What Happens When an Insurance Dispute Goes to Court?

Insurance companies have developed numerous ways to delay, deny, and undervalue claims, almost turning disappointment into an art form. We understand that they want to make money—everyone does—and it is clear that when they don’t pay claims, insurance companies have more money to keep. However, insurance companies have contractual obligations to their policyholders, and when they fail to fulfill these obligations, the law provides remedies.

Sometimes, receiving a notice that a lawyer is working on a dispute is enough to “remind” an insurance company of the need to live up to their obligations. At other times, companies persist in delaying, denying, or undervaluing claims. When negotiation fails to persuade the company to see reason, it’s time to turn to the law for enforcement.

What happens when you file a lawsuit against an insurance company? The answer often surprises people. Every case proceeds somewhat differently, of course, but here are some components of insurance litigation and how your attorney can use various opportunities to succeed in getting the insurance company to honor obligations.

Most Action in a Lawsuit Occurs Out of Court

We’ve seen numerous TV shows and movies depicting dramatic questioning in courtrooms, so when we think of a lawsuit, we picture attorneys arguing in front of a judge. But in reality, most of the work in a lawsuit occurs long before the trial date. In fact, the work done in preparation for trial is usually what wins a case. This is true whether the insurance dispute involves an individual claim based on policies such as disability insurance or homeowner’s insurance, or a commercial claim based on an issue such as corporate director liability.

The Start of a Lawsuit

When an insurance company fails to act as it should and the legal team working on behalf of the claimant determines that it is time to file a lawsuit, the claimant’s attorneys will prepare legal documents that explain the goal of the lawsuit and all of the arguments that support the claimant’s position. Taking the time to prepare these documents thoroughly and adequately enables the legal team to make a persuasive impression on the judge. The team initiating the lawsuit takes the offensive, and creating a solid drive that scores points will set the tone for the entire case. It is essential to work with an attorney who understands the dynamics of litigation and how to establish a strong foundation for a winning case from the outset.

After the claimant’s team files legal pleadings and serves the documents on the insurance company, the company’s legal team will prepare and file its response with the court. These litigation professionals specialize in insurance defense, focusing full-time on effectively fighting claims. At Ver Ploeg and Marino, we have extensive experience working in-house for insurance companies, so we know how they operate. This enables us to anticipate and counter their tactics.   

The Discovery Process

Once the case is officially underway, both sides engage in an informational sparring process known as the discovery phase. Legal teams for both sides will use a number of different tools to gain information from each other. These tools include:

• Interrogatories – written questions with written responses
• Requests for production of documents – written requests to supply particular documents
• Requests for admissions – written requests for the other side to agree on particular issues so that these issues do not need to be addressed in court
• Depositions – questions posed and answered orally in a special session under oath

Knowing how to make the most of opportunities during the discovery process enables a legal team to gather valuable evidence that can be leveraged to make critical points in the lawsuit. When your attorney understands the tactical use of discovery tools, you can gain an important advantage in your case. 

Negotiations Will Continue

Throughout the discovery process, which can take months or even years, both sides often will continue to negotiate to potentially settle the case. When parties can reach a resolution before actually appearing in court, it saves time for the claimant and money for the insurance company. Once the insurance company sees that a claimant has the evidence and arguments that will enable them to succeed in front of the judge, they often agree to the demands to put an end to the case. Since the claimant’s team has already completed most of their work by this point, they can confidently proceed to trial if the insurance company does not offer an appropriate settlement.

Appearances in Court

During pre-trial proceedings, either party may file motions with the court, requesting the judge to rule on a specific aspect of the case. The court may hold hearings on these motions. In a sense, they split the trial into separate hearings that addressed specific aspects of the case.

Additionally, during the discovery process, the insurance company may take a deposition of the claimant, which is similar to testifying in court. The claimant will be asked questions that can be used in court, and answers will be under oath. So it is just as important to be prepared and understand how to answer questions in a deposition as it is to understand how to testify during the trial itself.

If the parties do not settle before the time of trial, which is unusual, the trial proceedings in court will begin with opening arguments from each side, starting with the claimant’s attorney. Then, each side will present its evidence, which may include witness testimony. The other side will have the opportunity to cross-examine witnesses. If your attorney expects you to be called as a witness, they should review anticipated questions and provide guidance on how to respond.

In most cases of this type, the case will be heard solely by a judge, rather than a judge and jury. If a jury is involved, the members will rule on the facts of the case, and the judge will explain how the law applies. At the end, either side will have the opportunity to file an appeal if they don’t like the outcome. However, they cannot appeal the findings of fact. They must allege that an error occurred in the application of the law to succeed with an appeal.

Experience Matters When it Comes to Insurance Litigation

As noted above, the legal teams working for the insurance companies focus solely on insurance defense and are prepared with arguments to defeat the claimant’s case at various stages of the legal process. To succeed, an insurance claimant needs to have an equally experienced team fighting on their side.

At Ver Ploeg & Marino, we understand the insurance defense playbook because we used to be on their side. Now we know how to overcome their tactics to obtain justice for insurance policyholders who have had their claims wrongfully delayed, denied, or undervalued.

To learn how we can assist with an insurance matter anywhere in the country, schedule a consultation with our team today by calling 305-577-3996 or contacting us online.

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