Do not assume that the insurance company properly cancelled your policy. You should have the cancellation of coverage reviewed by a long-term care attorney. Insurance companies repeatedly cancel insurance policies in violation of the terms of the policy and/or statutory law.
The most common examples of improper cancellations of coverage include the following:
1. When there has been an unintentional lapse of coverage due to nonpayment of premium because the insured has cognitive issues or is experiencing a health crisis.
2. The insurance company fails to give the notice of lapse as required under the Policy before cancelling the coverage.
3. The insurance company fails to give notice to the third-party individual designated by the insured as required by statutory law.
Before an insurance company can cancel your policy it must strictly comply with the terms of the policy and statutory law.
The burden of proving cancellation falls squarely on the insurer.
K. C. Working Chemical Co. v. Eureka-Security Fire & Marine Ins. Co. (1947) 82 Cal.App.2d 120, 130 (citing
Rossini v. St. Paul Fire etc. Ins. Co. (1920) 182 Cal. 415, 420 and
Bebbington v. California Western etc. Ins. Co. (1947) 30 Cal.2d 157, 158).
In Mackey v. Bristol West Ins. Services of California, Inc., (2003) 105 Cal. App.4th 1247, 1257-58, the Court of Appeal held that in California, “notices of cancellation must strictly comply with statutory directives and the insurance policy’s termination provisions.” Id. If they do not, then the cancellation is ineffective and the policy remains in effect “regardless of whether the insurer acted upon a valid ground for canceling the policy,” such as nonpayment of premium.
Additionally, if there is any ambiguity in the Policy as to notice requirements before an insurance company may cancel a policy, it is a “fixed principle of California law” that ambiguities or uncertainties in a policy of insurance are to be construed against the drafter.
Holz Rubber Co. Inc. v. American Star Ins. Co., (1975) 14 Cal.3d 45, 55 and see also, Perkins v. Allstate Co., 63 F. Supp.2d 164 (E.D. Cal. 1999). That is especially so in the case of a forfeiture, such as cancellation of an insurance policy. As the California Supreme Court has stated, “[i]t is a well-recognized principle of law that forfeitures are not favored and will not be upheld in contracts for insurance if by a reasonable construction it can be avoided; and that when the words of a contract are susceptible of two interpretations, that interpretation which will sustain the claim must be given preference.” Bittinger v. New York Life Ins. Co., 17 Cal.2d 834, 841 (1941).
Kantor & Kantor’s caring and knowledgeable attorneys are here to assist you with your long-term care insurance needs. We offer free consultations, so get started with us today by completing our online form or calling our office today.