Common Insurance Company Tactics That Undermine Valid Claims

Intro

Most policyholders assume that once a claim is submitted, the insurer’s role is to evaluate it fairly and pay what the policy requires. In practice, many claims are met with strategies that quietly erode value long before any formal denial occurs. These tactics are often subtle, procedurally justified on their face, and difficult for insureds to recognize in real time. Presidio Law Firm LLP represents policyholders in disputes where claim-handling practices systematically undermine valid claims rather than resolve them.

Endless Requests for “Additional Information”

One of the most common tactics is the repeated request for documentation that has already been provided or that has little relevance to the disputed issue. Each request appears reasonable in isolation, but collectively they delay resolution and exhaust policyholder resources.

This approach shifts the burden of delay onto the insured while preserving the appearance of diligence on the insurer’s part.

Fragmenting the Claim Into Smaller Disputes

Insurers may acknowledge portions of a claim while carving out others for separate review. Coverage may be “pending” indefinitely for certain categories of loss, even when the underlying facts are not in dispute.

Fragmentation can reduce leverage, delay full payment, and create pressure to settle portions of the claim at a discount simply to move forward.

Reframing Facts to Fit Denial Language

Claim files are narratives as much as records. Adjusters may describe events in ways that subtly support exclusionary language or minimize covered loss. Facts are not necessarily falsified, but they may be selectively emphasized or characterized.

This framing can later be cited as justification for denial, even when alternative interpretations were equally or more consistent with the evidence.

Changing Adjusters or Supervisors Midstream

Policyholders often experience sudden changes in claim personnel after disputes arise. New adjusters may revisit settled issues, reinterpret prior communications, or require information that was previously deemed sufficient.

This reset effect can erase momentum and force insureds to relitigate their own claims internally.

Using “Independent” Experts Strategically

Insurers frequently retain experts to evaluate loss, causation, or value. While expert input can be appropriate, problems arise when opinions are sought to justify predetermined outcomes rather than objectively assess facts.

Experts may be given limited information, constrained scopes, or assumptions that tilt conclusions toward denial or undervaluation.

Low Initial Valuations as Anchors

Early offers often serve as psychological anchors rather than fair assessments. By starting low, insurers may normalize underpayment and shift negotiations toward compromise rather than policy compliance.

Over time, the focus becomes whether the insured can negotiate upward, rather than whether the original valuation reflected the loss.

Invoking Ambiguity Without Resolving It

Insurers may cite ambiguity in policy language or factual uncertainty without taking steps to resolve it. Claims remain open but unpaid, caught in a holding pattern that benefits the insurer.

Ambiguity alone does not excuse nonpayment. When uncertainty exists, insurers have an obligation to investigate and decide reasonably.

Relying on Policyholder Fatigue

Many tactics ultimately rely on attrition. Financial pressure, time, and emotional exhaustion can lead insureds to accept less than what is owed simply to conclude the process.

Fatigue is not an accident. It is often an anticipated outcome of prolonged, uneven engagement.

Why These Tactics Are Difficult to Recognize

Each tactic appears defensible when viewed in isolation. It is only when patterns emerge that their cumulative effect becomes clear. Policyholders experiencing loss rarely have the distance or context to see the strategy unfolding.

This is why claims that “just feel off” often deserve closer examination.

How Courts View Claim-Handling Tactics

Bad faith analysis examines whether insurer conduct was reasonable under the circumstances. Courts look at patterns, timelines, internal communications, and whether decisions were supported by the information available at the time.

The focus is not whether the insurer was perfect, but whether it acted fairly and in good faith.

Why Early Review Can Matter

Once tactics take hold, reversing their impact becomes harder. Early evaluation allows insureds to understand whether delays, denials, or valuations reflect legitimate dispute or strategic conduct.

Intervening before positions harden can preserve options that quietly disappear over time.

Closing

Insurance claims should be resolved through fair evaluation, not attrition or strategic delay. When claim-handling practices systematically undermine valid claims, accountability may be warranted. Presidio Law Firm LLP works with policyholders to identify when insurer tactics cross the line and to pursue remedies that reflect the coverage purchased. Recognizing these practices early can help restore balance in an uneven process.