Help for People Facing Denied Insurance Claims

We make insurance payments every month with the understanding that our insurance company will be there for us in our time of need. After all, nobody plans on getting into a car accident, having their house damaged by fire or experiencing a catastrophic medical event. Unfortunately, insurance companies often deny valid claims without a reasonable basis. The insured is left with no insurance benefits that he or she should have received during a very difficult time in their life.

When an insurance company unreasonably denies a claim or delays payment, the company is acting in "bad faith." The insurance company is referred to as the insurer. The "insured," or "policyholder" can file a lawsuit in court. The lawsuit is for both the 1) Benefits (money) promised under the policy for the loss, and 2) The emotional distress that the insured sustained as a result of the bad faith denial of their claim.

Punitive damages: When your own insurance company acts in bad faith, you may also be entitled to punitive damages. Punitive damages go beyond compensating you for your injuries, or bringing you "back to level." Instead, they are meant to punish the wrongdoer for its outrageous conduct. Punitive damages may be imposed when the defendant company or person acted with malice, oppression or fraud.

Malice is where the insurance company's conduct was despicable and done with a knowing disregard of the rights or safety of the insured.

Oppression occurs where the company's conduct subjects the insured to cruel and unjust hardship in conscious disregard of their rights.

Fraud occurs where the company intentionally deceived the insured or concealed material facts from the insured.

I am attorney Robert Ryan. I founded Robert Ryan Law because I believe in standing up for the rights of the "little person" against the large and powerful insurance company. To schedule a free initial consultation at my law office in San Diego, call 619-234-1800.

When Is an Insurance Company Acting in Bad Faith?

Your insurance policy contains a number of fine print provisions that are designed to exclude your claim. If an exclusion applies, then you are said to have "no coverage" under your policy. Often the exclusions are so numerous that they "wipe out" coverage or create a very narrow basis for coverage to exist. It can be difficult to tell if an insurance company is legitimately excluding your coverage, or instead they are unreasonably excluding your coverage and acting in bad faith. Generally speaking, you may have a bad faith claim if:

  • A valid claim is unreasonably denied based upon your facts.
  • You are paid substantially less by your insurance company than what your claim is worth.
  • Your insurance company is unreasonably delaying payment of your benefits.
  • Your insurance company refuses to cover essential necessary medical treatment.
  • You are sued, and your insurance company unreasonably refuses to defend you in the lawsuit against you. This type of bad faith is called "a breach of the carriers' duty to defend."

I represent people with claims against all types of insurance companies, such as:

1. Uninsured motorist auto insurance: Where the person who hit you has no insurance, or they hit you and flee the scene (a hit and run). Your carrier refuses to pay the full value of your claim.

2. Auto insurance for replacing your stolen car: Your insurance company refuses to pay you because they think that you are involved in the disappearance of your car or truck.

3. Fire insurance: Your house or business establishment is burned, and your insurer refuses to pay you the full amount of your losses.

4. Health insurance: You need a critical medical procedure that should be covered, but your carrier unreasonably concludes that they don't have to pay for the procedure or treatment.

Causation: In order to obtain bad faith damages, you must prove that 1. Your carrier unreasonably denied you your benefits or money, and 2. The denial of your benefits (money) caused you economic harm and/or serious emotional distress.

The insurance company's defense: In California, insurance companies always attempt to hide behind the defense of a "genuine dispute." The insurance company retains an expert who testifies that it was reasonable for the carrier not to pay the claim. Their goal is to get the bad faith cause of action dismissed based on this defense.

Fortunately, in many cases the judge will conclude that the question of whether the dispute was actually "genuine" or reasonable is a question for the jury. We can then take your case to a jury of 12 persons from the community to determine whether you were treated "reasonably" by your insurance company.

Experience: Bad faith" cases can be complex. Each case needs to be analyzed carefully. You need an attorney who has experience in analyzing insurance contracts and whether your insurance company has committed bad faith. Because I have worked as both an insurance defense attorney and as a plaintiff's attorney for more than 25 years, I have the experience to understand "both sides of the coin."

I co-prosecuted a bad faith trial in which we obtained a jury verdict of $4.8 Million. The verdict included substantial punitive damages. I am able to fight for you against your big and powerful insurance company, its large team of lawyers and their endless financial resources.

Contact Me If Your Insurance Claim Has Been Denied

As a trial lawyer, I am not afraid to take insurance companies on in a court of law. Call me at 619-234-1800 to speak with me, or to schedule a free initial consultation. You may also contact me online and I will respond to your message promptly. I provide representation to people throughout Southern California.