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Policyholder Rights for Health Insurance Plans & Insurance Benefits

Gianelli & Morris provides strong representation for California insurance policyholders who have been denied insurance coverage regarding medical treatment, as well as those who have been denied long-term care insurance benefits. Most people are surprised when an insurance claim is rejected. After all, the very reason we pay for health insurance is to cover the cost of unforeseen, but necessary, medical care. One of the primary ways to avoid surprises, handle insurance claims properly, and be a smart insurance buyer and policyholder is to know your policyholder rights. Read on for more information about policyholder rights in California.

Your Rights as an Insurance Policyholder in California

California has more laws to protect insurance policyholders than any other state. The laws tell insurance companies and their representatives what they must do, can do, and cannot do when an insurance claim is filed. Taking some time to understand these requirements as they pertain to your rights as an insurance policyholder in California can help speed up your insurance settlement and improve your odds of getting paid what you’re owed under your policy. Among these policyholder rights are the following:

  • Your insurance company has the legal duty to investigate, process, and pay your claim fully, promptly, and in good faith.
  • Your insurance company always must deal with you fairly.
  • Your insurance company must communicate fully and honestly with you about the policy it sold you and about rights and duties related to your insurance claim.
  • Insurance company representatives are legally required to tell you the truth and cannot misrepresent any information.
  • No insurance company can discriminate in its claim settlement practices based on age, race, gender, income, religion, language, sexual orientation, ancestry, national origin, physical disability, or upon the territory of the property or person insured.
  • An insurance company cannot make an unreasonably low offer, attempting to settle a claim for less than the amount to which a reasonable person would have believed he or she was entitled by reference to written or printed advertising material accompanying or made part of the application for insurance.
  • Your insurance company and all its representatives must respond to your communications within 15 calendar days.
  • Your insurance company must tell you about all deadlines that apply to your claim.

If you believe your insurance company has violated your policyholder rights in any way, please contact Gianelli & Morris to schedule a free initial consultation. Our Los Angeles law firm focuses on California insurance law and representing victims of insurance bad faith. We can help you assert your policyholder rights and obtain the maximum amount of benefits available to you under your policy, even if your claim was initially denied.

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