Bad faith insurance can turn an already challenging situation into a nightmare. Whether dealing with a health insurance claim or a disability insurance dispute, bad faith practices can leave you feeling helpless and betrayed. From unreasonably denying valid claims to dragging out the claim process indefinitely, insurance companies may prioritize their profits over your well-being, leaving you in financial distress and emotional turmoil.
If you’ve found yourself in a situation where your legitimate insurance claim has been denied, delayed, or unfairly undervalued, you’re not alone. At Kantor & Kantor, we provide expert guidance and unwavering advocacy to assert your rights and hold insurance companies accountable for their actions.
We’re not just attorneys but advocates for justice. We know insurance companies’ tactics to avoid paying what they owe, and we’re here to level the playing field. Our dedicated San Jose bad faith insurance lawyers have the experience, knowledge, and tenacity to take on even the most formidable adversaries. Contact us at 408-539-0081 to schedule a free consultation.
We are people helping people, and we are ready to fight for you.
What Is Bad Faith Insurance?
Bad faith insurance refers to the unethical practices of insurance companies when handling claims made by policyholders. It occurs when an insurer fails to uphold its contractual obligations fairly and reasonably. While insurance companies have a duty to act in good faith when processing claims, bad faith practices can result in unjust denials, delayed payments, or inadequate settlements, leaving policyholders vulnerable and financially burdened.
Key Elements of Insurance Bad Faith
- Failure to Investigate: One of the primary duties of an insurance company when a claim is filed is to conduct a prompt and thorough investigation. This investigation should assess the claim’s validity, including gathering relevant evidence and information. However, in bad faith insurance cases, the insurer may fail to investigate or deliberately overlook crucial evidence supporting the claim.
- Delay in Payment: Insurance policies typically require insurers to process and pay valid claims promptly. However, in instances of bad faith insurance, insurers may intentionally delay the payment of claims without valid reasons. Payment delays can cause significant financial hardship for policyholders, especially when they are relying on insurance benefits to cover medical expenses, property damage, or other losses. Insurance companies may employ tactics such as requesting unnecessary documentation, conducting multiple rounds of review, or simply dragging out the claim process to avoid or minimize payouts.
- Underpayment of Claims (Including Unfulfilled Payment Periods): Underpayment of claims occurs when insurance companies offer settlements that are lower than what is fair and reasonable based on the terms of the policy and the extent of the policyholder’s losses. This can include failing to compensate for all covered damages, undervaluing the value of property or injuries, or applying unjustified deductions or exclusions to the claim. Additionally, insurance policies often specify timeframes for claims to be paid or resolved. Insurers failing to meet these deadlines without valid reasons can constitute bad faith insurance practices, further exacerbating the hardships policyholders face.
Examples of Bad Faith in Insurance Practices
Bad faith in insurance practices can take various forms, all of which ultimately result in unfair treatment of policyholders. Here are some common examples of bad faith:
- Lack of Reasonably Prompt, Thorough Investigation: Insurance companies have a duty to promptly and thoroughly investigate claims submitted by policyholders. Bad faith arises when insurers neglect this responsibility or conduct insufficient or unreasonably delayed investigations. For instance:
- Failure to send an adjuster to assess damages promptly
- Ignoring critical evidence or witness statements
- Deliberately dragging out the investigation process without valid reasons.
- Denial Based on Incomplete or Inaccurate Justification: A key aspect of insurance contracts is that claims should only be denied for valid reasons supported by evidence. However, bad faith occurs when insurers deny claims without adequate justification or based on incomplete or misleading information. Examples include:
- Denying a claim without thoroughly reviewing relevant policy provisions
- Relying on vague or ambiguous policy language to justify denial
- Misrepresenting facts or misinterpreting policy terms to justify denial.
- Underpayment of Claims: Insurance companies are obligated to fairly compensate policyholders for covered losses according to the terms of their policies. However, bad faith arises when insurers intentionally offer unreasonably low settlements or fail to fully account for the extent of the damages. This can include:
- Assessing damages using undervalued or inappropriate methodologies
- Ignoring relevant expenses or losses when calculating settlement offers
- Pressuring policyholders into accepting inadequate settlements by withholding rightful payments.
Do you need a bad faith insurance attorney in San Jose? Contact Kantor & Kantor at 408-539-0081 to book a free phone, video, or in-person consultation.
What Constitutes a Breach of the Duty of Good Faith and Fair Dealing?
The duty of good faith and fair dealing is a fundamental principle that governs the relationship between an insurer and a policyholder. This duty requires insurers to act honestly, fairly, and in good faith when handling claims submitted by their policyholders. A breach of this duty can occur in various ways, each of which may give rise to legal action against the insurer. Here are some key elements that constitute a breach of the duty of good faith and fair dealing:
- A valid claim for benefits was denied: A breach of the duty of good faith and fair dealing often occurs when an insurance company denies a valid claim for benefits without reasonable justification. Policyholders purchase insurance coverage with the expectation that they will receive the benefits they are entitled to under the terms of their policy. When an insurer unjustly denies a legitimate claim, it violates its obligation to act in good faith.
