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California Insurance Bad Faith Questions & Answers
3 Answers | Asked in Contracts and Insurance Bad Faith for California on
Q: Insurance contract contradicts itself regarding if damage is covered or not. How is this handled and who's in the right?

My main water line within my property lines broke. I filed a claim with my home warranty to cover the damages. They state that the damage isn't covered as it's not within their Covered Items (this is correct). However, their contract also states that leaks within the Covered Home are... View More

Neil Anapol
Neil Anapol
answered on Sep 9, 2024

I would not attempt to interpret the contract without seeing the contract. However, home warranty contracts are not considered to be insurance. Therefore, there is no such thing as an action for bad faith against a home warranty company. At most, you could sue for the cost of the repair.... View More

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3 Answers | Asked in Insurance Bad Faith, Insurance Defense, Consumer Law and Car Accidents for California on
Q: can liberty mutual say (lie) that i called in to change my collision insurance (only the collision portion) to an older

car that i had, which was paid off. why would anybody do that? one car is 30 years old and the newer car is still on a lien with the bank!They switched it from, my bank owned mind you, car just when i get in an accident and file claim. all of a sudden they wont pay a dime saying 2year prior i... View More

Leon Bayer
Leon Bayer
answered on Aug 31, 2024

Your position sounds logical, but I do see some flaws in your argument. You say this happened 2 years earlier, right? So, are you saying that for the last 2 years, you never looked at your insurance bills, and never noticed that your rates and coverage had changed? I find that hard to believe, if... View More

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2 Answers | Asked in Collections and Insurance Bad Faith for California on
Q: Can an insurance co. threaten to send you to collections and to ding your credit when they made a mistake and overpaid?

I have been going through cancer treatments and have been on long term disability. The insurance co. made a mistake and are now wanting me to pay back $13800.00 + dollars and have threatened me with collections. Can they ding my credit when we did not enter into a credit agreement with them?

Tim Akpinar
Tim Akpinar
answered on Aug 9, 2024

Insurance companies can pursue overpayments. One option might be to discuss with your state's Department of Insurance in terms of your consumer protections and options, based on amount, nature, and timeline of overpayment. Good luck

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2 Answers | Asked in Insurance Bad Faith for California on
Q: Can my insurance go against California Law if they are based in another state?

I live and work in California. I have a PPO through my job with Blue Cross Blue Shield of Michigan because the company is a chain with headquarters in Michigan, but with locations all over the US. I recently had to use an ambulance, and BCBSM says that I am responsible for the full bill because the... View More

Tim Akpinar
Tim Akpinar
answered on Aug 8, 2024

I agree with my colleague. Insurance companies generally follow state regulations, even though most of them operate on a national level. You have already appealed the matter. One option may be to seek guidance from your state's department of insurance, which in most states, oversee compliance... View More

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2 Answers | Asked in Insurance Bad Faith, Elder Law and Construction Law for California on
Q: Two wks ago, Our homeowners insurance denied our claim after our entire kitchen was torn out and gutted by contractors.

The restoration company led us to believe that our insurance policy included coverage for damages. We called our insurance co and a plumber when we noted the leak. Insurance co. was there within hrs. and asked to see insurance policy. He began quoting dollar figures that we would be compensated... View More

James L. Arrasmith
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answered on Jul 1, 2024

This is a complex situation that involves multiple areas of law, including insurance, contract, and potentially elder law. Here's a breakdown of the key issues and some potential steps you might consider:

1. Insurance Claim Denial:

- Review your insurance policy carefully to...
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1 Answer | Asked in Insurance Bad Faith for California on
Q: My policy has a Cash Value Rider, can insurance company force conversion to paid-up insurance non forfeiture option?

My policy had a Cash Value Rider included. Been paying for 15 years but lapsed beyond grace period due to a move where mail forwarding was missed. Reinstatement application was declined. Does this mean I, policy owner, can request refund of premium paid towards policy? Insurance company is forcing... View More

James L. Arrasmith
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answered on Jun 19, 2024

I can provide some general information about life insurance policies with cash value riders and non-forfeiture options, but please note that the specific details and your options will depend on the terms of your individual policy and the laws of your state. It's best to carefully review your... View More

4 Answers | Asked in Personal Injury, Insurance Bad Faith and Insurance Defense for California on
Q: Can an insurance company ignore my request to settle a 998 offer? I am the defendant.

