual who has a meritorious claim that has been denied for no apparent reason often poses the question:
“Can I sue the insurance company for what they have done to me.”
Now, certainly you can see the at-fault party in a personal injury matter for the injury itself, and any damages attendant thereto, and the insurance company will appoint counsel for that person and tender a defense. In a workers' compensation the suit for workers’ compensation benefits is brought directly against the employer and the insurance company. It's a separate question as to whether the insurance company can be sued for inflicting emotional distress, aggravation and causing unneeded anxiety by their claim handling processes. Unfortunately the answer here is almost always “no”, you cannot sue, or you cannot do so successfully. There may be extraordinary, extreme cases, involving palpable bad faith and clear and intentional misconduct that could possibly be separately actionable against the insurance company. One case sets the standard as conduct "so extreme in degree as to go beyond all possible bounds of decency, and to be regarded as atrocious and utterly intolerable in a civilized ” society. Gallagher v. Bituminous Fire and Marine Ins. Co., 492 A.2d 1280, 303 Md. 201 (Md., 1984). The prevailing view is that there is no intentional misconduct in the typical claim denial.
The insurance company is not looking to hurt you, they are just looking not to pay you.
The reality is that as long as the insurance company can articulate a reason for the denial of a claim, and they almost always will be able to articulate their reasoning for the denial, there is no action for emotional distress, aggravation or anxiety caused by delayed or denied benefits.