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Bad faith behavior and foreseeable damages in Massachusetts Real Estate Insurance Law Insurance Blog



Massachusetts has adopted a version of the model unfair Claims Settlement Practices Act and recognizes a reason for unfaithfulness to a first-party insurance company. 1 Gen. General Laws Chs. 93A § 9 establishes a statutory action for each person who has been injured by another person's use or employment of any method, act or practice that has been declared illegal by the General Laws chap. 176D § 3 (9), an infringement of which may give rise to civil liability under 93A § 9. 2 While each state generally has its own specific malignant statute describing what constitutes an "unfair" or "Misleading" Law by an Insurer Massachusetts law includes behaviors commonly found throughout the country. 1

76D § 3 (9) identifies the following specific unfair practices and deceptive acts:

(1) Incorrect presentation of relevant facts or insurance provisions regarding coverage in

(2) Fails to recognize and act reasonably quickly in communication with respect to claims arising under insurance;

(3) Failure to adopt and implement reasonable standards for rapid investigation of claims arising in the field of insurance; [19659003] (4) Refuses to pay claims without making a reasonable inquiry based on all available information;

(5) Failure to confirm or refuse to cover claims within a reasonable time after proof of losses has been completed;

(6) Fails to implement prompt, fair and equitable settlements of claims where liability has become reasonably clear.

(7) Forcing insured persons to enter into disputes to recover sums under an insurance policy by offering significantly less than sums ultimately recovered in an action brought by such insured persons;

(8) Attempt to settle a claim for less than the amount that a reasonable man would have thought he was entitled to with reference to written or printed advertising material accompanying or included in an application;

(9) Attempt to settle claims on the basis of an application that has been amended without notice to, or knowledge or consent of the insured;

(10) To make damages payments to insured persons or beneficiaries which are not accompanied by a statement indicating the coverage under which payments are made;

(11) To make known to insured or tortfeasors a policy of appealing to arbitrators in favor of insured or tortfeasors in order to compel them to accept settlements or compromises less than the amount awarded in arbitration;

(12) Delay the investigation or payment of claims by requiring an insured or tortfeasor, or the physician to one of them, to submit a preliminary report of the minimum claim and then require formal proof of loss form, both of which have essentially the same information.

(13) Failure to settle claims immediately, where liability has become reasonably clear, during part of the insurance cover to affect settlements during other parts of the insurance cover; or

(14) Failure to promptly provide a reasonable explanation of the basis of the insurance policy in relation to facts or applicable law for refusal of claim or for offer of compromise settlement. 3

To issue a claim against an insurer under the Director General's Act Ch. 93A §9 and gen. Lagar Ch. 176D an insured must establish: (1) that an unfair commercial practice occurred; and (2) that the unfair practice resulted in a loss for the insured. 4 Any person whose rights are affected by another person's unfair settlement practices may bring an action before the Supreme Court for damages and such a just exemption as the court deems necessary and correct. 5

Another recent topic of investigation was whether an insured person is entitled to the foreseeable damages caused by the insurer's failure to pay benefits on time. There are several cases in Massachusetts that establish a viable theory of recovering the foreseeable compensatory damages based on a violation of Ch. 176D § 3 (9):

The following damages are available to a plaintiff where the consequences of an insurer's actions are foreseeable. 6 Furthermore, foreseeable losses arising from bad faith can also be recovered. 7 Actual damages under § 93A also include "all losses which were the foreseeable consequences of the defendant's unfair or misleading act or practice." 8 The complainants must establish a causal link between the insurer's misconduct. and the damage that occurred. 9

Regardless of whether they are located in Massachusetts or another state, the unfair practices and deceptive acts are described in ch. 176D § 3 (9) is generally prohibited throughout the United States. Any insured person who believes that their insurance company has violated any of these unfair practices or deceptive acts should immediately seek the advice of an attorney who has experience in this area of ​​law, such as those here at Merlin Law Group.
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1 [19659024] See e.g. Green v. Blue Cross and Blue Shield 713 NE2d 992 (Mass App. Ct).
2 Hopkins v. Liberty Mut. Ins. Co. 750 N.E.2d 943, 949-50 (Mass. 2001).
3 Ch. 176D § 3 (9) (1-14).
4 Ferrara & DiMercurio, Inc. v. St. Paul Mercury Ins. Co. 169 F.3d 43, 57 (1st Cir. 1999); Mass doctors make Ch. 93A §11; Mass doctors make Ch. 176D § 3 (9) (f).
5 Ciampa v. USAA Prop. & Cas. Ins. Co. 74 Mass App. Ct. 1129, 2009 WL 2432301, at * 6 (Mass. App. Ct. [Unpub.] August 11, 2009) with reference to G. L. c. 93A, § 9, as amended by St. 1979, pp. 406, § 1.
6 DiMarzo v. Am. Mut. Ins. Co. 449 N.E.2d 1189, 1200 (Mass. 1983).
7 Clegg v. Butler 676 N.E. 2d 1134 (Mass. 1997).
8 DiMarzo v. American Mut. Ins. Co. 389 Mass 85, 101, 449 N.E.2d 1189 (1983); Accord Hopkins vs. Liberty Mut. Ins. Co. 434 Mass 556, 566-567, 750 N.E.2d 943 (2001); Yeagle vs. Aetna Cas. & Sour. Co. 42 Mass App. Ct. 650, 654, 679 N.E.2d 248 (1997).
9 Rivera v. Com. Ins. Co. 84 Mass App. Ct. 146, 149, 993 N.E.2d 1208, 1210 (2013).


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