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Insurance Faith Cases

Insurance Faith Cases

For over 30 years, the lawyers have been helping residents in Arroyo Grande and who have been denied coverage by their insurance companies.

Below are some examples of our successful recoveries for clients:

Client’s mobile home suffered damage from a mud slide and wind and rain damage. They received a check from their insurance company for damage made payable to the insured’s and the lien holders of the mobile home. The insured’s (clients) signed the name of the lien holders on the check without permission.

Thereafter, the mobile home suffered additional water damage and another loss by vandalism. The insured’s submitted another claim for the subsequent damage. Prior to that subsequent claim, the insurance company did not cancel the policy.

The insurance company then refused to pay the claim, asserting that the ‘fraudulent endorsement of the lien holders’ signatures voided the policy. It cited the policy language and the California Insurance Code. The trial court agreed with the insurance company.

We appealed, contending that the Insurance Code and the fraud provisions of the policy concern an insured submitting false claims to the Insurance Company, and that the insured’s intent was material.

The California Court of Appeal agreed with us and in a published opinion held ‘As a matter of Law,’ the acts of signing the lien holders’ signatures on the checks issued after the insurance company investigated, approved and paid claims, DO NOT VOID THE INSURANCE POLICY, as the false representations do not relate to the investigation to determine the company’s obligations under the policy. CONFIDENTIAL SETTLEMENT

Doe Client v. Doe Insurance Company

Plaintiff, insured, was at fault in an automobile “rear-ender” and was subsequently sued by occupants in the other car.

The insurance company thought the accident was fraudulent and conveyed that suspicion to the law firm they hired to ostensibly defend their insured. That law firm provided information to the insurance company and eventually learned that the company was planning to sue its own insured (their client), but did not inform her.

After the insurance company sued its Spanish-speaking insured, it filed a request for a default and judgment in the amount of $38,000. Plaintiff did not understand the proceedings, and filed for bankruptcy protection.

We filed a bad faith lawsuit alleging no fraud on the part of the insured, but rather bad faith on the part of the insurance company with knowledge of its conflict of interest. We sought damages against the insurance company and the law firm for: legal malpractice; malicious prosecution; breach of the implied covenant of good faith and fair dealing. CONFIDENTIAL SETTLEMENT

Roe Client V. Roe Insurance Company.

Plaintiff, our client was at fault in an automobile accident. The third party in the accident claimed damages, and our client’s car was extensively damaged. Our client tendered the case to the insurance company who denied the claim based on the premise that they had not received his monthly premium payment on time.

We filed suit and argued that our client had not received proper notice of termination. Ultimately, the company agreed to pay for repairs to the car, damages to the third party claimant, and attorney fees. CONFIDENTIAL SETTLEMENT

Insurance Faith Cases

Doe Client v. Doe Insurance Company

Client’s 15 year old son was a passenger in the family truck which was driven by a friend of the family with permission. The driver lost control of the truck, and unfortunately both were killed. The driver was covered by a non-owner auto liability policy of his own with coverage of $15,000.00 which was paid to the 15 year old’s family. We then made claim for the underinsured portion of the family’s coverage which was denied alleging no coverage and further alleging that the insured was late with their payments such that the policy had been cancelled. We filed a lawsuit and extensive litigation followed.

Most insurance policies have language excluding a vehicle that is owned by the insured from being an underinsured vehicle. An example from a competitor’s policy reads: “However, underinsured motor vehicle does not mean a vehicle (a) owned by you, a relative or a resident of your household.” We scrutinized our client’s policy and found that this provision did not exist in the subject matter policy. The insurance company continued to fight payment.

The insurance company asked the court to find no coverage as a matter of law–stating there was a requirement of two cars for underinsured coverage to apply. We argued that this was a case of first impression and the court agreed with our position stating the “language of the insurance policy does not require that there be two vehicles involved in an accident in order to trigger the policy’s “underinsured motor vehicle” coverage.

The insurance company filed a Petition for Writ of Mandate with the Court of Appeals which was denied. CONFIDENTIAL SETTLEMENT

If you are facing coverage problems with your insurance company, contact our lawyers today to discuss your bad faith insurance claim.

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