- Unreasonable Conduct by the Insurer: The duty of good faith and fair dealing requires insurers to handle claims promptly, thoroughly, and fairly. Insurers are expected to conduct a reasonable investigation into each claim and to base their decisions on objective evidence rather than arbitrary or self-serving reasons. Any conduct by the insurer deemed unreasonable, dishonest, or deceptive may constitute a breach of the duty of good faith and fair dealing.
- Damages Resulting from the Insurer’s Conduct: A breach of the duty of good faith and fair dealing can significantly harm the policyholder. Damages may include financial losses, emotional distress, inconvenience, and other adverse consequences stemming from the insurer’s wrongful conduct. Policyholders who have suffered damages due to an insurer’s breach of the duty of good faith and fair dealing may be entitled to compensation for their losses.
Why Choose Kantor & Kantor?
At Kantor & Kantor, we understand that choosing the right legal representation is crucial when dealing with bad faith insurance claims. Here are several compelling reasons why clients continue to trust us to advocate for their rights and hold insurers accountable:
- Successful History of Holding Bad Faith Insurers Accountable: With a history of successful outcomes, we have earned a reputation for effectively challenging insurance companies that engage in bad faith practices. Our San Jose bad-faith attorneys relentlessly pursue justice, and we have secured substantial settlements and verdicts for our clients.
- Extensive Experience Litigating Bad Faith Cases: Our team has extensive experience litigating bad faith insurance cases in San Jose. We understand the nuances of insurance law and have the skills and resources to resolve complex legal challenges. Whether through negotiation or litigation, we are prepared to fight aggressively to protect your rights and interests.
- We Put Our Clients First: We are people helping people, and our clients are our top priority. We recognize that each case is unique, and we take the time to understand your needs and concerns. From the initial consultation to ultimate resolution of your case, we provide personalized attention and guidance every step of the way. Your success and satisfaction are paramount to us.
- Aggressive Advocacy: When facing off against insurance companies, you need a legal team that is not afraid to fight for what is right. Our attorneys are known for their tenacity and determination to pursue justice. We leverage our skills, knowledge, and resources to advocate aggressively on behalf of our clients, ensuring that their voices are heard and their rights are protected.
How We Can Help Your Case
We are dedicated to providing comprehensive support and strategic advocacy to clients facing bad faith insurance disputes. Here’s how our experienced team can assist you in navigating your case:
- Claim Evaluation and Strategy: Our first step is to thoroughly evaluate your insurance policy and the circumstances surrounding your claim. We meticulously review all relevant documentation to assess the validity of your claim and identify any indications of bad faith practices by the insurance company. With a deep understanding of insurance law and industry practices, we develop a customized strategy tailored to the specifics of your case. We aim to maximize your chances of success and secure the compensation you deserve.
- Litigation and Aggressive Advocacy: While we always strive to negotiate fair settlements with insurance companies, we are prepared to take your case to court if necessary. Our skilled litigators have a proven track record of success in bad faith insurance litigation, and we are not afraid to challenge powerful insurance companies in pursuit of justice for our clients. We approach each case with determination and tenacity, leveraging our knowledge and resources to fight for a favorable outcome. However, we also recognize the value of exploring settlement options when appropriate. Through strategic negotiation and mediation, we seek to reach a resolution that meets your needs while avoiding the uncertainty and expense of trial. Whether through litigation or settlement, our priority remains to achieve the best possible outcome for you.
- Experience in Specific Scenarios: Our firm has a proven track record of successfully handling many bad faith insurance scenarios. Some common situations where we can assist include:
- Disability Insurance Claims: We have extensive experience representing clients who have had their disability insurance claims unfairly denied or delayed by insurance companies. We fight tirelessly to secure the benefits you deserve to support you during times of illness or injury.
- Life Insurance Disputes: If you are facing obstacles in obtaining the life insurance benefits owed to you after losing a loved one, our compassionate attorneys can guide you through the process and hold the insurance company accountable for its obligations.
- Long-Term Care Insurance Claims: We assist individuals and families in navigating complex long-term care insurance claims, ensuring that policyholders receive the coverage they need to address their long-term care needs.
- ERISA Claims: We have in-depth knowledge of the Employee Retirement Income Security Act (ERISA) and represent clients in ERISA claims, including disputes over denied disability benefits and wrongful terminations.
Whatever your specific circumstances, you can trust Kantor & Kantor to provide skilled legal representation and unwavering support throughout resolving your bad faith insurance case.
What Damages Could You Receive for a Bad Faith Claim Against the Insurance Company?
