Lansdowne, PA asked in Consumer Law, Contracts and Insurance Bad Faith for Pennsylvania

Q: I need an attorney to sue my pet insurance company for bad faith. There is also a possible claim under the consumer ...

I have a pet policy with lemonade insurance company. I filed a claim for emergency services after my dog needed treatment. The company is only covering part of the cost. They are supposed to cover 90% of the cost minus the annual deductible. They are only covering about 50% of the costs and acting in bad faith. Furthermore, there may be a consumer protection act claim along with false advertising and a possible bait and switch. It may be something that fits into a class action package as I believe that if they are doing this to me then there are others they are doing the same thing to. I am interested in hearing from attorneys that can cover these issues.

1 Lawyer Answer

A: Given the facts you presented, you may have bad faith, breach of contract, and other claims. Damages for insurance bad faith can include actual damages, interest on the damages, punitive damages, attorney's fees, etc. Therefore, you should undoubtedly ask an attorney to review the policy, medical records, advertising, etc.

To win in an insurance bad faith case, you have to show that the insurer did not have a reasonable basis under the policy to deny benefits and knew its basis for the denial was unreasonable. If the policy provisions are as clear as you described, it is more difficult for the insurer to defend its decision. However, insurance policies can be tortuous.

Note that in most insurance bad faith claims, you must follow the insurer's internal appeal process before filing a claim in court. Therefore, you may have to jump through the insurer's procedural hoops first, although you may want to speak to an attorney first. Typically, there are specific deadlines for filing an appeal.

It is a little early to know if there is a potential class action here. However, it is possible if there are many similarly situated pet owners.

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