Dealing with Insurance Claim Denials
Insurance companies sometimes refuse to pay claims submitted by its policyholders. When an insurance company does so, this is called “denying” the claim. A claim may be denied, for example, because the company has determined that the loss is not a type that is “covered” by the terms of the insurance policy or that the person who suffered the loss is not an “insured” for purposes of the policy or that a policyholder engaged in some type of misconduct which “voided” the coverage. Occasionally, a claim may be denied in error. In any event, due to the complexity of insurance policies, any resolution of coverage disputes often requires careful analysis of the unique facts and circumstances specific to the denial in light of applicable state law. Time is of the essence. All disputes have a specific period of time for which they must be addressed, either through the State Insurance Commission, or by legal means. If you think your claim has been improperly denied, find out which statutes or time frames apply to ensure that you preserve your rights and claims against your insurer. Tips on what to do if your insurance claim is delayed or denied: Tips for Delay If your claim is unduly delayed, it is possible the insurance adjuster reviewing your claim has is missing information that they need to make a decision. There may also be times when the adjuster is undecided as to whether to pay the claim. In this instance, it is best to cooperate within reason with your insurer. You can provide the missing information which can turn a potential denial into an acceptance. Whenever you call your insurance company, make every effort to be helpful and not confrontational. Do not let them forget about you either! Telephone your insurer regularly — every 2-3 weeks. Be polite, and be persistent. If you do not receive suitable responses or see any progress always ask for a supervisor or manager. Keep detailed notes identifying who you talked to, what you discussed, and make sure you find out what is to occur next. If you still are not seeing timely progress, contact an attorney who can negotiate on your behalf and/or take the necessary steps to put the insurer on notice of a potential bad faith claim lawsuit. Tips for Denial If your claim is denied, make sure you get the denial in writing and insist on a written explanation of the reasons for the denial. Take note of the reason(s) given in the insurance company’s denial letter. Next, read your insurance policy carefully and check the reason for denial against your policy. Look for anything that does not add up or make sense. The denial may be due to an error based on a lack of complete information, an incorrect reading of your policy or misinformation. But it may also be a correct determination by the insurance company. Document every phone call to your insurer by noting the date, time, name of person you spoke with and a detailed summary of the conversation. Follow-up...
Tips for Filing Your Fire Insurance Claim
Insurance carriers are expecting to receive hundreds of thousands of fire claims in the upcoming months due to the recent southern California wildfires. Given the high number of cases that each insurer within the state will have to investigate, the earlier that you file the better. If your home was damaged by the fires and if you have not yet filed a claim with your insurance carrier, there are some simple tips that may make the difference between being compensated completely for your losses or receiving pennies on the dollar. Typically, homeowners’ policies cover wind, fire and lightning damage. If your home was damaged or completely destroyed by smoke or flames, the typical insurance company will pay to have your home rebuilt or to replace the damaged portions. In addition to paying for physical damage to your home, homeowners’ policies pay for damage to other property and structures on the premises, like your garage or tool shed, damage to your furniture, clothes, appliances and other personal possessions. Additional living expenses will likely be covered as well. Tip 1 – Contact Your Carrier Right Away IN WRITING Contact your insurance carrier to begin the process to file your claim as soon as possible. You will likely need to provide your insurance carrier with the following: A description of your loss. Be as detailed as possible, including: photos police reports inventories or itemizations of your destroyed or damaged personal and real property your date of loss the type of loss or damage that you suffered related injuries identity of all witnesses and all parties involved identity of all repairs that you made or that you know are required plans, accounting books, investigation reports or any other documents that the insurer requests Tip 2 – Know Your Deductible Your deductible is the amount that you are required to pay toward your claim before the insurance company begins to pay. Find out from your insurer how much your deductible is; if your losses are less than the deductible, you may want to reconsider filing the claim. Tip 3 – Keep Your Receipts Keep all of you receipts! If you stay at a hotel, eat at a restaurant, buy clothing, or make any other expenditure because of the fire, make sure you get a receipt. All of these items may be reimbursable depending on your coverage. Your insurance company might even cover your housing expenses, depending on your plan. Policies that include “additional living expense coverage” or “loss of use coverage” options will pay for similar housing while repairs are being made to your home or if you have to permanently relocate. Be aware that in most cases, you must request reimbursement for the expenses that you incurred. Tip 4 – Assess Your Damage Keep track of everything that was damaged, and be as accurate as possible. Identify the manufacturer, brand name, model and the place and date of purchase for as many of your losses as possible. Divide your list into categories, items in different locations in your home such as: living room,...
