In California, you can hold an insurer accountable when it denies, delays, or underpays a claim without a reasonable basis. At Kantor & Kantor, our Fresno bad faith attorneys help policyholders across the state challenge unfair claim decisions and understand what their coverage actually promised. We have focused on insurance and ERISA law for decades, so we know what is at stake when a claim goes wrong.
Insurance disputes are rarely straightforward, and we are people helping people. We start by listening to your story, then explain how we may be able to help.
Call our team at 818-886-2525 to talk through your claim and learn your options.
What Counts as Insurance Bad Faith in California?
Insurance bad faith involves an insurance company’s failure to handle a claim in a reasonable manner or to meet its obligations under California law. California requires insurers to treat policyholders fairly during the claims process, and certain actions may raise concerns about whether a claim was properly reviewed.
California Insurance Code § 790.03(h), part of the state’s Unfair Insurance Practices Act, identifies certain unfair claims settlement practices. These include the following:
- Misrepresenting policy terms
- Failing to do a reasonable investigation
- Refusing to pay claims without a reasonable basis
- Using altered applications without the insured’s knowledge
- Failing to disclose coverage under which payment is made
- Appealing arbitration awards to force lower settlements
- Failing to settle claims promptly to influence other portions of a claim
- Advising claimants against hiring an attorney
California courts have also recognized an implied covenant of “good faith and fair dealing” in insurance contracts. In simple terms, this means an insurance company must consider the interests of its policyholder while evaluating a claim, rather than focusing only on its own position.
However, not every insurance dispute involves bad faith. Insurance companies may have legitimate disagreements about coverage, policy interpretation, or the information available when a claim decision is made. The key questions often involve how the claim was investigated, how the policy was interpreted, and whether the decision-making process was reasonable.
At Kantor & Kantor, we help Fresno and Central Valley policyholders understand the details behind insurance claim decisions. We review the available information, explain how California insurance laws may apply, and help clients understand whether their concerns may involve an insurance bad faith issue.
Common Situations Our Fresno Bad Faith Attorneys See
The most common bad-faith situations we handle are wrongful denials, unreasonable payment delays, lowball settlement offers, and post-claim policy rescissions. Each one turns on whether the insurer’s handling of the claim was reasonable. Below is what each looks like:
Wrongful Denial of a Valid Claim
Sometimes an insurer points to a technicality, a policy exclusion, or a difference of medical or professional opinion as a reason to deny a claim outright. A denial letter can sound final, but the reasoning behind it does not always hold up once it is reviewed closely.
Unreasonable Delay in Payment
Insurance policies generally require insurers to investigate and pay valid claims within a reasonable time. When a company drags out the process by requesting duplicate documentation or repeatedly reopening the investigation without new information, the delay itself can support a bad faith claim, particularly when the policyholder is relying on the payment to cover medical bills, repairs, or lost income.
Lowball Settlement Offers
An insurer may acknowledge that a claim has some validity while offering far less than the loss is actually worth. California law prohibits insurers from offering substantially less than a reasonable person would believe they are entitled to under the policy.
Policy Rescission After a Claim Is Filed
In some cases, an insurer looks back at the original application after a claim is filed and argues that an error or omission voids the policy entirely. This practice, sometimes called post-claim underwriting, is closely scrutinized under California law, and our attorneys can help determine whether the rescission was legitimate or used as a pretext to avoid payment.
Do You Have to Prove the Insurer Acted on Purpose?
You do not always need to prove that an insurance company acted intentionally to raise concerns about how a claim was handled. The legal standards involved depend on the type of claim, the insurance policy, and whether the matter is evaluated under California law or a federal framework such as ERISA.
Under California law, insurance bad faith generally focuses on whether an insurer’s actions were reasonable under the circumstances. A disagreement about coverage or the value of a claim does not automatically mean bad faith occurred. Instead, the evaluation often considers the insurer’s investigation, the information available, and the basis for the decision.
The legal analysis can be different when an insurance plan is governed by ERISA, a federal law that applies to many employer-sponsored benefit plans. ERISA creates specific rules for reviewing certain disability, life insurance, and retirement benefit claims.
At Kantor & Kantor, we can help you understand which legal framework may apply to your insurance claim and what factors may affect your situation. Our Fresno bad faith attorneys can assess the details of each matter carefully and explain complicated insurance issues in clear terms.
How Kantor & Kantor Approaches Your Case
Every insurance claim we receive begins with a story, and we start by listening. We want to understand what happened, what information you received from your insurance company, and how the claim decision has affected you or your family. This conversation helps us understand the details that may shape our review of your situation.
Here is the process we use to manage your claim:
Step One: Understanding Your Insurance Claim
The first step is learning about your policy, your claim history, and the events that led to the dispute. Insurance matters can involve important details that are not always clear from a denial letter alone.
We take time to understand your concerns and answer questions about the process. Whether your claim involves homeowners insurance, disability insurance, life insurance, long-term care insurance, or another type of coverage, we focus on understanding the circumstances before discussing possible next steps.
Step Two: Reviewing the Policy and Claim File
After learning about your situation, we examine the available records connected to your claim. This may include the insurance policy, denial letters, communications with the insurer, claim documents, investigation materials, and other information related to the decision.
A complete assessment can help clarify how the insurance company evaluated the claim and what information was considered. We examine the policy language and applicable California insurance laws to better understand the issues involved.
Step Three: Evaluating the Applicable Insurance Rules
Insurance disputes can involve different legal standards depending on the type of coverage and the circumstances of the claim. Our attorneys consider whether California insurance law, ERISA, or another legal framework applies to the matter.
