Where to Turn When Your Insurance Company Won’t Pay

If you have been injured in a car accident, your own insurance company may be one of the first places you turn for help. After all, you pay premiums to maintain coverage and expect your policy to provide benefits when a covered loss occurs.

But what happens when your insurer denies your claim, delays payment, or refuses to provide benefits you believe your policy covers? Can you sue your own insurance company?

In some circumstances, yes. Washington policyholders may have legal options when an insurer fails to honor its contractual obligations or handles a claim in bad faith. However, a denied or delayed claim does not automatically mean the insurer broke the law. The terms of your policy, the facts of the claim, and the insurer’s conduct all matter.

If you are dealing with an insurance dispute after an injury, Rush, Hannula, Harkins & Kyler PLLC (RHHK) can help you understand your potential legal options.

What Insurance Coverage May Apply After an Accident?

Your available benefits depend on the insurance policies you have purchased, their limits, and the circumstances of your accident.

Depending on your coverage, your own auto insurance policy may include:

• Personal Injury Protection (PIP): May cover certain medical expenses and other eligible losses following an accident, regardless of who caused it, subject to policy terms and applicable law.
• Medical payments coverage: May help pay eligible medical expenses for covered individuals, depending on the policy.
• Uninsured or underinsured motorist coverage: May provide benefits when an at-fault driver has no insurance or insufficient insurance, subject to the policy and applicable requirements.
• Collision coverage: May help pay for covered damage to your vehicle after a collision, subject to your deductible and policy terms.
• Comprehensive coverage: May cover certain types of vehicle damage unrelated to a collision, such as specified losses involving theft or certain weather events.

These coverages serve different purposes. For example, collision coverage generally concerns damage to your vehicle, while PIP and uninsured motorist coverage may address certain losses arising from injuries.

If your insurer refuses to pay a claim, the first step is to identify which coverage applies and review the policy language, exclusions, limits, and claim requirements.

When Your Insurance Company Won’t Pay

Insurance companies must handle claims according to applicable laws, regulations, and policy obligations. In Washington, insurers also have a duty to act in good faith and deal fairly with their policyholders.

Problems may arise when an insurer does not properly investigate a claim, misapplies policy terms, or unreasonably denies benefits.

Examples of conduct that may warrant further review include:

• Failing to conduct a reasonable investigation.
• Denying a claim without a reasonable basis.
• Misrepresenting relevant policy provisions.
• Unreasonably delaying the investigation or payment of a covered claim.
• Failing to communicate appropriately about important claim decisions.
• Offering a resolution that does not reasonably account for the coverage and evidence available.

Not every disagreement over coverage amounts to bad faith. An insurer may have a legitimate reason to dispute a claim, and the specific facts determine whether its conduct violated the law.

If your insurer is delaying or denying benefits, keep copies of the denial letter, policy documents, medical records, bills, claim submissions, and communications with the company.

Can You Sue Your Own Insurance Company in Washington State?

Yes. Depending on the circumstances, a policyholder may be able to bring a lawsuit against their own insurance company for breach of contract, insurance bad faith, or another legally recognized claim.

For example, a dispute may arise when:

• Your insurer denies an uninsured motorist claim after an accident involving an uninsured driver.
• Your insurer refuses to pay eligible PIP benefits despite receiving the required documentation.
• Your insurer denies collision coverage for vehicle damage that you believe is covered by your policy.
• The insurer unreasonably delays a claim or fails to investigate important evidence.
• The insurer misrepresents policy terms or otherwise handles the claim in a manner that violates applicable law.

The appropriate legal claim depends on the coverage involved, the insurer’s actions, and the harm caused.

A disagreement about the amount of a settlement is not automatically proof of bad faith. An attorney can review the policy, the claim history, and the insurer’s stated reasons to assess whether legal action may be appropriate.

What Is Insurance Bad Faith?

Insurance bad faith generally refers to an insurer’s unreasonable conduct in handling a claim or fulfilling its obligations to a policyholder.

In Washington, insurers are required to act in good faith and deal fairly with their insureds. A bad faith claim may arise when an insurer’s conduct falls short of its legal obligations and causes harm.

Potential warning signs include:

Unreasonable Claim Delays

An insurer may need time to investigate a claim, request documents, or evaluate medical information. However, unexplained or unreasonable delays may warrant closer examination, particularly when the insurer has the information needed to make a decision.

