California Insurance Bad Faith Questions & Answers
Q: Pet insurance won’t pay my dog’s treatment due tu “pre-existent” condition.
1 Answer
| Asked
in
Animal / Dog Law and Insurance Bad Faith
for
California
on
Answered on May 23, 2018
Answered on May 23, 2018
William John Light's answer
The policy will define "pre existing condition". It probably doesn't require a pre existing diagnosis. However, in determining whether the insurer is accurately denying coverage, you have to examine the actual language of the policy.
The policy will define "pre existing condition". It probably doesn't require a pre existing diagnosis. However, in determining whether the insurer is accurately denying coverage, you have to examine the actual language of the policy.
Q: If a claimant withdrawals a claim due to errors of the examiner in an interview will you loose all your benefits f
William John Light's answer
The Government Pension Offset (GPO), reduces Social Security benefits paid to spouses or survivors when the spouse or survivor earned a pension from a government job that was not covered by Social Security. The GPO reduction is equal to two-thirds of the amount of the pension payment from noncovered government work (SSA 2012).
There are many SSI/SSD attorneys out there who can advise you on this. It is not the kind of question for a quick and easy response from the internet. You are...
The Government Pension Offset (GPO), reduces Social Security benefits paid to spouses or survivors when the spouse or survivor earned a pension from a government job that was not covered by Social Security. The GPO reduction is equal to two-thirds of the amount of the pension payment from noncovered government work (SSA 2012).
There are many SSI/SSD attorneys out there who can advise you on this. It is not the kind of question for a quick and easy response from the internet. You are...
Q: I am looking for a lawyer to help with a car accident insurance claim loss of vehicle.
3 Answers
| Asked
in
Car Accidents and Insurance Bad Faith
for
California
on
Answered on May 4, 2018
Answered on May 4, 2018
Peter N. Munsing's answer
First problem is valuation--unless you can get someone to say your daughter's "classic" is worth more than book that's all you get.
She has an injury claim and that would be the driver, but sounds like you /she may not have documented the injury.
Contact a member of CAOC. They give free consultations, will take the case on a contingent fee.
Good luck!
First problem is valuation--unless you can get someone to say your daughter's "classic" is worth more than book that's all you get.
She has an injury claim and that would be the driver, but sounds like you /she may not have documented the injury.
Contact a member of CAOC. They give free consultations, will take the case on a contingent fee.
Good luck!
Q: Small Claims Court plaintiff loss
William John Light's answer
The winning party can recover costs. That would include, for a defendant, the fee for filing an answer, and possibly a court reporter, if they requested one.
The winning party can recover costs. That would include, for a defendant, the fee for filing an answer, and possibly a court reporter, if they requested one.
Q: Since California Small Claims court has a $10,000 limit, I am inquiring if I have sufficient cause to file a case.
William John Light's answer
You haven't posted any details about your case. No one can evaluate without facts.
You haven't posted any details about your case. No one can evaluate without facts.
Q: I contacted my insurance company a few days about about a claim - how long do they have to get back to me?
William John Light's answer
The California Department of Insurance (CDI) published "Fair Claims Settlement Practice Regulations" under Title 10 of the California Code of Regulations.
Section 2695.5 sets out limits insurers must comply with when adjusting claims:
When an agent or other insurance representative receives a claim, that claim must be immediately tendered to the insurer;
Within 15 days of Notice of a claim, the insurer must acknowledge receipt AND provide the insured with all necessary...
The California Department of Insurance (CDI) published "Fair Claims Settlement Practice Regulations" under Title 10 of the California Code of Regulations.
Section 2695.5 sets out limits insurers must comply with when adjusting claims:
When an agent or other insurance representative receives a claim, that claim must be immediately tendered to the insurer;
Within 15 days of Notice of a claim, the insurer must acknowledge receipt AND provide the insured with all necessary...
Q: The claim process has been going on for a while - at what point is it considered too long
William John Light's answer
Depends on the facts of the claim, the type of insurance policy, the amount of your claim, the proof you have submitted, the amount of your cooperation, whether you have an attorney, etc.
Depends on the facts of the claim, the type of insurance policy, the amount of your claim, the proof you have submitted, the amount of your cooperation, whether you have an attorney, etc.
