California Law Protects Consumers Against Unfair Insurance Practices
A Few Things Insurance Companies Are Not Allowed To Do
Delaying the investigation or payment of claims by requiring an insured, claimant, or the physician of either, to submit a preliminary claim report, and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information is just one way insurance companies delay claims processing. This practice, along with many others, is prohibited under California insurance laws.
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.
If an insurer violates these minimum standards of care, it could be considered insurance bad faith, which may allow the insured who was wronged, 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.
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.
Contact A Santa Ana Denied Disability Claims Attorney Today for a Free Legal Consultation
If you are denied disability insurance benefits, it can be a frustrating and frightening experience. Many individuals are confused about why they were denied, and are worried that they will face financial ruin without the necessary benefits. It is important to remember that a denial at the initial application stage is quite common, and an experienced attorney can explain the options open to you.
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.
Our attorneys have extensive experience representing clients in Santa Ana, Los Angeles and throughout Southern California who have been denied insurance benefits for disabilities of all types, including:
- Back and neck injuries
- Rheumatoid arthritis
- Chronic fatigue syndrome
If you have been denied disability benefits, it is important not to give up. Our lawyers are skilled at uncovering the reasons your claim was denied and quickly acting to rectify errors, and negotiate with the insurance carrier to ensure you receive the proper benefits. Contact our firm today to discuss your situation through a free consultation.
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.