CACI No. 2337

In determining whether [name of defendant] acted unreasonably, that is,

without proper cause, you may consider whether the defendant did any

of the following:

[(a) Misrepresented to [name of plaintiff] relevant facts or

insurance policy provisions relating to any coverage at issue.]

[(b) Failed to acknowledge and act reasonably promptly after

receiving communications about [name of plaintiff]’s claim arising

under the insurance policy.]

[(c) Failed to adopt and implement reasonable standards for the

prompt investigation and processing of claims arising under its

insurance policies.]

[(d) Failed to accept or deny coverage of claims within a

reasonable time after [name of plaintiff] completed and submitted

proof-of-loss requirements.]

[(e) Did not attempt in good faith to reach a prompt, fair, and

equitable settlement of [name of plaintiff]’s claim after liability

had become reasonably clear.]

[(f) Required [name of plaintiff] to file a lawsuit to recover

amounts due under the policy by offering substantially less than

the amount that [he/she/ nonbinary pronoun /it] ultimately recovered

in the lawsuit, even though [name of plaintiff] had made a claim

for an amount reasonably close to the amount ultimately

recovered.]

[(g) Attempted to settle [name of plaintiff]’s claim for less than the

amount to which a reasonable person would have believed [name

of plaintiff] was entitled by referring to written or printed

advertising material accompanying or made part of the

application.]

[(h) Attempted to settle the claim on the basis of an application

that was altered without notice to, or knowledge or consent of,

[name of plaintiff], [his/her/ nonbinary pronoun /its] representative,

agent, or broker.]

[(i) Failed, after payment of a claim, to inform [name of plaintiff]

at [his/her/ nonbinary pronoun /its] request, of the coverage under

which payment was made.]

[(j) Informed [name of plaintiff] of its practice of appealing from

arbitration awards in favor of insureds or claimants for the

purpose of forcing them to accept settlements or compromises less

than the amount awarded in arbitration.]

[(k) Delayed the investigation or payment of the claim by

requiring [name of plaintiff], [or [his/her/ nonbinary pronoun]

physician], to submit a preliminary claim report, and then also

required the submission of formal proof-of-loss forms, both of

which contained substantially the same information.]

[(l) Failed to settle a claim against [name of plaintiff] promptly

once [his/her/ nonbinary pronoun /its] liability had become apparent,

under one portion of the insurance policy coverage in order to

influence settlements under other portions of the insurance policy

coverage.]

[(m) Failed to promptly provide a reasonable explanation of its

reasons for denying the claim or offering a compromise

settlement, based on the provisions of the insurance policy in

relation to the facts or applicable law.]

[(n) Directly advised [name of plaintiff] not to hire an attorney.]

[(o) Misled [name of plaintiff] as to the applicable statute of

limitations, that is, the date by which an action against [name of

defendant] on the claim had to be filed.]

[(p) Delayed the payment or provision of hospital, medical, or

surgical benefits for services provided with respect to acquired

immune deficiency syndrome (AIDS) or AIDS-related complex for

more than 60 days after it had received [name of plaintiff]’s claim

for those benefits, doing so in order to investigate whether [name

of plaintiff] had the condition before obtaining the insurance

coverage. However, the 60-day period does not include any time

during which [name of defendant] was waiting for a response for

relevant medical information from a healthcare provider.]

The presence or absence of any of these factors alone is not enough to

determine whether [name of defendant]’s conduct was or was not

unreasonable, that is, without proper cause. Y ou must consider [name of

defendant]’s conduct as a whole in making this determination.

New April 2008; Revised December 2015, May 2020