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San Jose Life Insurance Claims Attorney

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San Jose Life Insurance Claims Attorney

A life insurance policy is a contract between the individual insured and the insurance company. The insured pays premiums and, upon the death of the insured, the company pays the claim. The insurance company is required by law to act in good faith and fair dealing in paying or denying all such claims. If the decedent purchased the policy through an employer, the claim process is also likely subject to the provisions of the Employee Retirement Income Security Act (ERISA). A San Jose life insurance claims attorney can help recover the benefits payable to you or your loved one. 

What Is Bad Faith in Denying a Claim

California law requires that for each policy an insurer sells in the state, the insurer has a duty of good faith and fair dealing as an implied term of the contract of insurance. If the insurer unreasonably or without good cause denies a claim for benefits, the failure to pay constitutes a breach of the implied duty. Although the failure can apply in many kinds of insurance, one of the more common instances is a failure to pay out a claim on a life insurance policy.

Sometimes the insurance company will claim that the insured committed suicide or that the insured engaged in acts that contributed to the death. On the other hand, the insurance company may attempt to argue that the insured misrepresented material facts on the insurance application. 

What Constitutes Good Faith

An insurer does not have to pay claims immediately, of course. There are good-faith reasons for some delay in making the payments. Among these good-faith acts are:

  • Investigating the claim promptly and objectively 
  • Promptly pay the benefits due under the policy
  • Speaking with the decedent’s physicians
  • Refrain from engaging in fraudulent or oppressive acts seeking to lower the amounts payable under the policy
  • Refraining from “low ball” settlement offers
  • Reserving rights only when there is a good faith belief in the existence of the rights reserved
  • Refraining from an overly zealous or restrictive interpretation of policy terms
  • Refraining from imposing additional preconditions to payment beyond what is in the policy

Not acting in accordance with these good faith requirements can mean that the insurance company is failing in its duty of good faith and fair dealing.

What a San Jose Life Insurance Claims Attorney Can Do for You

If you or a loved one has experienced what you think may be a bad-faith denial of a life insurance claim in California, you should consider contacting a life insurance claims attorney as soon as possible. An insurance claims attorney can investigate the circumstances of the insurance company’s handling of your claim and, if it appears you have a case for bad faith, work with you in obtaining the life insurance proceeds to which you are entitled. Our skilled and experienced attorneys at Roberts Disability Law, P.C. focus our practices on bad faith insurance claims, particularly those covered by ERISA. Contact us today for an initial consultation and case evaluation.

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