Insurance is often viewed by many in today's modern world as a necessary expense. It may be required by law or mandated as a condition of a private contractual agreement. For whatever reason people carry insurance, there are two certainties -- no one likes to pay the premiums, but they expect insurance companies to step up to the plate and take care of the covered losses. For one group of California residents, however, some insurers are intent on denying coverage.
Suffering from an injury is a burden, and having insurance that doesn't hold up its end of the agreement only makes that person's suffering worse. Insurance companies that operate in California have a duty to investigate and settle claims with their insureds fairly. Failure to do so is known as operating in bad faith. Thankfully, there are steps that can be taken to hold an insurer liable for acting in bad faith.
A lawsuit alleging that the insurance company Aetna broke a contract has blown up into an investigation led by the California Department of Insurance. When CNN showed the transcript of a deposition taken from Aetna's medical director in Southern California from March 2012 to February 2015 to the California Insurance Commissioner, he became alarmed when the medical director stated that he never looked at medical records when authorizing or denying medical care.
Golf lovers in San Diego know that a hole-in-one is an event to be celebrated. Unfortunately, the for-charity 2015 Greenbrier PGA Classic showed that it's best to read the fine print before getting too excited. Its apparent oversight led to insurance litigation over bad faith claims, ultimately leaving the tournament's charitable partners in the rough.
Having the right type of insurance coverage is a part of operating a successful business in California. One type of insurance that tends to be ignored by people who run businesses is errors and omissions insurance.
California business owners and entrepreneurs should have peace of mind regarding the ability and professionalism of their accountants. Some of that peace of mind may come in the form of the accountant's malpractice insurance. Also referred to as errors and omissions insurance, or E&O insurance, malpractice policies apply to cover harm to clients resulting from misinterpreted or misleading statements, errors, breaches of professional duty, performance-related claims or professional negligence.
Previously, we began looking at a dispute between Farmers Insurance and the California Department of Insurance over whether the agency is allowed, under Proposition 103, to retroactively review previously approved insurance rates.
Insurance rate-setting is an important issue for insurance companies, since it has a direct impact on their ability to pay claims and their financial viability. Profit is certainly not the only concern when it comes to insurance rate setting—there is also the need to ensure that consumers are being treated fairly. California law accounts for both of these factors.
Previously, we began looking at the massive jury verdict in favor of the plaintiff in a talc liability case against Johnson & Johnson. As we noted, talc liability litigation has to be a frustrating thing for the company to be dealing with, given that the weight of the overall evidence does not support finding a connection between use of talc-containing products and development of ovarian cancer.
Previously, we began looking at California’s Fair Claims Settlement Practice Regulations, which identify some of the minimum standards insurance companies need to follow in order settle claims fairly. In addition to this statute, another source of law for bad faith insurance claims is implied covenant of good faith and fair dealing.