Inadequate Investigation

An insurer may act improperly if it fails to reasonably investigate relevant evidence before making a claim decision. The adequacy of the investigation depends on the circumstances and the information available.

Denial Without a Reasonable Basis

A denial may raise concerns if the insurer fails to consider important evidence, misapplies policy terms, or cannot provide a reasonable explanation supported by the policy and facts.

Misrepresentation of Coverage

Policyholders should receive accurate information about relevant coverage provisions. Misrepresenting the terms of a policy or the basis for a claim decision may raise legal concerns.

Unfair Claim Handling

Other conduct, such as failing to communicate appropriately or not addressing relevant information, may warrant review under Washington’s insurance laws and regulations.

Whether any of these situations supports a legal claim depends on the details. Keep written records and request the insurer’s explanation for important decisions.

What Is the Insurance Fair Conduct Act in Washington?

Washington’s Insurance Fair Conduct Act (IFCA), codified at RCW 48.30.015, provides a potential legal remedy for certain first-party insurance claims involving unreasonable denials of coverage or benefits.

A first-party claim is generally a claim an insured makes under their own insurance policy, rather than a claim against another person’s insurer.

Under IFCA, an eligible policyholder may be able to seek actual damages, reasonable attorney fees, and litigation costs when the legal requirements are met. A court may also increase the damages award, subject to the statute’s limits, in qualifying cases.

IFCA has specific procedural requirements. For example, a policyholder seeking to bring an IFCA lawsuit generally must provide written notice to the insurer and the Washington State Office of the Insurance Commissioner at least 20 days before filing suit. The applicable notice requirements and timing should be reviewed carefully.

Not every insurance dispute qualifies for an IFCA claim, and enhanced damages are not automatic. An attorney can assess whether the statute applies to your policy and circumstances.

What Compensation May Be Available if You Sue Your Insurer?

The potential recovery depends on the type of claim, the policy, the insurer’s conduct, and the losses caused.

Depending on the legal basis and evidence, a successful claim may involve:

• Unpaid policy benefits: Benefits owed under the insurance contract.
• Other actual damages: Losses caused by the insurer’s actionable conduct, where recoverable under applicable law.
• Attorney fees and litigation costs: These may be available under certain legal claims, including qualifying claims under IFCA.
• Enhanced damages: In qualifying IFCA cases, a court may increase the actual damages award within the limits established by statute.

Additional damages are not available in every case. For example, punitive damages are generally not awarded simply because an insurer acted in bad faith under Washington law. The type of claim and the applicable legal authority determine which remedies may be available.

An attorney can review your losses and explain which remedies may apply to your situation.

What Should You Do if Your Insurance Company Denies Your Claim?

If your insurer denies or delays payment after an injury, taking organized steps can help you understand the dispute and protect important documentation.

1. Review the Denial Letter

Read the insurer’s explanation carefully. Identify the policy provisions cited, the reasons given for the decision, and any missing information the company says it needs.

If the explanation is unclear, ask the insurer to identify the relevant policy language and explain the basis for its decision in writing.

2. Review Your Insurance Policy

Check the declarations page, coverage provisions, exclusions, limits, deductibles, and claim reporting requirements. If you are unsure how a provision applies, consider seeking help interpreting the policy.

3. Gather Supporting Documentation

Keep copies of relevant records, which may include:

• Your insurance policy and declarations page.
• The insurer’s denial or reservation-of-rights letter.
• Accident and police reports.
• Medical records and bills.
• Repair estimates and other expense documentation.
• Copies of claim forms and submitted evidence.
• Emails, letters, and notes from conversations with the insurer.

Organizing these records can help clarify what the insurer considered and whether additional evidence may be needed.

4. Consider Filing a Complaint

The Washington State Office of the Insurance Commissioner accepts complaints from consumers who believe an insurer has handled a claim unfairly or violated applicable requirements.

A complaint may prompt the agency to seek a response from the insurer, but the process does not replace a lawsuit or provide legal representation. It also may not resolve every coverage dispute.

Visit the Washington State Office of the Insurance Commissioner to learn more about the complaint process.

5. Speak With an Insurance or Personal Injury Attorney

An attorney can review your policy, the insurer’s decision, the available evidence, and any deadlines that may apply. Depending on the situation, the next step may involve providing additional information, challenging a denial, negotiating with the insurer, or pursuing legal action.