Understanding the applicable rules helps explain what factors may affect the claim. We focus on providing a clear explanation of the process and helping clients understand the issues that may be important in their situation.
Step Four: Discussing Options and Moving Forward
Once we have reviewed the available information, we discuss what we have learned and explain the potential paths forward. Every claim is different, so we take the time to consider each client’s goals and concerns.
If representation is appropriate, we advocate for policyholders through negotiations, litigation, or other legal processes when needed. Our attorneys have represented clients throughout Fresno and the Central Valley, as well as policyholders nationwide, in insurance claim disputes. Our goal is to provide thoughtful guidance while helping you better manage your insurance claim.
Why Trust Kantor & Kantor With Your Fresno Bad Faith Claim?
Kantor & Kantor has focused on insurance and ERISA law for decades, helping policyholders understand complex claim disputes and the legal issues that may affect their coverage. Our attorneys handle matters involving disability insurance, life insurance, long-term care insurance, homeowner’s insurance, and other insurance-related claims.
Insurance disputes often depend on the details. A policy provision, claim record, or communication with an insurer can influence how a matter is evaluated. Our experience reviewing these details helps us provide clients with a clearer understanding of their claims and the legal issues involved.
We Understand Insurance From Multiple Perspectives
One advantage Kantor & Kantor brings to insurance disputes is our understanding of how insurers approach claims. Some of our attorneys have experience working with insurance companies, giving us insight into claim assessment processes, policy interpretation, and the considerations that may influence an insurer’s position.
This perspective helps us evaluate insurance matters from multiple angles while representing policyholders. We understand that behind every claim file is a person, family, or business seeking answers about coverage they expected to have available.
We Represent Policyholders Against Major Insurance Companies
No insurer is too large for Kantor & Kantor to challenge through negotiations or litigation when appropriate. Our attorneys have litigated insurance matters involving major insurance companies and handled complex coverage disputes on behalf of policyholders. Our focus on insurance law helps us anticipate the challenges that arise when policyholders disagree with a claim decision.
A Focused Approach To Insurance Claims
Unlike firms that handle many unrelated areas of law, Kantor & Kantor focuses on insurance and ERISA matters. Our work includes denied disability claims, life insurance disputes, long-term care coverage issues, retirement benefit matters, and insurance bad faith concerns.
We take time to listen to each client’s experience, evaluate the available information, and explain complicated insurance issues in clear language. We are people helping people, and that commitment guides how we work with individuals and families throughout California and nationwide.
A Contingency Fee Approach
In many cases, our clients do not have to pay attorney’s fees unless there is a recovery. This makes it possible to access quality legal representation without worrying about upfront costs. Call our Fresno bad faith attorneys at 818-886-2525 for a free consultation to discuss how fees would apply in your case.
FAQs: Fresno Bad Faith Claims
The answers below offer general information on the bad faith issues Fresno policyholders ask us about most.
What should I do if I think my insurer is acting in bad faith?
Keep copies of your policy, claim correspondence, denial letters, and any related documents, since they preserve information that matters later. Speaking with an attorney can also help you understand the issues and whether your concerns point to a coverage dispute or a potential bad-faith matter.
What is the difference between a coverage dispute and insurance bad faith?
A coverage dispute is a disagreement over whether a policy applies to a particular loss, and insurers are allowed to have a genuine, reasonable disagreement about coverage. Insurance bad faith goes further and involves unreasonable conduct in how the claim was investigated, evaluated, or handled, regardless of the ultimate coverage question.
Can I still bring a bad-faith claim if my insurer already paid part of my claim?
A partial payment does not automatically resolve every issue related to an insurance claim. Whether additional concerns exist depends on factors such as the policy language, the reason for the remaining dispute, and how the insurer handled the claim review process. We can evaluate your claim file to help you understand whether this applies to your situation.
Does filing a complaint with the California Department of Insurance replace hiring an attorney?
A complaint with the California Department of Insurance and working with an attorney serve different purposes. The Department of Insurance can evaluate certain consumer complaints about insurance practices, while an attorney can help evaluate the legal issues connected to an individual insurance dispute. In most cases, an attorney can help pursue remedies that a regulatory complaint alone may not provide.
How long do I have to file a bad faith claim in California?
It depends on the type of claim. A tort-based bad faith claim generally has a two-year deadline under California Code of Civil Procedure § 339(1), while a breach of contract claim generally has a four-year deadline under § 337(1). An attorney can confirm which limit applies to your case.
What can I recover in a successful Fresno bad faith case?
It depends on the facts and the law that applies. Potential damages may include unpaid policy benefits, interest, financial losses caused by the claim handling, emotional distress, attorney’s fees in some circumstances, and punitive damages when the legal standard is met. We can review your case and explain which of these categories may apply.
Contact Our Fresno Bad Faith Attorneys
Facing a denied, delayed, or underpaid insurance claim can leave you feeling like the odds are stacked against you. This is especially true when you are already dealing with a medical issue, property loss, or other hardship. At Kantor & Kantor, we represent policyholders in Fresno, the Central Valley, and throughout the country in insurance disputes.
When an insurance company has not treated your claim fairly, we are ready to provide thoughtful guidance through a complicated situation.
Call us today at 818-886-2525 for a free bad-faith case evaluation.
Attorney Glenn R. Kantor
Glenn Kantor is a founding partner of Kantor & Kantor LLP. As a young attorney, Glenn saw the injustice of wrongful insurance denials and created a law firm to represent individuals seeking to obtain their rightful benefits. Glenn is committed to ensure that clients receive the benefits they are entitled to under their insurance policies or group health plans. [Attorney Bio]