When you file a bad faith claim against your insurance company, you may be entitled to various types of damages, depending on the circumstances of your case and the extent of the insurer’s misconduct. Here are the damages you could receive:
- Consequential Damages: Consequential damages, also known as special damages, result indirectly from the insurer’s breach of contract. These damages may include financial losses or harm you suffer due to the insurer’s wrongful denial or delay of your claim. Examples of consequential damages may include medical expenses, property damage, or lost income resulting from the insurer’s misconduct.
- Contract Damages: Contract damages, also called compensatory damages, are intended to compensate you for the losses directly caused by the insurer’s breach of contract. These damages typically cover the amount you would have received under the terms of your insurance policy if the insurer had acted in good faith. Contract damages may include the value of the denied claim plus any additional costs or losses incurred due to the insurer’s misconduct.
- Emotional Distress: In some cases of bad faith conduct, you may be entitled to compensation for emotional distress or mental anguish caused by the insurer’s actions. Emotional distress damages can include anxiety, stress, frustration, and other psychological harm suffered as a result of the insurer’s wrongful denial or delay of your claim. These damages acknowledge the toll bad faith practices can take on your mental well-being.
- Punitive Damages: In particularly egregious cases of bad faith conduct, courts may award punitive damages to punish the insurer for its wrongful actions and deter similar misconduct. Punitive damages are intended to signal that such behavior will not be tolerated and to hold the insurer accountable for its wrongdoing. The amount of punitive damages awarded varies depending on the severity of the insurer’s misconduct.
- Legal Fees: In many bad faith insurance cases, policyholders can recover their attorney’s fees and court costs in pursuing the claim. If you succeed in your bad faith claim against the insurer, they may be required to reimburse you for hiring legal representation and litigating the case. This provision helps ensure that policyholders can access competent legal assistance to seek justice against unscrupulous insurers.
Long-Term Disability (LTD) Bad Faith
Long-term disability insurance provides vital financial protection for individuals unable to work due to illness or injury. Unfortunately, insurance companies may engage in bad faith practices by wrongfully denying or terminating valid LTD claims. This can leave individuals facing financial strain and uncertainty during already challenging times.
Our San Jose LTD attorneys are well-versed in the complexities of LTD claims and the tactics used by insurance companies to avoid their obligations. We understand the importance of thorough documentation and persuasive argument in demonstrating the legitimacy of your disability claim.
Here is how we can help with LTD bad faith:
- Claim Evaluation: We conduct a comprehensive review of your LTD policy and medical records to assess the strength of your claim and identify any instances of bad faith by the insurance company.
- Appeals and Litigation: If your claim has been denied or terminated unfairly, we will pursue all available appeals avenues, including administrative appeals and litigation in state or federal court.
- Negotiation: Our attorneys are skilled negotiators who will engage in strategic discussions with the insurance company to seek a fair and just resolution for your LTD claim.
Long-Term Care (LTC) Bad Faith
Long-term care (LTC) insurance covers the cost of long-term care services, such as nursing home care or in-home assistance, for individuals unable to perform activities of daily living due to illness, injury, or age-related conditions. However, insurance companies may engage in bad faith practices by denying or undervaluing valid LTC claims, burdening policyholders and their families with exorbitant expenses.
Our San Jose LTC attorneys understand the emotional and financial toll LTC disputes can take on individuals and their loved ones. Here is how we can help with LTC bad faith:
- Policy Review: We carefully review your LTC policy to ensure you understand your coverage and identify any instances of bad faith by the insurance company.
- Appeals and Litigation: If your LTC claim has been wrongfully denied or undervalued, we will pursue all available legal remedies, including appeals and litigation, to seek a favorable outcome.
- Advocacy: Our dedicated attorneys will work tirelessly to protect your rights and pursue maximum compensation for your LTC expenses.
Life Insurance Bad Faith
Life insurance provides financial security for loved ones after the policyholder’s death. However, insurance companies may engage in bad faith practices by denying or delaying death benefit payments to beneficiaries, citing ambiguous policy provisions, or conducting inadequate investigations.
We recognize the importance of timely and fair payment of life insurance benefits to support grieving families in need. Here is how our bad faith attorneys in San Jose can help you:
- Policy Analysis: Our attorneys thoroughly review the life insurance policy and any related documentation to identify potential instances of bad faith by the insurance company.
- Claims Assistance: We assist beneficiaries with the claims process, ensuring that all necessary documentation is submitted accurately and efficiently.
- Litigation: If negotiations with the insurance company are unsuccessful, we are prepared to take your case to court and fight for the full payment of life insurance benefits to which you are entitled.
Contact a Plaintiffs Bad Faith Insurance Lawyer in San Jose Today
If you’ve been unfairly treated by your insurance company, resulting in the denial, delay, or underpayment of your valid insurance claim, our experienced plaintiffs bad faith insurance lawyers are here to help.
You need a bad faith insurance lawyer in San Jose to provide you with the experienced representation and dedicated advocacy to pursue justice and obtain the compensation you deserve.
We are people helping people. Contact us at 408-539-0081 to schedule a free consultation.
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]