The insurance company I am under received a 998 offer , it is within my policy limits but they want me to continue to fight the case. I want to settle this case and allow my policy to pay it. Can they ignore my request ,drag this case out to trial? Even though I will suffer the most damage in the... View More

William John Light
William John Light
answered on May 28, 2024

The decision to settle or litigate belongs to the insurance company. If it exposes you to a judgment in excess of your policy limit, it might be responsible to pay the entire amount. You should probably send the adjuster a letter, certified mail, demanding that it, alone, be responsible for any... View More

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4 Answers | Asked in Personal Injury, Insurance Bad Faith and Insurance Defense for California on
Q: Can an insurance company ignore my request to settle a 998 offer? I am the defendant.

The insurance company I am under received a 998 offer , it is within my policy limits but they want me to continue to fight the case. I want to settle this case and allow my policy to pay it. Can they ignore my request ,drag this case out to trial? Even though I will suffer the most damage in the... View More

James L. Arrasmith
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answered on May 28, 2024

In California, a 998 offer (also known as an Offer to Compromise) is a settlement offer made by either party in a civil case, pursuant to Section 998 of the California Code of Civil Procedure. If the offer is not accepted and the party who rejected the offer fails to obtain a more favorable... View More

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1 Answer | Asked in Car Accidents and Insurance Bad Faith for California on
Q: Had a total loss on my vehicle in 11/2023. It's been six months, no payment from Gap Insurance. What can I do?

All paperwork has been submitted and accepted from GAP insurance company-Smart AutoCare. They keep telling me its "processing". Meanwhile, I am still making payments on a vehicle I no longer possess. Please help.

James L. Arrasmith
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answered on May 24, 2024

Under California law, if your GAP insurance company is delaying payment without a valid reason, you have options to resolve the issue. First, document all your communications with the insurance company, including dates, times, and the names of representatives you spoke with. This record will be... View More

1 Answer | Asked in Contracts, Civil Litigation, Insurance Bad Faith and Securities Law for California on
Q: What would a cause of action be if an ins co rescinded changes an owners POA made w/out serving Notice of Rescission 1st

The ins company had to know or at very least became aware of the fact service of Notice of Rescission prior to exercising rescission is a California statutory requirement,"no Notice, no rescission." Americo was repeatedly asked to provide the citation, code or case law relied on to... View More

James L. Arrasmith
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answered on May 22, 2024

Based on the information provided, it seems that the insurance company (Americo) rescinded changes made by the policy owner through a Power of Attorney (POA) without properly serving a Notice of Rescission as required under California law. This action by the insurance company could potentially give... View More

2 Answers | Asked in Insurance Bad Faith and Workers' Compensation for California on
Q: What grounds is it legal for a state insurance agency to prevent an injured worker from being evaluated to treatment?

I reported a psychological injury in February, and I still have not even been evaluated. My claims adjuster has been avoiding both my emails and phone calls. It is almost June.

James L. Arrasmith
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answered on May 21, 2024

Under California law, an insurance company is required to authorize medical treatment that is reasonably required to cure or relieve the injured worker from the effects of their work-related injury, and they must do so in a timely manner.

The claims administrator is required to authorize...
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2 Answers | Asked in Insurance Bad Faith for California on
Q: Can I sue Mercury Insurance for bad faith failure to cover loss and damages?

I have renters insurance. A portion of the ceiling fell in my living room. The sofa had water damage. I filed a claim but it got denied due to the fact I did not have an addendum to my renters insurance. When I got the insurance, no one mentioned addl insurance.

James L. Arrasmith
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answered on May 9, 2024

In California, insurance companies have a legal obligation to act in good faith and deal fairly with their policyholders. This means that they must handle claims properly, investigate them thoroughly, and pay valid claims in a timely manner.

If you believe that Mercury Insurance has acted...
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2 Answers | Asked in Car Accidents and Insurance Bad Faith for California on
Q: At fault accident.is my insurance responsible for any amount excessive of my 25k/50k policy ??

Basically we were at red light.its turned green I let the brake go and the car suddenly stopped.probly 1mph and barely vumbed into the.yook a picture only a scratch on car.no police came nor ambulance.they said we can just get it fixed and not involve insurance.they lied as they filed a claim.my... View More

James L. Arrasmith
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answered on May 3, 2024

In California, if you have an auto insurance policy with liability limits of $25,000 per person and $50,000 per accident (25k/50k), your insurance company is generally responsible for paying up to those limits for damages you cause to others in an accident.

If the damages exceed your policy...
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2 Answers | Asked in Insurance Bad Faith and Health Care Law for California on
Q: Whom do I seek help from when I have an insurance coverage problem with Kaiser, beyond Kaiser grievance and DMHC?

