While an insurance company owes its clients a duty to act in good faith, you should always keep in mind they are commercial enterprises that have the goal of maximizing their profit. This means the less they pay you, the more money they earn for their shareholders. You have to look out for yourself.

Your insurance company is not your enemy, but it is also not your friend. While insurance companies have a legal duty to place their client's interests above their own, they rarely do so. Far too often, they unreasonably delay paying their clients in order to maximize their profits. Sometimes they deny claims that should have been paid, and routinely, aggressively defend against claims in order to pressure their clients into accepting less money. Insurance companies know you are relying on them when you make a claim and you are likely to be vulnerable to their tactics. If they can wear you down so you take less, they earn more.

Insurance companies want you to believe their adjusters are your new friend and are trying to help you obtain a fair settlement. Part of their training often involves techniques in how to make the insured believe the adjuster is looking out for the insured. The truth is that the claims department is a profit center for the insurance company. The less they pay out, the more money the insurance company earns. Often insurance adjusters are paid bonuses if claims paid out are below a certain percentage of premium revenues. They won't tell you this important fact.

Some insurance companies are better than others. Some are worse than others. What is important is that the insured must protect his or her interest because the interest of the insurance company is to protect the insurance company.

What can I do if my insurance company denies a covered claim?
You can file suit for breach of contract and possibly a tort action seeking damages based on the insurer's bad faith handling of the claim.

 

Can recovery of damages for an insurer's bad faith exceed what the insured is entitled to receive under the insurance policy?
Yes. In addition to what the insurer is required to pay under the policy, if the denial is unreasonable, you may be able to recover "consequential damages" (money you were required to pay because of the denial) and "extra-contractual damages" which are designed to punish the insurance company and to deter it from wrongfully denying similar claims in the future.

 

What obligation does my insurance company owe me regarding my claim?
An insurance company has an obligation or duty to handle a claim reasonably, promptly, and in good faith.

 

What is the duty of good faith?
It means that your insurance company must:
  1. Pay or deny (adjust) your claim within a reasonable period of time,
  2. Timely respond to your phone calls and letters,
  3. Inform you in writing why it is denying your claim specifying each contract provision upon which it is relying,
  4. Attempt to find a basis for paying the claim rather than reasons to deny it, and 
  5. Treat you fairly.
What obligations do I owe my insurance company when making a claim?
You must:
  1. Submit your claim timely,
  2. Provide all information reasonably requested,
  3. Provide a statement under oath concerning the claim, and
  4. Reasonably cooperate with the insurance company.
Will the State of California Department of Insurance (DOI) help me if my claim is unreasonably denied?
Possibly, but don't rely on it.  They do not respond to every complaint and sometimes their responses are inadequate.  Never wait to pursue a claim because you are waiting for the DOI to investigate or act.  You may never receive a response or the response may come too late.  If you fail to comply with a notice requirement, you may lose your right to recover damages.  If you allow the statues of limitations to run, you will definitely lose your rights to recover.  In short, do not delay making a legal claim.

 

Is there any general advice you can offer when making a claim?
Yes.  After calling the insurance company, always summarize the complete conversation in a letter addressed to the person to whom you spoke.  The letter should refer to the date your conversation took place and a copy should be retained.  The initial claim letter should be sent by certified mail, receipt requested.

 

 

 

 



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Acton, Agoura, Agoura Hills, Agua Dulce, Alhambra, Altadena, Arcadia, Arleta, Artesia, Avalon, Azusa, Baldwin Hills, Baldwin Park, Bassett, Bell, Bell Canyon, Bell Gardens, Bellflower, Beverly Hills, Bouquet Canyon, Box Canyon, Burbank, Calabasas, Calabasas Hills, Canoga Park, Canyon Country, Carson, Castaic, Century City, Cerritos, Chatsworth, Claremont, Commerce, Compton, Covina, Cudahy, Crystalaire, Culver City, Del Sur, Diamond Bar, Downey, Duarte, East Los Angeles, East Rancho Dominguez, El Monte, El Segundo, Encino, Firestone Park, Flintridge, Gardena, Glassell, Glassell Park, Glendale, Glendora, Granada Hills, Hacienda Heights, Hawaiian Gardens, Hansen Dam, Hawthorne, Hermosa Beach, Hidden Hills, Highland Park, Hollywood, Huntington Park, Industry, Inglewood, Irwindale, La Canada Flintridge, La Crescenta- Montrose, La Habra Heights, La Mirada, La Puente, La Verne, La Canada, Lake Hughes, Lake Los Angeles, Lake View Terrace, Lakewood, Lancaster, Lawndale, Leimert Park, Lennox, Leona Valley, Lincoln Heights, Littlerock, Lomita, Long Beach, Los Angeles, Lynwood, Malibu, Manhattan Beach, Marina Del Rey, Maywood, Mission Hills, Monrovia, Monte Nido, Montebello, Monterey Park, Mount Baldy, Mount Wilson, Newhall, North El Monte, North Hills, North Hollywood, Northridge, Norwalk, Pacoima, Palisades, Palmdale, Paramount, Pearblossom, Pico Rivera, Pomona, Quartz Hill, Rancho Dominguez, Rancho Palos Verdes, Rancho Park, Redondo Beach, Reseda, Ritter Ranch, Rolling Hills, Rolling Hills Estates, Rosemead, San Dimas, San Fernando, San Gabriel, San Marino, San Pedro, Santa Clarita, Santa Fe Springs, Santa Monica, Saratoga Hills, Saugus, Sherman Oaks, Sierra Madre, Signal Hill, South El Monte, South Gate, South Pasadena, Stevenson Ranch, Studio City, Sun Valley, Sun Village, Tarzana, Temple City, Toluca Lake, Topanga, Torrance, Tujunga, Universal City, Val Verde, Valencia, Valley Village, Van Nuys, Venice, Vernon, Walnut, Walnut Park, West Covina, West Hills, West Hollywood, West Los Angeles, West Toluca Lake, Westchester, Whittier, Wilmington, Windsor Hills, Winnetka, Woodland Hills.

