Court upholds Commissioner’s Contention: A Single Insurance Code Violation Can Constitute Bad Faith Without Evidence of a General Business Practice

Posted in: Bad Faith, Insurance Bad Faith, Insurance Commissioner, Insurance Litigation Blog, Policy Interpretation, Regulations, Unfair Business Practices/Unfair Competition October 02, 2018

Every insurance policy, including disability, life, health or accidental death policies, contains an implied covenant of good faith and fair dealing between the insurance company and the insured.  This covenant requires that insurance companies refrain from acting in a way that unreasonably jeopardizes, impairs or interferes with the rights of the insured to receive the benefit of the insurance contract.  The Unfair Insurance Practices Act (California Insurance Code Sections 790, et seq., “UIPA”) was enacted to regulate the business of insurance by defining and prohibiting practices which constitute unfair methods of competition or unfair or deceptive acts or practices.

California Insurance Code Section 790.03(h) (“Section 790.03(h)”) enumerates a list of sixteen specific unfair claims settlement practices that insurance companies are …

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Los Angeles Daily Journal Publishes Small Firm Profile on the McKennon Law Group PC Entitled “Shifting Allegiance: No Longer Insurers’ Advocates, McKennon Law Group Attorneys Stand Up for Policyholders”

Posted in: Bad Faith, Breach of Contract, Disability Insurance, ERISA, Health Insurance, Insurance Bad Faith, Insurance Litigation Blog, Legal Articles, Life Insurance, Long Term Care Insurance, News, Retirement Plans May 10, 2018

In the May 7, 2018 issue of the Los Angeles Daily Journal, Daily Journal Staff Writer Melanie Brisbon authored a “small firm profile” article on the McKennon Law Group PC.  The article covers the firm’s path to success, starting with its unconventional background: several of the firm’s attorneys left established careers defending insurance companies before “shifting allegiance” to represent insureds, policyholders and claimants.  The firm started with three lawyers, including founding partner Robert J. McKennon and senior associate Scott E. Calvert.  Now, the firm consists of five attorneys and has a thriving practice in insurance litigation representing policyholders, especially involving life, health and disability insurance cases governed by insurance bad faith or ERISA.  The text portion of the profile is …

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Agents, Brokers and Rescission of Insurance Policies

Posted in: Accidental Death or Dismemberment, Agent/Broker, Disability Insurance News, Insurance Bad Faith, Insurance Litigation Blog, Life Insurance, Long Term Care Insurance April 09, 2018

Generally, an insurer need not investigate statements made in an application for insurance, subject to certain exceptions. Instead, the potential policyholder or applicant must fully disclose all known material information. If a potential insured does not correctly disclose information on an application (even innocently), the insurer may later try to rescind the insurance policy. When an insurer “rescinds” a policy, it renders the contract as if it never existed and frees both parties from their obligations under the contract. Practically, this means that the insurance company is no longer obligated to pay the claims for life insurance, accident insurance, health insurance, long-term care insurance or long-term disability insurance benefits and the policyholder no longer has to pay the policy’s premiums. …

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Bad Faith Claims Handling: California Department of Insurance Investigates Aetna’s Health Claim Denials

Posted in: Bad Faith, Breach of Contract, Disability Insurance, Disability Insurance News, ERISA, Health Insurance, Insurance Bad Faith, Legal Articles February 21, 2018

On our blog, we frequently discuss the improper tactics insurers use to deny legitimate claims for life, health, disability and other forms of insurance. For our latest article on the pervasive problem in health insurance claims denials, see https://mslawllp.com/la-times-report-pervasive-problem-of-improper-health-insurance-denials/. Mckennon Law Group PC has had much experience litigating against health insurers who deny legitimate medical claims. We know this is a rampant problem. So, it was not shocking to us that at least one very large health insurer, Aetna, took highly improper actions to deny medical insurance claims.

On February 12, 2018, the California Department of Insurance (“CDI”) issued a press release confirming its investigation of Aetna, one of the largest health insurance providers in the U.S. California Insurance …

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Court Rejects Third Party Administrator's Demurrer to Insurance Bad Faith Claim Based on Plaintiffs' Theory of Joint Venture Liability

Posted in: Bad Faith, Breach of Contract, Case Updates, Disability Insurance, Disability Insurance News, Insurance Bad Faith, Insurance Litigation Blog, Non-ERISA January 24, 2018

Implied in every insurance contract is a promise of “good faith and fair dealing,” which means that the insurer must not take unreasonable steps to prevent an insured’s right to receive benefits under the policy. To comply with its promise to act in good faith, the insurer must adhere to certain duties, such as the duty to adequately investigate a claim made by an insured. An insurer acts in bad faith when it fails to meet those duties unreasonably and without proper cause. Determining whether there has been bad faith conduct is important, in part, because it directly affects the insured’s potential recovery. If the insurer is found to have acted in bad faith, the insured may have access to …

