Insurance is a safety net that we anticipate will ease the burden in times of need. Unfortunately, the reality often falls short of these expectations.
When faced with tragedy, the last thing anyone wants is to engage in negotiations with an insurer regarding benefits that should have been provided under their policy. The ordeal can be overwhelming, with medical bills to contend with, families to support, and lives to piece back together. Our insurance attorneys in Sacramento understand that every insurance battle is more than just a legal matter – it is a personal journey laden with stress, frustration, and a longing for fairness. We understand the strategies employed by insurance companies and boast years of experience in handling claims related to bad faith (violations of the covenant of good faith and fair dealing.)
At Kantor & Kantor, we recognize that insurance-related challenges can be emotionally and financially draining. From the moment you reach out to us, you will experience the difference—a combination of legal acumen, compassionate representation, and unwavering dedication to achieving results. Your peace of mind is our priority, and we will work tirelessly to resolve your insurance matter efficiently and effectively. We are well-versed in long-term disability claims, life insurance claims, and long-term care claims.
We can be your steadfast partners, advocating fiercely for your rights and interests. Contact us at 818-886-2525 to schedule a consultation and take the first step toward a resolution.
We offer a free case evaluation to discuss how our attorneys can assist you. Contact us now at 818-886-2525 for a free consultation.
What Is Insurance Bad Faith?
Insurance bad faith occurs when an insurance company fails to uphold its contractual obligations to its policyholders unfairly or unreasonably. When individuals purchase insurance policies, they contract with the insurer, expecting fair treatment and timely resolution of claims. However, in some cases, insurance companies may act in bad faith, placing their interests above those of their policyholders.
Why Insurance Companies Deny Benefits
Operating as profit-driven entities, insurance companies are not inclined to easily pay benefits. Every payout to policyholders directly impacts their financial bottom line, reflecting the inherent nature of the insurance industry. Consequently, insurance providers meticulously scrutinize claims, actively seeking reasons to deny them. Disability insurance companies have a reputation for denying, delaying, or downgrading claims, often for seemingly minor reasons.
Moreover, for a claim to be successful, it necessitates comprehensive documentation, including detailed assessments of your diagnosis, treatment, prognosis, and limitations, all of which must align with the insurance company’s criteria. Given the complexity of these requirements, errors may occur, leading to claim denials. This bureaucratic hurdle becomes particularly exasperating for claimants already navigating medical appointments, hospitalizations, and the challenges of recovery.
Examples of Bad-Faith Insurance Practices
Under California law, instances of bad faith can manifest in various ways. If you sense that your insurance provider is handling your claim unfairly, it might indicate a situation of bad faith. Several common examples include:
1. Neglecting to Conduct a Thorough Investigation
When you pay for insurance coverage, you rightfully anticipate support from your insurer rather than evasion of responsibility. The insurance company must diligently investigate your claim. Failure to do so may constitute an act of bad faith.
2. Selectively Reviewing Medical Records for Long-Term Disability Claims
Many insurance companies selectively review medical records to emphasize and prioritize aspects of records that support a denial while ignoring aspects of records that support disability.
3. Violating California Insurance Laws
The California Department of Insurance establishes regulations that insurance companies must adhere to. Failing to comply with the California Fair Claims Settlement Practices Regulations, which outlines specific requirements for how insurance companies must handle a claim, can be considered an act of bad faith.
4. Rejecting a Legitimate Claim or Offering Inadequate Compensation
Without a reasonable justification or proper explanation, an insurance company cannot decline payment or offer less than the rightful amount. Such actions likely qualify as instances of bad faith.
5. Inordinate Delay in Processing Your Claim
Insurance companies are generally expected to accept or deny claims within 40 days. Unjustified delays can be the basis for a bad faith claim.
6. Failure to Communicate
Insurers have an obligation to communicate openly and honestly with policyholders regarding their claims. Failing to respond to communications, providing misleading information, or refusing to explain claim decisions can indicate bad faith.
For more information about your legal options and to determine if we can assist with your case, contact our Sacramento insurance attorneys at 818-886-2525.
Tactics Insurance Companies Use to Deny Claims
Insurance companies may employ various tactics to deny or minimize claims, often in an attempt to protect their financial interests. Some common tactics include:
- Policy Exclusions and Misinterpretation: Insurance policies often contain exclusions and limitations. Insurance companies may attempt to argue that a specific event or damage is not covered due to policy exclusions or by interpreting policy language in their favor. Insurers might argue that the damage or loss is a result of a pre-existing condition not covered by the policy. This tactic is often used to avoid paying claims related to health, property, or other types of insurance.
- Incomplete or Inaccurate Documentation Requirements: Insurers may request extensive documentation to support a claim. They may use strict documentation requirements as a tactic to deny claims if the policyholder fails to provide all requested information or makes minor errors in the documentation.