Catalano & Catalano announces the launch of the California Workers Blog.
Catalano & Catalano announces the launch of the California Workers Blog.
The California Workers Blog examines all areas of employee rights and employer obligations. Here you will find useful, easy-to-read news and information, designed to assist you in maintaining and protecting your rights as a California Worker regardless of the type of job you have, or your income level.
Catalano & Catalano represents California companies, executives and individuals (both plaintiff and defendant) in labor issues, employment disputes, and class actions involving:
- Discrimination (age / race / sex / religion / national origin)
- Harassment
- Wrongful Termination / Discharge
- Severance Agreements
- Whistle Blower / Retaliation / Qui Tam Lawsuits (Federal Whistleblower)
- Wage & Hour Claims
- Restrictive Covenants
- Employment Agreements
- Regulatory Compliance
- FMLA Violations
- Americans with Disabilities Act Complaints
- EEOC Complaints
- Fair Labor Standards Act Violations
- Overtime Disputes
- Hiring Violations
- Violations of the Fair Labor Standards Act
Catalano & Catalano announces a move to their new San Diego, CA office
The law firm of Catalano & Catalano announces the move to their new SD office. The firm is now located in the very elegant and modern building called Broadway 655. By adding additional office space the firm can continue to grow and build its ever developing plaintiffs construction defect, landslide and bad faith insurance practice, which are the firms largest practice areas in San Diego.
The new office is located at:
655 W Broadway, Suite 880
San Diego, CA 92101
Catalano & Catalano was founded by Patrick Catalano in 1979. The California law firm is a general civil trial and appellate practice firm, with an emphasis on handling cases involving fraud in the purchase of real estate, contract disputes, construction defect litigation, legal malpractice, accounting malpractice, security & exchange commission cases, general real estate matters, business and contractual fraud cases, and other general and civil business litigation matters. The firm has extensive experience with complex litigation, including multi-plaintiff matters, class actions and construction defect cases.
The Law Offices of Patrick E. Catalano announces name change to Catalano & Catalano
The Law Offices of Patrick E. Catalano, one of the leading plaintiffs’ Real Property & Construction Law Firms in California, announced today that effective immediately, the firm will be known as Catalano & Catalano. The name change also involved a firm logo re-brand and the launching of a new web site which can be viewed at www.legalcat.com.
Patrick E. Catalano, the firm’s President commented that “Unifying our brand name to Catalano & Catalano is a sign of the legacy our firm has built. The name change is a tribute to my late sister Janice K. Catalano who practiced with me for 20 years.”
Catalano & Catalano was founded by Patrick Catalano in 1979. The California law firm is a general civil trial and appellate practice firm, with an emphasis on handling cases involving fraud in the purchase of real estate, contract disputes, construction defect litigation, legal malpractice, accounting malpractice, security & exchange commission cases, general real estate matters, business and contractual fraud cases, and other general and civil business litigation matters. The firm has extensive experience with complex litigation, including multi-plaintiff matters, class actions and construction defect cases.
Work Begins To Stabilize Landslide
It is being speculated by some of these experts that the hillside can in fact be fixed permanently and the houses rebuilt, but that the cost of the rebuilding will likely have to be borne by the homeowners themselves. Patrick E. Catalano and Jannik P. Catalano are referenced in the article.
The full text of this article can be found here:
http://www.nbcsandiego.com/news/14264940/detail.html
Slide Victims Planning Legal Action Against City
Homeowners are complaining that they were never warned about the scope of the Soledad Mountain Road landslide, while city officials claim that warnings were sent out. Some homeowners claim they received a letter regarding water maintenance, but that there was no mention of a potential landslide. Patrick E. Catalano is quoted in the article.
The full text of this article can be found here: www.nbcsandiego.com/news/14273737/detail.html
More Mount Soledad Homes Appear To Be At Risk
The landslide that occurred on Soledad Mountain Road in La Jolla, California caused the destruction of seven homes and the evacuation of over one hundred others. The alleged cause of the landslide is leaking city of San Diego water pipes that weakened the hillside, eventually leading to a slope failure. Some consultants are worried that the same slope could slip again, destroying additional homes. Patrick E. Catalano is referenced in the article.
The full text of this article can be found here: www.signonsandiego.com/news/metro/20071009-9999-1n9slide.html
Gov. Declares State of Emergency In Wake Of Slide
Thus far, the estimated damage of the slide stands at $48 million. The declaration of a state of emergency clears the way for various governmental agencies to participate in remedying the situation on Soledad Mountain Road.
The full text of this article can be found here: www.10news.com/news/14260985/detail.html