Q: In Car Accident In Rental Car No Insurance
3 Answers
| Asked
in
Car Accidents, Insurance Bad Faith and Personal Injury
for
California
on
Answered on Mar 12, 2018
Answered on Mar 12, 2018
William John Light's answer
Driving without insurance in California is a violation of California Vehicle Code Section 16020–16033.
First offense: Minimum fine of $100. Additional fees and penalty assessments will result in a total fine of about $450.
Second or subsequent offenses can result in fines totaling between $900 and $2,500.
Potential impound of your vehicle.
Potential suspension of your driver's license.
Also, you may have a personal injury claim. If you are driving...
Driving without insurance in California is a violation of California Vehicle Code Section 16020–16033.
First offense: Minimum fine of $100. Additional fees and penalty assessments will result in a total fine of about $450.
Second or subsequent offenses can result in fines totaling between $900 and $2,500.
Potential impound of your vehicle.
Potential suspension of your driver's license.
Also, you may have a personal injury claim. If you are driving...
Q: Rented car: damaged and claimed responsible for full payment even though so many things were not right?
William John Light's answer
Your agreement with Turo will govern. You should read it.
Ordinarily, the renter is responsible for damage to the vehicle during the term of the rental. If you have liability or comprehensive coverage of your own, you should notify it of the claim. If you don't have that coverage, you can try to dispute the charges by showing that the vehicle you rented was not in proper condition and that you were required to get the car washed for safety purposes. However, there doesn't seem to be...
Your agreement with Turo will govern. You should read it.
Ordinarily, the renter is responsible for damage to the vehicle during the term of the rental. If you have liability or comprehensive coverage of your own, you should notify it of the claim. If you don't have that coverage, you can try to dispute the charges by showing that the vehicle you rented was not in proper condition and that you were required to get the car washed for safety purposes. However, there doesn't seem to be...
Q: I want to go to small claims court to the Insurance co. Do I tell them to take me or do I file to take them.
William John Light's answer
You would probably wait to get sued and defend yourself with evidence of the alleged fraud: photos of the cars, the parking lot, comparative quotes for repair of damage, witnesses, etc.
You would probably wait to get sued and defend yourself with evidence of the alleged fraud: photos of the cars, the parking lot, comparative quotes for repair of damage, witnesses, etc.
Q: MY insurance denied my claim. How do I go about appealing the decision?
1 Answer
| Asked
in
Appeals / Appellate Law, Civil Litigation, Insurance Bad Faith and Insurance Defense
for
California
on
Answered on Jan 22, 2018
Answered on Jan 22, 2018
John Karas' answer
Sounds like your insurance company doesn't believe you regarding the theft.
If you are unfairly denied the benefits under the policy, you sue the insurance company for bad faith.
Sounds like your insurance company doesn't believe you regarding the theft.
If you are unfairly denied the benefits under the policy, you sue the insurance company for bad faith.
Q: Proof of Loss. What do I fill in after/do I leave blank "...or received indemnity therefore except as follows:"
1 Answer
| Asked
in
Contracts, Collections, Insurance Bad Faith and Consumer Law
for
California
on
Answered on Jan 19, 2018
Answered on Jan 19, 2018
William John Light's answer
It sounds like if you have received payment from anyone for any of your losses, you would itemize those payments in that space, but it's hard to say without reading the entire document.
It sounds like if you have received payment from anyone for any of your losses, you would itemize those payments in that space, but it's hard to say without reading the entire document.
Q: I am currently in Escrow and had the inspection done. We noticed trees that we believe to be on our property
1 Answer
| Asked
in
Insurance Bad Faith, Land Use & Zoning and Real Estate Law
for
California
on
Answered on Jan 12, 2018
Answered on Jan 12, 2018
William John Light's answer
This is a common legal question, and the answer is that the tree owner is liable under trespass and private nuisance theories (in most cases, at least). Whether you, as new property owner are liable, is something a a real estate attorney should be retained to evaluate. It may be something that can be passed on to the prior owner, but it appears to be an obvious and open condition, so it might be difficult to claim that it wasn't disclosed, and you purchased the problem with the house....