Do not assume that filing a complaint or continuing to communicate with the insurer automatically extends a legal deadline.

How Can a Lawyer Help With an Insurance Dispute?

Taking legal action against your own insurer can feel overwhelming, particularly when you are already dealing with injuries and financial pressure.

An attorney may help by:

• Reviewing your policy and identifying relevant coverage provisions.
• Evaluating the insurer’s stated reasons for denying or delaying payment.
• Gathering medical records, accident reports, and other supporting evidence.
• Communicating with the insurer about the dispute.
• Assessing potential claims for breach of contract, bad faith, or statutory violations.
• Explaining procedural requirements and filing deadlines.
• Pursuing negotiation or litigation when appropriate.

The appropriate strategy depends on the coverage involved and the facts of the dispute. A lawyer can explain the available options without guaranteeing a particular outcome.

Insurance Disputes After Car, Motorcycle, and Other Accidents

Insurance disputes can arise in many types of personal injury cases. A policyholder may have difficulty obtaining benefits after a collision even when they have maintained coverage.

Examples include:

• Car accidents involving uninsured drivers: A policyholder may need to pursue benefits under uninsured motorist coverage.
• Underinsured driver accidents: Available coverage may depend on the applicable policy limits and the amount of the losses.
• Motorcycle accidents: Coverage disputes may involve medical benefits, vehicle damage, or uninsured and underinsured motorist protection.
• Wrongful death claims: Eligible parties may face disputes involving insurance coverage for a fatal accident.
• PIP benefit disputes: An insurer may question whether certain treatment or expenses qualify under the policy.

RHHK represents injured people in a range of personal injury matters. Learn more about our vehicle accident representation and uninsured and underinsured motorist claims.

Contact RHHK About an Insurance Dispute

When your own insurance company will not pay a claim, it can be difficult to know whether the decision is justified or whether you have grounds to challenge it.

Rush, Hannula, Harkins & Kyler PLLC (RHHK) helps injured people throughout Washington understand their legal options after accidents and insurance disputes. Our team can review the circumstances, discuss potential claims, and help you determine what steps may be appropriate.

Call RHHK at 253-383-5388 to request a consultation.

You can also contact our office online to get started.

This article is for informational purposes only and is not legal advice. Insurance coverage, legal remedies, and filing deadlines depend on the policy, the facts, and applicable law. Reading this article or contacting the firm does not automatically establish an attorney-client relationship.

Frequently Asked Questions About Suing Your Own Insurance Company

Can I sue my own insurance company for denying my claim?

Potentially. If your insurer breached the policy or handled your claim in a way that violates applicable law, you may have grounds for legal action. A denial alone does not establish wrongdoing. The policy terms, evidence, and insurer’s conduct must be evaluated.

What is insurance bad faith?

Insurance bad faith generally involves unreasonable conduct by an insurer in handling a claim or fulfilling its obligations to a policyholder. Whether a specific action qualifies depends on the facts and applicable law.

Can I sue my insurer for delaying payment?

You may have legal options if the delay is unreasonable and violates the insurer’s obligations. However, some delays may be justified by legitimate investigation or documentation needs. The circumstances determine whether a legal claim is available.

Can I recover attorney fees if I sue my insurance company?

Attorney fees may be recoverable under certain legal claims, including qualifying claims under Washington’s Insurance Fair Conduct Act. The availability of fees depends on the statute, the claim, and the outcome.

Can I receive punitive damages for insurance bad faith in Washington?

Punitive damages are generally not available simply because an insurer acted in bad faith. Other remedies, including actual damages, attorney fees, and potentially enhanced damages under IFCA, may be available when the legal requirements are met.

Should I file a complaint with the Washington State Office of the Insurance Commissioner?

A complaint may be appropriate if you believe your insurer has treated your claim unfairly or violated insurance requirements. The Office of the Insurance Commissioner can seek a response from the insurer and review issues within its authority, but it does not act as your personal attorney.

How long do I have to sue my insurance company?

The applicable deadline depends on the type of claim, policy language, and legal basis for the lawsuit. Some insurance disputes have specific limitation periods or procedural requirements. Consult an attorney promptly rather than relying on a general deadline.