Rackohn & Rackohn

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.

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.

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.

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.

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.

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.

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.

The appropriate procedure to obtain production of other claim files handled by claim adjusters is to obtain an order to compel that requires the parties to agree on a letter sent to the policyholders requesting authorization to release their claims files. Any order for discovery of other claims files must be conditional on obtaining the written consent of the other claimants in response to a court-approved request form. The consent form must be dated, signed, and obtained within a year prior to disclosure.

If you want to know if your insurance company is withholding insurance benefits from you call us for your free consultation. No recovery. No fee.

Even though you have insurance coverage under your homeowners policy for bodily injuries on your property there is exclusion for accidents caused by a vehicle. There still may be coverage for your injuries, your children’s injuries.

You may have a cause of action for negligent supervision as a result of the homeowner not supervising your child that leads to the child being injured by a vehicle on the premises. Even the homeowners policy excludes injuries caused by an automobile, there still may be coverage under their homeowner’s policy.

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

When water from a broken pipe come from a water main pipe to the house that enters the house causing damage to the foundation causing it to rise, shift or subside there may be coverage under your homeowner policy. There may be damage to the floor insulation, framing and sheeting, floors, walls, and ceiling. There may be buckling in the hardwood floors and walls, kitchen cabinets and doors out of adjustment, cracks in the ceiling, and walls separating from the ceiling.

Most homeowner insurance policies provide coverage for “sudden and accidental direct physical loss to property” described as the “dwelling including attached structures.”
Most homeowner policies contain various exclusions and exceptions to the exclusions. Usually the following exclusions are identified in the policy:
a) wear and tear, aging, marring, scratching, deterioration, inherent vice, or latent defect;
b) mechanical breakdown;
c) growth of trees, shrubs, plants or lawns whether or not such growth is above or below the surface of the ground;
d) rust or other corrosion, mold, wet or dry rot;
e) contamination, including, but not limited to the presence of toxic, noxious, or hazardous gasses, chemicals, liquids, solids or other substances at the residence premises or in the air, land or water serving the residence premises;
f) smog, smoke from the manufacturing of any controlled substance, agricultural smudging[ ] and industrial operations;
g) settling; cracking; shrinking; bulging or expansion of pavements, patios, foundations, walls, floors, roofs or ceilings;
h) insects, rodents, birds or domestic animals. We do cover the breakage of glass or safety glazing materials caused by birds; or
i) seizure by government authority.

Many homeowner insurance policies provide an exception to the exclusions, causes by the sudden and accidental escape of water or steam from a plumbing, heating or air conditioning system, household appliance or fire protective sprinkler system within your dwelling, that cause direct physical damage by the water or steam.

Don’t let your insurance company deny your claim because the broken water main or sewer main is outside your house or dwelling. Call us today for your free consultation with a partner. No recovery. No Fee.