A Few Things California Law Requires Of Insurance Companies When Processing Claims

Our Law Firm Handles ERISA and Private Disability Insurance Appeals

Whether you have an employer-provided disability insurance policy that is governed by Employee Retirement Income Security Act (ERISA) law or you have a private disability insurance policy, it is very likely that your initial application for benefits will be denied. It is important not to give up and assume this denial is a final decision on your qualifications for benefits. Our Santa Barbara denied disability claims attorneys will follow every legal avenue to help you receive the proper benefits.

The lawyers at Donahue & Horrow LLP, pride themselves on quickly gaining a clear understanding of your situation. It is possible that your claim was denied based on a simple error such as missing documentation or misinterpreted responses. We strive to quickly resolve the matter, or pursue it through appeals or trial litigation.

Insurance Bad Faith Lawyers in Santa Barbara

It is possible that your claim was denied due to the insurance company acting to simply protect its bottom line. In these situations, an unreasonable denial can be considered insurance bad faith.

Our attorneys can file a lawsuit against the insurance company if it acted in bad faith when denying your disability benefits claim. You might be entitled to additional money through a bad faith lawsuit. This additional compensation might include attorneys fees or damages for emotional distress caused by the denial and subsequent lawsuits. Trust our Los Angeles-area lawyers to guide you through the process.

Insurance companies are allowed to deny disability claims; however, they must first give your claim proper consideration and have a valid reason for denying the claim. And, they must also do so within a reasonable time frame and tell you the reason for the denial. Specifically, Subsection 790.03(h) of the California Insurance Code (called the Insurance Unfair Practices Act) defines a number of actions that are considered unfair practices by insurance companies.

Things Insurance Companies May Not Do

If an insurer violates these minimum standards of care, it could be considered insurance bad faith, which may allow the insured who was wrong additional compensation for damages. Just a few of the things insurance companies may not do:

  • They may not misrepresent information to claimants including pertinent facts or insurance policy provisions relating to any overages at issue.
  • Insurers may not delay fair and equitable settlements of claims in which liability has become reasonably clear.
  • Insurance companies may not attempt to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of, the insured, his or representative, agent or broker.
  • May not delay or fail to settle claims promptly where liability has become apparent under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
  • They may not directly advise a claimant not to obtain the services of an attorney.
  • The are prohibited against misleading a claimant as to the applicable statute of limitations.

Things Insurance Companies Are Required By Law To Do

Some of the things that insurance companies are required to do by law include:

  • They must acknowledge and act upon, in a reasonable time frame, all communications with respect to claims arising under insurance policies.
  • Must adopt and implement reasonable standards for the prompt investigation and processing of claims arising under insurance policies.
  • They must affirm or deny coverage of claims within a reasonable time after proof of loss requirements have been completed and submitted by the insured.

At Donahue & Horrow LLP, our Santa Ana denied disability claims lawyers have more than five decades of experience helping clients receive the benefits they deserve. Our thorough understanding of the application and appeals process is a direct benefit to our clients. We can answer your questions in detail through all phases of appeal, and guide you to a successful conclusion.

Contact a Santa Barbara Denied Disability Claims Attorney Today

All cases are taken on a contingency basis, which means you pay nothing and we receive nothing unless you win your case by way of settlement or verdict. Call us toll free at 877-664-5407 or e-mail us to schedule a free consultation to discuss your case.