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Category: Bad Faith Insurance

Posted November 18, 2021

Bad Faith Tactics Of Disability Insurance Companies

An unexpected illness or injury can befall anyone. Whether you are a physician, osteopath, attorney, architect, scientist, accountant, a manager, supervisor or other employee of a city, county or state, a construction worker, restaurant manager, hotel clerk or you pursue any other type of occupation, you may one day find yourself to be disabled. Your […]

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Posted September 04, 2018

The Collateral Source Rule

If you have suffered personal injuries due to the negligence of another party, such as in an auto accident or in some other circumstance, and you have medical insurance that has paid some or all of your resulting medical expenses on your behalf, the wrong doer cannot claim that such medical insurance payments should reduce […]

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Posted July 25, 2017

Courts Accept That “objective Evidence” Is Not Required To Prove Disability Due To Fibromyalgia

Many insurance companies insist that a person suffering from fibromyalgia must provide “objective evidence” of disability in order to qualify for disability benefits.  A number of federal decisions, however, make very clear that a person seeking disability benefits for fibromyalgia need not establish “objective evidence” of disability. In Hawkins v. First Union Corp. Long-Term Disability Plan, […]

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Posted July 06, 2017

Insurance Can’t Add New Defenses In Litigation

When an insurance company denies a claim, it will purport to state the reasons on which it bases its denial.  The insurance company’s reasons are all too often no more than a pretext for denying a claim it knows it should pay.  If the case proceeds to litigation, the insurance company will then assert any […]

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Posted June 20, 2017

An Erisa Insurer Or Erisa Plan Must Sufficiently Explain Its Denial

When an insurance company or ERISA plan denies your disability claim, it often leaves you with more questions than answers.  You will likely receive a letter littered with conclusions as to why you are not disabled without any reasoned explanation as to why you do not qualify.  The law is clear, however, that an ERISA […]

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Posted June 14, 2017

Recovering Attorneys Fees Where Your Public Interest Lawsuit Has Limited Success

Under California law, a private citizen can bring a lawsuit specifically intended to address the ills or injustices in society.  Recognizing that such lawsuits are highly risky and may be prohibitively expensive, in 1977, California passed a law often referred to as the Private Attorney General’s Act (“PAGA”).  Under PAGA, found at California Code of […]

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Posted June 13, 2017

Insurer Mention Of Contrary Evidence Not Consideration

When an insurance company denies a claim, it will often summarize in its denial letter the evidence cited by the insured in support of the claim.  The insurance company will do so in order to attempt to create an appearance that it actually reviewed and considered in good faith the evidence contrary to its decision.  […]

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Posted October 28, 2016

Your Attempt To Return To Work Does Not Bar A Finding Of Disability

California case law is clear that an insured’s attempt to return work may not bar a finding of disability.  The California courts have long recognized that people who are struggling with pain and other symptoms will nevertheless attempt to work.  In recognizing that people may continue perform job duties that endanger their health, courts have […]

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Posted September 14, 2016

Erisa: Disability Insurer Must Consider Job Duties

Some disability insurance policies include a provision that the insurer will try to use to disregard the insured’s actual job duties in deciding whether the insured is disabled.  A number of these policies, especially those sold by Standard Insurance Company, contain language that states that, in deciding whether to pay the claim, the insurer can […]

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Posted September 09, 2016

Erisa Insurer Must Explain Medical Evidence

In the recent case of Backman v. Unum Life Ins. Co. of Am., 2016 U.S. Dist. LEXIS 74918 (N.D. Cal. June 8, 2016), in which the claimant sought disability benefits for a painful back injury, the US District Court for the Northern District reversed Unum’s denial and ordered the payment of benefits. Unum had denied benefits based on the opinions […]

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