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Does ERISA Apply to County and City of Los Angeles Employee Disability Benefit Plans? Why You Should Care

Posted in: Bad Faith, Church Plans, Disability Insurance, ERISA, Government Plans, Insurance Bad Faith December 08, 2017

Do you have a long-term disability claim with the County of Los Angeles, City of Los Angeles or another Los Angeles government organization? If so, you might be wondering: do the limited remedies available under a federal law called the Employee Retirement Income Security Act of 1974 (“ERISA”) apply to your claim? It is crucial that you determine whether the specific Los Angeles or County of Los Angeles employee welfare benefit plan at issue is governed by California’s insurance bad faith laws, ERISA, or the Los Angeles County Code. The answer will dramatically affect your recoverable damages.

ERISA applies to most employer-sponsored disability, life, health, retirement and many other employee benefit plans. ERISA exempts only two types of employer plans …

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Top 8 Tips for When You Take Your Insurer to Court

Posted in: Accidental Death or Dismemberment, Breach of Contract, Insurance Bad Faith, Life Insurance, Non-ERISA November 29, 2017

If you have a claim that has been wrongfully denied or are currently in the claims handling process, it is important to always keep in mind the potential impact of your conduct on future litigation. When dealing with a sophisticated insurance company, you want to put your best claim forward and be prepared for the potential need to file a lawsuit. In this article, we discuss our top eight tips for when you take your insurer to court, from the importance of hiring an attorney with relevant experience to preparing for the long haul that is litigation against an insurance company.

1. Hire an attorney with experience in insurance litigation who actually goes to trial.
This may seem like a …

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California Court Affirms Decision Finding Bad Faith Where Insurer Interprets Policy Against Insured's Interests

Posted in: Attorneys Fees, Attorneys' Fees, Bad Faith, Commercial General Liability Insurance, Duty to Defend, Insurance Bad Faith, Insurance Litigation Blog, Life Insurance, Punitive Damages October 11, 2017

On August 31, 2017, the California Court of Appeal discussed a variety of topics touching upon important matters in insurance “bad faith” litigation in Pulte Home Corp. v. Am. Safety Indemnity Co., 14 Cal.App.5th 1086 (Aug. 31, 2017). In this blog, we discuss the case in detail as well as the potential benefits the opinion provides to insureds’ future claims for bad faith. Before we discuss the details of the case, we first address the basics of insurance bad faith. Next, we detail the issues addressed in the case, the facts of the case, the court’s reasoning and ultimate rationale. Finally, we address the Pulte’s broader impact, solidifying the insurer’s good faith duty to interpret ambiguous policy provisions in …

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Does an Insurance Company Need to Deny a Claim to be Liable for Bad Faith Damages? You May Be Surprised to Learn the Answer is "No."

Posted in: Bad Faith, Disability Insurance News, Insurance Bad Faith, Insurance Litigation Blog, Life Insurance, Premiums, Transamerica, Universal Life Insurance August 09, 2017

Every insurance contract is accompanied by an implied covenant of good faith and fair dealing, meaning that the insurer cannot “unfairly frustrate” or unreasonably “deprive” the insured of the benefits of the insurance contract. This implied covenant applies to all types of insurance policies, including disability insurance, life insurance, health/medical insurance, long-term care insurance, accidental death and dismemberment insurance, and homeowners insurance. If the insurer unreasonably or without proper cause refuses to pay a benefit due under in insurance policy, the insurer may have acted in “bad faith.” This may allow an insured to collect extra-contractual damages, such as emotional distress damages, attorney’s fees and punitive damages. Typically, bad faith allegations follow a decision by the insurance company to deny …

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Robert McKennon Quoted in Los Angeles Daily Journal Article on Important Insurance Coverage Issue

Posted in: Accidental Death or Dismemberment, Bad Faith, Benefits, Insurance Bad Faith, Insurance Litigation Blog, Life Insurance, News, News Blog July 25, 2017

On July 20, 2017, the Los Angeles Daily Journal quoted Robert McKennon of McKennon Law Group PC in an article entitled “Insurance Claim Denial Because Airbnb Rental May Have Wider Implications,” by Andy Serbe.  The article discusses a recently filed complaint, and its broader applications regarding insurance coverage exclusions involving rentals and the impact on the potential for insureds to lose important coverage rights when they engage in once only or sporadic rentals of all or parts of their home.  In the article, Mr. McKennon explains that the insurer failed to define the terms in the exclusion, specifically the phrase “other structures reserved for rental.”  Accordingly, those terms were ambiguous as applied to the facts of the case (the complaint …

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