Under California Law Your Insurance Company Has Duty to Defend You If Your Business Has Been Served With a Lawsuit If There Is a Potential For Coverage

Commercial General Liability policy is often referred to as a business general liability policy that provides liability insurance for businesses.

Your Commercial General Liability policy has two essential parts: the insuring agreement that identifies the risks that are covered, and the exclusion portion that excludes coverage for risks that are not covered by the policy.

When you are sued by someone as a result of your business activity if there is a potential for coverage under your Commercial General Liability policy your insurance company is obligated to provide a defense for you.

The duty to defend has always been interpreted broadly in determining whether or not your insurance company has to provide a defense to a lawsuit. The policyholder must prove the existence of a potential for coverage, while your insurance company must establish the absence of any such potential coverage.

If the insurance company has denied your claim for a defense to a lawsuit call today for your free consultation with a partner. No recovery. No fee.

In California the Ultimate Test for Bad Faith is Withholding Benefits Without Proper Cause.

The ultimate test for bad faith is when your insurance company withholds insurance benefits that are due and owing without proper cause. Unreasonable conduct can include unreasonable delay in paying insurance benefits based on an inadequate or tardy investigation, paying less than is due, out right denial of the claim when there is coverage.

If your claim has been wrongfully denied call today for your free consultation with a partner. No recovery. No fee.

California Statute Limitations on Bad Faith Claim is Controlled by Policy Provision

In California the statute of limitations when suing your insurance company for policy benefits is the time specified in the policy. Most fire insurance policies provide for a one year statute of limitation. Suit must be filed within one year from the loss. The time to file is extended during the time your insurance company is investigating your claim.
Once the claim is denied you have 12 months from the date of denial to file a claim.

Your insurance company may be estopped to assert the statute of limitations contained in the policy where there have been representations that the policyholder relied on to delay filing suit.

If your claim has been wrongfully denied call today for your free consultation with a partner. No recovery. No fee.

California Law Allows an Insured Who Relies On Representations from the Insurance Company To Toll the Statute of Limitations

An insurance company may be estopped from raising a statute of limitations defense if the policyholder can show that he or she relied on representations by the insurance company. An insurance company’s representation that the policy does not cover the claim does not constitute grounds for estoppel. There must be a misrepresentation of fact that can lead to estoppel.

If your claim has been wrongfully denied call us for your free consultation with a partner. No recovery. No fee.

Wrongful Denial of Insurance Benefits Based On a Biased Investigation

It is not an excuse for your insurance company to deny your claim by relying on an expert that conducts an investigation that is bias and unreasonable against the policyholder. To protect the policyholder’s peace of mind and security, an insurance company cannot reasonably and in good faith deny payments without thoroughly investigating the foundation for its denial.

Your insurance company has a duty to conduct a thorough investigation that includes interviewing witnesses with significant information. Your insurance company must fully inquire into possible bases that might support the policyholder’s claim.

Call today to speak to a partner for your free consultation. No recovery. No fee.

Wrongful Denial of Damages Caused by a Broken Water Pipe Based On the Wear and Tear Exclusion

When you have a broken water pipe or sewer pipe your insurance company is always looking to see if wear and tear caused the break.

Your policy is not a maintenance policy and will not cover the repair of the pipe. But if may cover the costs to get to the pipe for example when access is through the floor or wall. If the pipe that broke causes damage to your home or personal property you may have coverage for consequential damage caused by water escaping into the home.

In California your fire policy covering your home is an all risk policy. If the loss is not excluded by the policy it is included in coverage. Your insurance company has a duty to diligently search for and consider evidence that supports coverage of the claimed loss.

When your insurance company has wrongfully denied your claim, call today to speak to a partner. No recovery. No fee.

Notice of Claim More Than 30 Days After Loss To The Insurance Company Is Not Grounds To Deny Your Claim

Your insurance company must show substantial prejudice to deny your claim when you provide notice of claim more than 30 days after loss. The reason you are required to present a claim under your insurance policy within 30 days is to prevent fraud.

The purpose of the proof of loss requirement is to give the insurance company the necessary facts to facilitate its investigation of a claim of loss after it has received notice of the claim.

To show substantial prejudice the insurance company has to show the delayed notice and proof of loss impaired its ability to investigate and settle the claim.

If your claim has been wrongfully denied call us today for your free consultation with a partner. No recovery. No Fee.

Mercury Insurance Company Responsible for Punitive Damages for failing to pay insurance Claim

In Amerigraphics, Inc. v. Mercury Casualty Co. a jury determined that Mercury insurance breached the covenant of good faith and fair dealing by denying its policy holder insurance benefits for loss of income under its business interruption coverage.

The trial court found that the language in Mercury’s insurance policy was not vague and ambiguous. The court found that the plain language of the policy provided coverage for both net income and continuing normal operating expenses without having to offset one against the other.

Testimony at trial proved that all Mercury had to do was provide its policy holder with a working scanner and printer and pay the claim in a timely manner the policy holder could have kept the business going.

Instead the delays caused by the way Mercury handled the claim caused their policy holder to go out of business.

The jury determined that an agent or employee of Mercury Casualty Company engaged in conduct with malice, fraud, or oppression in support of punitive damages.

Our firm has successfully handled claims against Mercury. Call us today for your free consultation with a partner. No recovery. No Fee.

Insurance Brokers that Hold Themselves out As Specialists in Income Property are Responsible for Not Obtaining the Right Policy

Your insurance agent assumes an additional duty by holding himself out as having expertise in a given field of insurance being sought by you. For example if your insurance agent tells you he specializes in rental income properties he has a duty to obtain insurance that will cover you for foreseeable losses that a bare bones policy would not cover for the same losses. Your insurance agent’s failure to obtain insurance as a specialist for rental income property may be grounds to hold him responsible for losses caused by his negligence in not obtaining you the proper policy.

Call us today for your free consultation with a partner. No recovery. No fee.

Insurance Appraisal is not the same as Arbitration and does not have the Same Binding Effect on the Parties.

An appraisal provision in an insurance policy constitutes an agreement for contractual arbitration. Appraisal hearings are a form of arbitration and are generally subject to rules governing arbitration. The function of appraisers is to determine the amount of damage resulting you are entitled to for property damage. It is not the function of an appraiser to resolve questions of insurance coverage in your policy.

Don’t let your insurance company deny your claim based on an appraiser’s interpretation of coverage under your policy. When the insurance company wrongfully denies insurance benefits based on an appraisers interpretation of your policy you may have a valid right to sue your insurance company for damages for your losses.

Call us today for your free consultation with a partner. No recovery. No Fee.

WordPress Blog Support