According to the law, ambiguous insurance policy provisions are to be interpreted in favor of the policyholder and against the insurance company. Too often, insurance adjusters do just the opposite and deny coverage based on ambiguous policy provisions.
Insurance policies are contracts between the insurance company and the policyholder. Insurance companies draft the language of
Timeliness of insurance claim investigation and payment is often critical to the well-being of a policyholder. One of the fundamental “rules of the road” of good faith claim handling requires the insurance company to timely investigate, evaluate and pay claims if owed. Likewise, a company’s unreasonable, unfair failure or refusal to do so is bad faith. Unfortunately,
How can an insurance company’s evaluation of its policyholder’s personal injury claim be considered fair, reasonable and in good faith if the insurance company cannot explain how it arrived at the dollar value it assigned to the claim? I don’t believe it can.
This issue often arises in uninsured motorist (“UM”) breach of contract/bad faith cases. As part of the handling
The momentum created by the Cunningham v. Aetna case in Oklahoma has contributed to a national trend of lawsuits being filed against health insurers who deny proton therapy to their policyholders suffering from cancer. Readers of this blog may will recall the Cunningham vs. Aetna case in Oklahoma County,
As we frequently discuss on this blog, insurance companies owe a duty of good faith and fair dealing to their policyholders. Unfortunately, insurers regularly violate this important duty in a myriad of ways. This is not uncommon. However, it is very uncommon for an insurance company’s actions to be called out as forcefully as they
A high-profile California insurance bad faith lawsuit brought by Gillen Washington and his attorney Scott Glovsky against his health insurance company, Aetna, has now been settled. In this case, first reported on by CNN, evidence emerged in the form of the Aetna-in house doctor’s testimony that Aetna medical directors make decisions on policyholders’ claims without first reading the medical
United Healthcare (“UHC”), the largest health insurance company in America, was found by the California Department of Insurance to have committed over 900,000 violations of California laws and regulations. As a result, the California Insurance Commissioner imposed $173 million in fines. UHC challenged the fines in court, and in early January the California Supreme Court
I am happy to announce we obtained a $25.6 million verdict for our clients Ron and Orrana Cunningham this week in Judge Lisa Davis’ court in Oklahoma County. The case is Cunningham v. Aetna, CJ-2015-2826. It is a non-ERISA health insurance bad faith case. I apologize for the length of this post, but I think
A recent story in the Guardian reveals the statistics on how CEO pay at the largest US corporations has skyrocketed over the last few decades. The Guardian story says in 1965, CEO pay was 20 times that of workers. That would mean if a worker made $30,000.00 per year, the CEO would be making about
Insurance companies often hire an “expert” as part of their investigation of a policyholder’s claim. The expert can be a doctor, an engineer, an accident reconstructionist, an accountant, etc. , depending on the type of claim and the issue being investigated. Insurance companies and their lawyers love nothing better than to claim that because they