My teen daughter needed a long-term RTC. I informed Kaiser (K.) of her need for this level of care, though I did not specifically ask for it. (I did not know K. offered that level of care.) When my daughter's K. clinician walked her through our chosen RTC's website, the K. clinician... View More

James L. Arrasmith
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answered on Apr 9, 2024

In California, if you have exhausted the internal grievance process with Kaiser and the complaint process with the Department of Managed Health Care (DMHC), you have a few additional options to seek help for your insurance coverage problem:

1. Contact the California Department of Insurance...
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1 Answer | Asked in Products Liability, Civil Litigation and Insurance Bad Faith for California on
Q: Can atty file MTS, then demurrer to complaint, demurrer to 1st amend, demurrer and MTS to 2nd amended ?

Defendants failed to answer complaint for water damages to home-defective part; Defendant insurance adjuster emailed for 60 extension; plaintiff filed default after 58 days; court issued order plaintiff may be sanctioned for failure to file default; complaint filed over 100 days, Def atty filed to... View More

James L. Arrasmith
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answered on Mar 25, 2024

In California, an attorney can indeed file a motion to strike (MTS) and a demurrer to the original complaint, first amended complaint, and second amended complaint as you've described. This can be part of a defensive strategy to challenge the legal sufficiency of the plaintiff's case. If... View More

3 Answers | Asked in Personal Injury, Car Accidents, Civil Litigation and Insurance Bad Faith for California on
Q: Can an insurer my deny injury liability coverage on an active claim if my vehicle was not registered at the time?

I said "I saw a green light for me.", before I turned left. He said "I saw a green light for me.", and went straight. To my best knowledge, there were no cameras and it's just my word and his. He is claiming personal injury. I claim nothing. My insurer wants me to sign an... View More

Dale S. Gribow
Dale S. Gribow
answered on Mar 19, 2024

Your insurance policy terms and conditions should govern.

You want to read or have a lawyer read it to see what it says.

I assume insurance costs in Louisiana were lower, which is why many people do not register their cars in California.

If your policy does not address this...
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3 Answers | Asked in Personal Injury, Car Accidents, Civil Litigation and Insurance Bad Faith for California on
Q: Can an insurer my deny injury liability coverage on an active claim if my vehicle was not registered at the time?

I said "I saw a green light for me.", before I turned left. He said "I saw a green light for me.", and went straight. To my best knowledge, there were no cameras and it's just my word and his. He is claiming personal injury. I claim nothing. My insurer wants me to sign an... View More

William John Light
William John Light
answered on Mar 19, 2024

Almost certainly not. A review of your policy terms would have to be completed to be definitive. Your insurer insured the car for the policy period. If the collision occurred during the policy period, the car should be covered. Registration, or failure to register, does not affect the risk to... View More

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3 Answers | Asked in Car Accidents, Insurance Bad Faith, Personal Injury and Health Care Law for California on
Q: Can a car insurance company such as AAA call a hospital to request billing info without you signing anything/release?

I got into a car accident, the party who hit me insurance (AAA) accepted liability after sending them my dash cam footage. I had to go to the ER, I was hesitant because I lost my job 5 months ago and I thought I didn't have health insurance. Three days later I get a notification email saying... View More

William John Light
William John Light
answered on Mar 14, 2024

There might be a violation, but there is no private lawsuit for a HIPAA violation. You might be able to pursue an invaion of privacy lawsuit, but since you gave AAA the hospital bill, it doesn't really seem like your privacy has been violated. You should probably focus on a personal injury... View More

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3 Answers | Asked in Car Accidents, Insurance Bad Faith, Personal Injury and Health Care Law for California on
Q: Can a car insurance company such as AAA call a hospital to request billing info without you signing anything/release?

I got into a car accident, the party who hit me insurance (AAA) accepted liability after sending them my dash cam footage. I had to go to the ER, I was hesitant because I lost my job 5 months ago and I thought I didn't have health insurance. Three days later I get a notification email saying... View More

James L. Arrasmith
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answered on Mar 14, 2024

Based on the information you've provided, it doesn't appear that any HIPAA (Health Insurance Portability and Accountability Act) laws were violated. Here's why:

1. HIPAA allows healthcare providers to share a patient's protected health information (PHI) with third-party...
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2 Answers | Asked in Consumer Law, Contracts and Insurance Bad Faith for California on
Q: Hi, my storage unit was broken into. I discovered it June 2023. I notified the manager immediately. Then got the police

Report and a list of items missing, what they cost me new and gave them multiple examples of what these items are selling for new. I waited for a month and then when I went to the office to get an update, I was informed the manager was no longer there and they new nothing of the paperwork. They... View More

Leon Bayer
Leon Bayer
answered on Mar 2, 2024

You have an insurance policy. Does it cover losses from theft? If so, it's time for you to visit one or more lawyers who deal with insurance law, and find one who will sue the insurance carrier. When an insurance carrier fails to deal with you in good faith, you may be able to collect not only... View More

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