Ventura County:

Camarillo, Channel Islands, Faria Beach, Fillmore, Moorpark, Newbury Park, Oak Park, Oak View, Ojai, Oxnard, Port Hueneme, Santa Paula, Saticoy, Somis, Simi Valley, Thousand Oaks, Ventura (San Buenaventura), Westlake Village.

Orange County:

Aliso Viejo, Anaheim, Balboa Island, Brea, Buena Park, Corona Island, Costa Mesa, Cypress, Dana Point, Foothill Ranch, Fountain Valley, Fullerton, Garden Grove, Huntington Beach, Irvine, La Habra, La Palma, Ladera Ranch, Laguna Beach, Laguna Hills, Laguna Niguel, Laguna Woods, Lake Forrest, Los Alamitos, Mission Viejo, Newport Beach, Newport Coast, Orange, Placentia, Rossmoor, San Clemente, San Juan Capistrano, Santa Ana, Santa Ana Heights, Seal Beach, Stanton, Tustin, Tustin Foothills, Villa Park, Westminster, Yorba Linda.

San Bernardino County:

Adelanto, Apple Valley, Barstow, Big Bear, Big Bear City, Chino, Chino Hills, Colton, Crestline, Fontana, Grand Terrace, Hesperia, Highland, Joshua Tree, Lake Arrowhead, Landers, Loma Linda, Montclair, Morongo Valley, Needles, Ontario, Rancho Cucamonga, Redlands, Rialto, Running Springs, San Bernardino, Twentynine Palms, Upland, Victorville, Yucaipa, Yucca Valley.

Riverside County:

Anza, Banning, Beaumont, Bermuda Dunes, Blythe, Cabazon, Calimesa, Canyon Lake, Cathedral City, Cherry Valley, Coachella, Corona, Desert Hot Springs, East Blythe, East Hemet, El Cerrito, Glen Avon, Hemet, Highgrove, Home Gardens, Homeland, Idyllwild-Pine Cove, Indian Wells, Indio, La Quinta, Lake Elsinore, Lakeland Village, Lakeview, Mecca, Mira Loma, Moreno Valley, Murrieta, Murrieta Hot Springs, Norco, Nuevo, Palm Desert, Palm Springs, Pedley, Perris, Quail Valley, Rancho Mirage, Riverside, Rubidoux, San Jacinto, Sun City, Sunnyslope, Temecula, Thousand Palms, Valle Vista, Wildomar, Winchester, Woodcrest.

San Diego County:

Carlsbad, Chula Vista, Coronado, Del Mar, El Cajon, Encinitas, (Cardiff-by-Sea, Leucadia, Olivenhain), Escondido, Fairbanks, Ranch, Fallbrook, Imperial Beach, Julian, La Mesa, Lake San, lakeside, Lemon Grove, National City, Oceanside (San Luis Rey), Poway, Romona, Rancho San Diego, Rancho Santa Fe, San Diego, San Marcos, Santee, Solana Beach, Hidden Meadows, San Diego County Estates, Spring Valley, Vista.

San Luis Obispo County:

Arroyo Grande, Atascadero, Avila Beach, Baywood-Los Osos, Cambria, Cayucos, Grover Beach, Lake Nacimiento, Los Osos, Morro Bay, Nipomo, Oceano, Paso Robles, Pismo Beach, San Luis Obispo, San Miguel, San Simeon, Santa Margarita, Templeton.

Kern County:

Arvin, Bakersfield, Bear Valley Springs, Bodfish, Boron, Buttonwillow, Caliente, California City, China Lake Acres, Delano, Ford City, Frazier Park, Golden Hills, Kernville, Lake Isabella, Lamont, Lebec, Lost Hills, Maricopa, McFarland, Mojave, North Edwards, Oildale, Pine Mountain Club, Ridgecrest, Rosamond, Rosedale, Shafter, South Taft, Stallion Springs, Taft, Taft Heights, Tehachapi, Wasco, Weedpatch, Weldon, Wofford Heights.

California:

Alameda County, Alpine County, Amador County, Butte County, Calaveras County, Colusa County, Contra Costa County, Del Norte County, El Dorado County, Fresno County, Glenn County, Humboldt County, Imperial County, Inyo County, Kern County, Kings County, Lake County, Lassen County, Los Angeles County, Madera County, Marin County, Mariposa County, Mendocino County, Merced County, Modoc County, Mono County, Monterey County, Napa County, Nevada County, Orange County, Placer County, Plumas County, Riverside County, Sacramento County, San Benito County, San Bernardino County, San Diego County, San Francisco County, San Joaquin County, San Luis Obispo County, San Mateo County, Santa Barbara County, Santa Clara County, Santa Cruz County, Shasta County, Sierra County, Siskiyou County, Solano County, Sonoma County, Stanislaus County, Sutter County, Tehama County, Trinity County, Tulare County, Tuolumne County, Ventura County, Yolo County, Yuba County

 





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