Lengthy Delays And Wrongfully Denied Claims Are Just Two Examples Of Insurance Bad Faith

Los Angeles Insurance Bad Faith Attorneys

You paid your premiums, you thought you understood the terms of your coverage, but when you went to file a claim, your insurance company denied the claim, or refused to pay the benefits you believe you were entitled to.

If this sounds like your situation, you are not alone. Every day, insurance companies throughout California making decisions on claim benefits look for ways to minimize payments. In fact, insurance companies are so aggressive in looking for ways to maximize profits and minimize payouts that they use automated tools that scour claims submitted online or that have been entered into databases looking for coding or other errors as a reason to automatically deny or delay a claim. This practice is called “claim editing.”

…They [insurance companies] use auditing software, often called “claim review programs” to sift through millions of submitted claims. Others have dubbed this software “denial engines” because their intent is to lower the amount of money paid to physicians and hospitals. These auditing programs work by finding technical errors in billing codes that all doctors, hospitals and clinics, among others, submit for payment. The programs use data-mining technology and can even be tuned to capture a predetermined percentage of financial return. Forbes.com

Insurance carriers must uphold a duty of good faith and fair dealing. This means that benefits claims must be thoroughly investigated before being challenged or denied. If an insurance company denies a claim unreasonably or without giving it the proper consideration, it is said that the company acted in bad faith.

California’s insurance laws are not only lengthy, they are complex and it can be difficult for policyholders to know whether or not their insurance company made an honest mistake or if they purposely denied or delayed your claim. If your claim was wrongfully denied or you suspect your insurance company has acted in bad faith, it is important to seek the counsel of an experienced attorney. By filing a bad faith lawsuit, our legal team can attempt to recover damages outside your benefits coverage. These damages can include attorneys’ fees and emotional distress.

At Donahue & Horrow, LLP, our attorneys have more than five decades of combined experience guiding clients through emotionally and financially challenging times. We understand the worry and frustration that comes from receiving an insurance denial. It is our goal to fight on your behalf to ensure you receive the benefits you are owed.


The Duties of Implied Covenant of Good Faith

The implied covenant of good faith is an unwritten promise in every insurance policy sold in California and carries several duties, including, but not limited to:

  • Thoroughly investigate the insured’s claim and to fully inquire into all possible bases that might support payment of the claim;
  • Objectively evaluate the insured’s claim and to give at least as much consideration to the insured’s interests as it does its own;
  • Promptly investigate the insured’s claim;
  • Timely respond to the insured’s inquiries and otherwise communicate with the insured.

Just a few more examples of insurance bad faith include:

  • An intent to deceive or mislead the policy holder to gain some advantage;
  • Issuing a cancellation under an insurance policy (insurance rescission);
  • Using unreasonable interpretations in translating policy language to avoid paying fairly on claims;
  • Or having practices or policies in place that cause unreasonable delays in payment or that unreasonably deny benefits.

It is important to hold your insurance company responsible for its actions. If the insurance company has ignored its good faith duties and unreasonably denied your benefits claim, we encourage you to call our office and schedule a free consultation.


Contact an Experienced Los Angeles Insurance Bad Faith Attorney Today

Insurance companies are not allowed to give you legal advice regarding your claim, and are prohibited by law from telling you not to contact a lawyer. They are not allowed to use tactics such as delaying claims, or scaring, or coercing you into accepting a settlement in order to avoid a lawsuit. Additionally, insurance companies may not compel insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by the insureds, when the insureds have made claims for amounts reasonably similar to the amounts ultimately recovered.

To learn more about how our Los Angeles insurance bad faith attorneys can help you, schedule a free consultation today. We represent clients in Los Angeles and other communities throughout Southern California. Call us at 877-664-5407 or contact us online to schedule an appointment.


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