When people in California are mistreated by their insurance company, the lawyers at Kingsley & Kingsley work to make sure that they receive the benefits to which they are entitled.
It may come as no surprise to learn that insurance companies are in business to make money, and it costs them to pay claims. Paying less than the full amount, or denying a claim altogether, saves money for an insurance company; some companies will even look for ways to cancel the insured's policy rather than pay a claim submitted to them.
Denials and Bad Faith
Whether you are privately insured or covered under a group health or disability plan at work, you are entitled to benefits according to the terms of your policy. When benefits are denied or underpaid due to an improper motive or unreasonable position of the insurance company, you may, under certain circumstances, be able to pursue a claim of insurance bad faith against the company.
An insurance company can act in bad faith in many ways other than just unreasonably refusing to pay a claim. Insurance companies are under a duty to conduct a reasonable investigation of every claim submitted; if the company unreasonably delays processing the claim (perhaps in hopes the insured would settle for less), this is considered bad faith.
Most insurance policies also agree to defend the insured in claims brought against them by third parties. In these cases, the insurance company has a duty to defend, and an unreasonable refusal to do so may constitute bad faith.
It is not uncommon for an insurance company, in a health or disability policy, when faced with a claim to go back to the insured's original application and scrutinize it for any reason to rescind (cancel) the policy altogether. When a company behaves in this way, their actions and motives should be thoroughly investigated to determine whether they actually had grounds to rescind, and whether their reason for doing so was based on business or bad faith. It's important to review all of the potential legal resources you have available.
Experienced Insurance Law Attorneys
At Kingsley & Kingsley, our team of attorneys has a long history of going up against insurance companies when they are in the wrong. In addition to health and disability, we also handle casualty insurance claims involving fire, robbery, or earthquake insurance. If you have been denied medical or disability benefits, or if you feel that you have been unfairly denied benefits or inadequately covered on your home, fire, auto, or other insurance policy, contact Kingsley & Kingsley for a free consultation and evaluation of your situation.