This form for use in litigation against an insurance company for bad faith breach of contract. Adapt this model form to fit your needs and specific law. Not recommended for use by non-attorney.
A North Carolina Complaint for Failure of Insurer to Pay Benefits — Jury Trial Demand is a legal document filed by individuals or entities who have been denied benefits by their insurance company. This complaint holds the insurer accountable for their failure to fulfill their contractual obligations in providing the benefits they promised. Here is a brief overview of the key elements and types of North Carolina Complaints for Failure of Insurer to Pay Benefits — Jury Trial Demand: 1. Purpose: This complaint is a means for the claimant to seek resolution and compensation for the unpaid benefits by taking the insurer to court. It asserts that the insurer has violated their duty to act in good faith and deal fairly with the policyholder. 2. Identification: The complaint typically begins by identifying the parties involved, including the claimant (plaintiff) and the insurance company (defendant). It outlines the policy details, dates, and relevant information pertaining to the denied benefits. 3. Allegations: The complaint enumerates the specific acts or omissions of the insurer that constitute a failure to pay benefits. These may include unjust denial, unreasonable delay, denying coverage for wrongful reasons, or breach of contract. 4. Legal Grounds: Claimants must provide legal reasoning to support their claim, such as violation of the North Carolina Insurance Code, breach of contract, or acting in bad faith. They may refer to specific provisions of the insurance policy. 5. Demands: The complaint states the relief sought by the claimant, typically including the payment of the owed benefits, statutory damages, attorney fees, and any other appropriate relief. Additionally, it may demand a trial by jury to resolve the dispute. Types of North Carolina Complaints for Failure of Insurer to Pay Benefits — Jury Trial Demand: 1. Health Insurance: This complaint is used when a health insurance provider denies or delays the payment of medical expenses or denies coverage for necessary treatments. 2. Auto Insurance: This type of complaint is filed when an auto insurer denies claims for property damage, medical expenses, or uninsured/under insured motorist benefits after an accident. 3. Homeowners Insurance: Claimants may file this complaint when their homeowners' insurance company denies or fails to pay for property damage caused by covered events like fire, theft, or natural disasters. 4. Life Insurance: In the case of a life insurer denying death benefits to the beneficiaries stated in the policy, a complaint can be filed to demand payment. 5. Disability Insurance: This complaint is relevant to situations where a disability insurance provider refuses to pay policyholders the benefits they are entitled to due to illness or disability preventing them from working. Through a North Carolina Complaint for Failure of Insurer to Pay Benefits — Jury Trial Demand, claimants can seek justice and obtain the benefits they deserve but have been wrongfully denied by their insurer.
