Insurance Claims & Bad Faith Expert Witness

Insurance claims and bad faith expert witnesses evaluate whether an insurer handled a claim in line with industry claims handling standards, the policy language, and the duty of good faith and fair dealing it owes to its insured. They review the claim file, adjuster notes, reserve history, coverage correspondence, internal guidelines, and settlement communications to determine whether the insurer investigated fairly, evaluated the claim reasonably, and paid or defended it in a timely way.

Cases commonly involving insurance experts include an insurer’s failure to accept a reasonable settlement offer within policy limits, which can expose the company to the full excess verdict, along with wrongful denials, unreasonable delays, lowball offers, and disputes over uninsured and underinsured motorist benefits. Bad faith claims often follow a personal injury case, when a verdict exceeds the policy limits and the question becomes whether the insurer should have settled earlier.

Bad faith analysis depends on the type of claim. In third-party cases, the focus is usually on how the insurer responded to a time-limited demand: whether it evaluated liability and damages promptly, communicated with its insured about the risk of an excess judgment, and gave the insured’s interests at least equal weight to its own. In first-party cases, where the insured is claiming benefits directly, the focus shifts to the thoroughness of the investigation, the basis for any denial, and whether the insurer looked for reasons to pay or reasons to deny.

Most states have adopted some version of the Unfair Claims Settlement Practices Act, which sets baseline expectations for prompt communication, reasonable investigation, and fair settlement offers. An insurer’s own claims manuals and best practices are often just as important, since a gap between what the company required of its adjusters and what actually happened in the file can be powerful evidence. Reserve changes and supervisor notes frequently show how the insurer valued the claim internally compared to what it offered.

The strongest insurance experts typically have years of hands-on claims experience, often including supervisory or claims management roles at a major carrier. Designations such as the Chartered Property Casualty Underwriter or the Associate in Claims add credibility. Attorneys should match the expert’s background to the line of insurance at issue, since auto liability, property, and disability claims are handled under very different practices and regulations.