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Over Two Decades Of Holding Insurance Companies Accountable

San Francisco Law Blog

Musculoskeletal disorders the most common long-term disability

The vast majority of disabilities arise from medical disorders rather than from an accident or injury.

Musculoskeletal disorders – such as back problems, arthritis and carpal tunnel syndrome -- are the biggest category of long-term disability claims. These claims are also frequently denied. Unlike cancer or a broken bone, it it not always easy to quantify or document the pain and limitations of these conditions.

Why is it important to have an attorney in LTD cases?

Long-term disability insurance provides a portion of your income as a beneficiary if you become ill or injured and cannot work. This extended period of nonworking usually is more than 90 days. To receive such benefits, you may file a timely proof of loss and disability claim that an insurance company can approve.

If your employer provides and pays for your plan, it is likely that ERISA governs it. The Employee Retirement Income Security Act of 1974 set out to establish minimum standards for employee benefits. ERISA does not cover claims if you purchased a private disability policy.

How to file a claim if your home was damaged in a fire

California is again facing a series of wildfires, with numerous large and small blazes burning throughout the state. Some Californians are being forced to evacuate their homes when fires get too close.

Being forced to flee from your home is difficult, but returning to a seriously damaged or destroyed home can be emotionally devastating. Beyond your big screen TV, you may have lost irreplaceable family heirlooms or treasured photos. The good news is that your homeowners’ insurance should cover the damage to your home and the cost of replacing its contents. Here is how you should move forward with your insurance claim if your home was damaged in a fire.

Fighting a long-term disability claim denial

Suffering from a long-term disability (LTD) means you already have enough to deal with. You do not want to add fighting with an insurance company to the list. All too often, insurance companies try to avoid paying for coverage. That could leave you vulnerable both physically and financially.

There are actions you can take to fight for LTD coverage. Most insurance policies allow for one or two levels of appeals, after their claim denial. These appeals go to different departments than your original claim, so these may prove successful. If you are on an employee plan, you have to go through the appeals process before you can take steps toward filing a lawsuit.

Seeking recovery on a bad faith insurance claim

When you purchased your home about 10 years ago it was the home of your dreams. Like so many other responsible homeowners, the first thing you did was purchase a home insurance policy. However, recently, the home of your dreams was damaged and needs to be repaired. When you call to notify your insurance carrier of the damage, they inform you they are not responsible and will not pay for the damage and that you will have to pay for the repairs. What do they mean they will not pay? What can you do about it?

Is the Insurance Company Acting in Bad Faith?

Provisions to be aware of in long term disability contracts

It is not uncommon for today’s professionals to feel a significant obligation to their clients. While this commitment is admirable and essential to their success, some professionals may carry this burden even in the midst of debilitating illnesses or chronic pain. As much as someone wants to do for their clients, what happens when they cannot work?  

One would think that in these instances, long term disability (LTD) insurance will be the stopgap that was promised when the policy was originally sold. Depending on the stage of their career, an injured professional may even rely on their (LTD) policy to usher them into retirement.

Understanding ERISA denials and remedies

The basic concept of insurance is that it functions as a pooling of risk for policy holders and the insurer. Policy holders pay into a common fund to be drawn upon at a later date if needed. The money in the common fund belongs to policy holders and the insurer earns a fee for managing it. However, in application the insurer regards income generated from premiums as its own and works steadfastly to avoid returning it to policy holders. This means claims made by policy holders are often denied.

A compliant denial letter

What you should know about ERISA’s regulations

Navigating the many laws regarding disability insurance can be daunting. There are many complicated regulations to keep track of, which adds an extra layer of difficulty when you are also struggling with a disability.

One important law that is confusing for many disability claimants is The Employee Retirement Income Security Act (ERISA). Created in 1974, the act imposes standards and regulations on retirement, health and welfare benefit plans. When employers offer welfare benefit plans to their employees, ERISA sets certain standards that the employer must meet.

California wildfires continue to impact our state

Thomas, the historic California wildfire—the largest wildfire in California history—is fully contained after burning for over a month. With nearly $1.8 billion in insurance claims after the fires destroyed more than 1,000 structures and scorching 281,893 acres, the fire was devastating.

However, Thomas continues to impact our state. Beyond the issues of mudslides, air quality and watershed damage, property owners in fire-prone areas are finding it difficult to obtain affordable insurance. And in some cases, to find any insurance at all.

Three things common in insurance bad faith claims

Many California homeowners have been impacted by the devastating wildfires throughout the state this past fall. These homeowners will often have to file claims with their insurance companies in order to recover compensation under their policy in order to rebuild or repair their homes or property.

Unfortunately, many of these insurance companies will try to make it difficult for individuals to recover the money they are rightfully owed. They will deny the claims repeatedly in the hopes that the policyholders will simply give up.

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