This is a common legal question, and the answer is that the tree owner is liable under trespass and private nuisance theories (in most cases, at least). Whether you, as new property owner are liable, is something a a real estate attorney should be retained to evaluate. It may be something that can be passed on to the prior owner, but it appears to be an obvious and open condition, so it might be difficult to claim that it wasn't disclosed, and you purchased the problem with the house....
Q: Do I have to attend a PQME appointment if my attorney file a DOR petition to withdrawal representation? thank you all.
2 Answers
| Asked
in
Employment Law, Workers' Compensation, Insurance Bad Faith and Legal Malpractice
for
California
on
Answered on Jan 5, 2018
Answered on Jan 5, 2018
William John Light's answer
You'll get better answer by calling some WC attorneys and speaking directly to them.
You'll get better answer by calling some WC attorneys and speaking directly to them.
Q: Where do I even start with a bad faith claim against my home insurance company?
William John Light's answer
Get a certified copy of the policy from your adjuster. Assemble all of the correspondence and emails to/from the adjuster. Assemble all of the items that constitute proof of your claim/damages. Call an attorney with experience in insurance matters.
Get a certified copy of the policy from your adjuster. Assemble all of the correspondence and emails to/from the adjuster. Assemble all of the items that constitute proof of your claim/damages. Call an attorney with experience in insurance matters.
Q: What can you do if you suspect that your insurance company is unreasonably handling your insurance claims?
William John Light's answer
Ask for a copy of your claims file and a certified copy of your policy and have it reviewed by insurance coverage/bad faith counsel.
Ask for a copy of your claims file and a certified copy of your policy and have it reviewed by insurance coverage/bad faith counsel.
Q: What's the threshold for holding insurance companies accountable for actions made in bad faith? What do I need to prove?
William John Light's answer
There are a number of different legal theories that can result in a finding of "Bad Faith". The jury instructions are linked below:
https://www.justia.com/trials-litigation/docs/caci/2300/2330.html
https://www.justia.com/trials-litigation/docs/caci/2300/2331.html
https://www.justia.com/trials-litigation/docs/caci/2300/2332.html
https://www.justia.com/trials-litigation/docs/caci/2300/2333.html
However, if you are doing this yourself, you have already...
There are a number of different legal theories that can result in a finding of "Bad Faith". The jury instructions are linked below:
https://www.justia.com/trials-litigation/docs/caci/2300/2330.html
https://www.justia.com/trials-litigation/docs/caci/2300/2331.html
https://www.justia.com/trials-litigation/docs/caci/2300/2332.html
https://www.justia.com/trials-litigation/docs/caci/2300/2333.html
However, if you are doing this yourself, you have already...
Q: I just lost my home and everything I own due to the wildfires in Santa Rosa. Insurance company is asking for a lot!
2 Answers
| Asked
in
Insurance Bad Faith and Insurance Defense
for
California
on
Answered on Oct 13, 2017
Answered on Oct 13, 2017
Gerald Barry Dorfman's answer
Unfortunately, that won't do it, although you may be able to handle the necessary paperwork in a way that takes a lot less time than you anticipate. The amount of coverage really doesn't determine the amount of your claim, except to put a cap on it. Of course, if you have $400K in coverage, own the home outright, and can demonstrate the value of the home vastly exceeds the policy limits, that could work. Then, you would not have to bother with a contents claim. So sorry for your loss.
Unfortunately, that won't do it, although you may be able to handle the necessary paperwork in a way that takes a lot less time than you anticipate. The amount of coverage really doesn't determine the amount of your claim, except to put a cap on it. Of course, if you have $400K in coverage, own the home outright, and can demonstrate the value of the home vastly exceeds the policy limits, that could work. Then, you would not have to bother with a contents claim. So sorry for your loss.
Q: agent said he could not determine coverage till he talks to my wife 2 hours later,a letter of denial! Bad Faith suit?
William John Light's answer
Impossible to say. You haven't described the nature of your insurance claim, the type of policy, the reason for the denial of coverage, or what your wife told the agent (adjuster?).
Impossible to say. You haven't described the nature of your insurance claim, the type of policy, the reason for the denial of coverage, or what your wife told the agent (adjuster?).
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