- Allegations of Fraud or Misrepresentation: Insurance companies may accuse policyholders of providing false information or committing fraud in an attempt to deny claims. These allegations can be serious and may require legal intervention.
- Selective Claim Investigation: Insurance companies may conduct selective or biased investigations to find reasons to deny a claim. They might focus on certain aspects of the claim while neglecting others that support the policyholder’s case. For example, in disability claims, insurers may focus on records that support denial while ignoring records that support disability.
- Rescission of Policies: In some cases, such as life insurance cases, insurers may attempt to cancel or rescind a policy based on alleged misrepresentations made by the policyholder during the application process. Rescinding based on an unfair interpretation of the application, if the death occurs within two years of policy activation, is bad faith dealing.
- Changing Reasons for Denial: Insurers may provide multiple or changing reasons for denying a claim, making it challenging for policyholders to address the issues raised and leading to confusion during appeals.
Damages for Insurance Bad Faith
The compensation awarded for instances of bad faith committed by insurance companies can vary based on the nature of the wrongdoing. Whether your claim was outright denied, unreasonably delayed, or only partially fulfilled will influence the type and amount of damages.
Your bad faith insurance claim has the potential to recover the following types of compensation:
- Contractual Losses: This category considers what the policyholder was rightfully entitled to and the monetary amounts denied by the insurer. In many instances, a judge may include interest as part of contractual damages.
- Extracontractual Losses: A denial of an insurance claim can result in additional financial burdens, such as emotional distress and attorney fees, which fall under the umbrella of extracontractual losses.
- Punitive Damages: Unlike other damages, punitive damages are not contingent on the losses the policyholder suffers. Instead, they are awarded as a form of punishment to deter wrongful behavior by the insurance company.
Why Choose Kantor & Kantor?
At Kantor & Kantor, we prioritize our clients’ needs and tirelessly advocate on their behalf. Here is why you should choose us for your insurance-related legal matters:
- Expertise: Our team is comprised of skilled Sacramento insurance lawyers with extensive experience handling various insurance claims and disputes. We possess in-depth knowledge of insurance laws and regulations, allowing us to devise effective strategies tailored to each client’s unique situation.
- Client-Centered Approach: We understand that insurance disputes can be stressful and overwhelming. That is why we adopt a client-centered approach, providing personalized attention and guidance every step of the way. We take the time to listen to our clients’ concerns, thoroughly evaluate their cases, and offer honest and pragmatic legal advice.
- Proven Track Record: We have successfully resolved numerous insurance cases over the years, securing favorable outcomes for our clients. Whether through negotiation, mediation, or litigation, we are committed to achieving the best possible results for those we represent.
- Comprehensive Services: We handle various insurance-related matters, from denied claims to bad faith practices. Our comprehensive services include policy review, claim assessment, negotiation with insurance companies, and representation in court proceedings, ensuring that our clients receive comprehensive legal support from start to finish.
- Reputation for Excellence: We have built a reputation for excellence within the legal community and among our clients. We are known for our integrity, professionalism, and dedication to achieving justice for those we serve.
How We Can Help With Your Case
Navigating insurance-related legal matters can be daunting, and we are here to guide you through every step of the process. Our Sacramento insurance attorneys are committed to providing comprehensive assistance tailored to your unique case. Here is how we can help:
Thorough Case Evaluation
We begin by comprehensively evaluating your case. This involves reviewing your insurance policy, assessing the facts and circumstances surrounding your claim, and identifying any potential legal issues or challenges.
Policy Interpretation and Analysis
Insurance policies can be complex documents, with legal jargon. We help demystify these policies, clearly interpreting and analyzing your coverage. Understanding the terms and conditions is crucial in determining the scope of your insurance rights, and we ensure that you are well-informed throughout the process.
Strategic Legal Representation
Armed with a deep understanding of insurance law and extensive experience in handling insurance cases, our attorneys develop strategic legal methodologies tailored to the specifics of your case. Whether through negotiation, mediation, or litigation, we are committed to pursuing your most favorable outcome.
Skilled Negotiation
Many insurance disputes can be resolved through negotiation outside of court. Our attorneys are skilled negotiators who know how to effectively communicate with insurance companies and leverage our clients’ positions to achieve favorable settlements.
Expertise in the Litigation Process
In cases where negotiation is not possible or advisable, we are prepared to take your case to court. With a track record of successful litigation in insurance matters, we have the knowledge, resources, and courtroom experience to present your case before a judge and jury.
Contact an Insurance Attorney in Sacramento Today
If you believe you have been a victim of insurance bad faith, seeking legal guidance from an experienced insurance lawyer in Sacramento is essential. Our Sacramento insurance lawyers can assess your case, advocate on your behalf, and pursue the compensation you deserve.
Contact us at 818-886-2525 to schedule a consultation and learn more about your rights and options in pursuing an insurance claim.
