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Posted in Uncategorized on August 26, 2020   |  by Gary Burger

Vexatious Refusal by Insurance Companies

Vexatious Refusal

Vexatious refusal in Missouri are penalties against the injured person's insurance company and is thus different than bad faith.

Vexatious means "without reasonable or probable cause or excuse."

Elements of a claim for vexatious refusal to pay:

  1. Issuance of an insurance policy within the scope of §§ 375.296 and 375.420 to a plaintiff who is a Missouri resident or Missouri corporation;
  2. The plaintiff sustains a loss and makes a first-party claim under the plaintiff's insurance policy against the defendant insurance carrier;
  3. The claim is wrongly denied;
  4. The defendant's refusal to pay the loss was willful and without reasonable cause or excuse;
  5. The plaintiff is entitled to damages for breach of the insurance contract, and penalties and fees are warranted due to the insurer's vexatious and recalcitrant claim handling, as established in V.A.M.S. § 375.420.

See V.A.M.S. §§ 375.296, 375.420; Progressive Preferred Ins. Co. v. Reece, 498 S.W.3d 498 (Mo. Ct. App. W.D. 2016); Vantage Credit Union v. Chisholm, 447 S.W.3d 740 (Mo.Ct. App. E.D. 2014).

Common Grounds for an Action for Vexatious Refusal to Pay

  • Refusal to pay the claim without a valid reason. Russell v. Farmers & Merchants. Ins. Co., 834 S.W.2d 209 (Mo. Ct. App. S.D. 1992).
  • Inadequate investigation and refusal to explain its denial of coverage. Allen v. State Farm Mut. Auto. Ins. Co., 753 S.W.2d 616 (Mo. Ct. App. E.D. 1988);
  • Claim denied without explanation. Hensley v. Shelter Mut. Ins. Co., 210 S.W.3d 455, 467 (Mo. Ct. App. S.D. 2007); Hounihan v. Farm Bureau Mut. Ins. Co. of Missouri, 523 S.W.2d 173 (Mo. Ct. App. 1975)
  • 18-month delay in paying life insurance policy proceeds when the company knew of the beneficiaries and their residences. Victor v. Manhattan Life Ins. Co., 772 S.W.2d 826 (Mo. Ct. App. E.D. 1989).
  • Inadequate investigation of the claim; Watters v. Travel Guard Intern., 136 S.W.3d 100, 110 (Mo. Ct. App. E.D. 2004);
  • Bad or BS explanation of the insurance company's denial of a claim and improper delay in payment. DeWitt v. American Family Mut. Ins. Co., 667 S.W.2d 700 (Mo. 1984).
  • So what damages do you get for Vexatious?

    Under § 375.420 20% of the first $1,500 of the loss and 10% of the loss in excess of $1,500 together with reasonable attorney's fees, in addition to the amount of recovery owing under the policy.

    Attorney fees can be assessed in a vexatious refusal to pay case even if the jury does not assess any penalty damages under the statute. DeWitt.

    It is kind of funny that courts say the trial court is an expert on the value of legal services - however, a jury is not. See Howard Const. Co. v. Teddy Woods Const. Co., 817 S.W.2d 556 (Mo. Ct. App. W.D. 1991).

    What if they pay the day before trial?

    Answer: The fact that the insurance company pays, paid, or eventually pays all or part of the amount owing under the policy does not eliminate a claim under § 375.420.

    The Supreme Court in Dhyne, in response to such an argument, stated:

    Adopting State Farm's argument would permit an insurance company to refuse payment and avoid liability under section 375.420 by simply paying prior to trial. Such an interpretation would, from a practical standpoint, eliminate section 375.420.

    If you have questions regarding insurance companies and vexatious refusal, call us at (314) 500-HURT.