Understanding Your Rights When Insurers Delay or Deny Collision Claims in West Virginia

Disclaimer: This article is for general informational purposes only and does not constitute legal advice. Consult a qualified attorney for legal guidance.

Detailed Answer

After a collision, your insurer or the at-fault driver’s liability insurer must investigate and pay valid claims promptly. West Virginia law prohibits unfair claim settlement practices. Under W. Va. Code §33-11-4, insurers must:

• Acknowledge receipt of a claim promptly.
• Conduct a reasonable, good-faith investigation into covered losses.
• Effectuate fair and equitable settlements once liability is clear (W. Va. Code §33-11-4(6)).
• Refuse to pay only after reasonable justification, issuing denial letters that cite policy language and facts.

If your insurer unreasonably delays or denies payment, you can challenge these tactics at several levels:

1. Review Your Policy and Communications: Gather all policy documents, claim forms, denial or delay letters and correspondence. Note dates—you often have contractual deadlines for appeals.
2. Send a Demand or Reservation of Rights Letter: Draft a clear letter citing your policy, describing the accident facts, detailing your damages and demanding a written explanation or payment by a specific date (typically 15–30 days).
3. File an Administrative Complaint: Submit a complaint online with the West Virginia Offices of the Insurance Commissioner. While not a substitute for court, the Commissioner can investigate unfair practices under W. Va. Code §33-2-4 and may order corrective action.
4. Consider a Private Lawsuit for Bad Faith: West Virginia recognizes a common-law tort for insurer bad faith. If the carrier refuses valid claims without a reasonable basis, you can sue for breach of contract and bad faith in civil court. In Arkwright-Boston Mfrs. Mut. Ins. Co. v. Maynard, 200 W. Va. 734 (1997), the Supreme Court of Appeals allowed extra-contractual damages for bad faith.
5. Seek Remedies Under the West Virginia Unfair Trade Practices Act: You may file a separate claim under W. Va. Code §33-11-1 et seq. for unfair or deceptive practices, which can yield fines and attorney fees.
6. Keep Detailed Records: Document every phone call, email and letter. Courts and regulators look favorably upon claimants who maintain clear evidence of bad-faith tactics.

Helpful Hints

• Track key dates: Note when you filed your claim, when reminders were sent, and any insurer responses.
• Read your policy’s “proof of loss” and “appeals” sections to meet deadlines.
• Use certified mail when sending formal letters to insurers to prove delivery.
• Request a copy of the insurer’s internal claim notes—this can reveal their reasoning.
• Consult an attorney early if the insurer denies or delays payment beyond 30 days.
• File your administrative complaint before the statute of limitations expires (usually two years for contract claims in West Virginia, W. Va. Code §55-2-6).