Life Insurance Claims Delayed
CALIFORNIA INSURANCE LAW FIRM GIANELLI & MORRIS CAN PROTECT YOUR RIGHTS AND MAKE SURE YOU GET THE BENEFITS YOU ARE OWED
Your life insurance company owes you a prompt investigation and timely payments
You purchase a life insurance policy and pay your monthly premiums in order to have peace of mind knowing that your family will be provided for after your passing. Life insurance can be a critical asset for surviving family members after the passing of a loved one, especially when the deceased party was the breadwinner of the family. Life insurance proceeds help surviving family members pay for a mortgage and other living expenses, educational costs, estate tax and probate expenses, as well as replacing the income lost.
Unfortunately, many life insurance providers, like other insurance companies, care more about their own bottom line than about the well-being of policyholders and beneficiaries. In addition to wrongfully denying claims, insurance providers are known to engage in a variety of bad faith tactics aimed at bullying beneficiaries into accepting a reduced settlement. At Gianelli & Morris, our life insurance lawyers know California and federal insurance law, and we know the insurance provider’s duties under their policies and the law. We know when you are being treated fairly, when delays are justified, and when life insurance providers are stalling for time in order to string you along.
If your life insurance claim investigation or payment is being unjustifiably delayed, the California life insurance delay legal team at Gianelli & Morris is prepared to offer you a no-cost, confidential consultation. Let us determine how we can help you and your family get the coverage that you deserve, promptly and without unnecessary hassle.
Life Insurance Timelines
Insurance providers must follow strict rules when it comes to investigating and paying out on claims. The rules differ depending on whether the life insurance policy is individually-owned or whether it is a non-governmental employment-based group plan. Employer policies are typically governed by the federal Employee Retirement Income Security Act of 1974 (ERISA). Individually-purchased policies are governed by California law.
Pursuant to ERISA:
- Claims should be approved or denied within 90 days of receipt of the claim.
- If the insurer needs more time to review a claim or more information, they must inform the insured within 90 days after the claim is filed. They must provide written notice, including an explanation of why additional time is needed, what information is missing, and when a decision will be reached.
- After a claim has been denied, the insured has 60 days to file an appeal. A decision on the appeal must be reached within 60 days unless special circumstances exist. The insurer can claim special circumstances, with a written explanation, and seek an additional 60 days to resolve the appeal.
California law is even more favorable to beneficiaries. Pursuant to California law:
- A claim should be approved or denied within 40 calendar days of receipt of all necessary information.
- The insurer can request additional necessary information, provided that it provides written notice of the request and lists all information reasonably needed to investigate the claim. The written notice must be provided within 40 days of the claim being filed.
- The insurer must provide an update to the insured every 30 days if they need additional time to review the claim, and such notice must clearly state the reason for the continued investigation as well as any additional documents required.
- California law provides parties four years to sue on an insurance contract, although the policy can set forth a shorter time limit for filing a claim.
Responding to a Delay
If your life insurance provider is delaying a decision on your life insurance claim, you have the right to know why. They must issue adequate, written notice, and they must do so within the appropriate time frame under federal or state law. Do not let a life insurance company browbeat you into accepting a lowball settlement or dropping your claim by delaying their investigation or sending you endless, unnecessary, demanding document requests.
If your life insurance company is dragging their feet investigating your claims, call a life insurance delay attorney at Gianelli & Morris for help. We will communicate with your insurance provider on your behalf, making sure that they either give a true and proper reason for their delay or that they resolve your claim promptly in accordance with their duties. If their delay is in bad faith, you might be able to recover the value of your claim as well as additional statutory damages.
Call Gianelli & Morris for Advice and Representation if Your Life Insurance Claim Has Been Improperly Delayed
For help with a life insurance claim investigation or payment delay, or help with any other problems regarding your California life insurance policy, call the California life insurance attorneys Gianelli & Morris for a complimentary consultation at 213-489-1600.