Newport Beach Insurance Claim Lawyers

Denied ERISA & Life Insurance Claims

The attorneys at McKennon Law in Newport Beach, California, have a deep understanding of the tactics insurance companies and plan administrators use to deny valid claims. While California holds insurers accountable for providing ethical and reasonably prompt service, insurers will still often take a chance to see if you will settle for less, change the terms of your contract without notice, or unjustly reject a claim.

If you are waiting to collect so you can pay your medical bills, or if you were seriously injured, the last thing you need is an insurance company dragging its feet or lowballing a settlement. This is where our Newport Beach insurance claim lawyers step in to help.

We are prepared to provide aggressive, effective representation on a contingency fee basis, meaning we do not recover unless we obtain a favorable settlement, judgment, or verdict at trial for your case.

Representing You In ERISA Claims Denials

Claims for benefits under an employer-sponsored plan (such as group disability or life insurance) are governed by the Employee Retirement Income Security Act of 1974 (ERISA). The structure of ERISA plans creates a structural conflict of interest—the plan administrator issues claim decisions and pays benefits, giving them a financial incentive to prioritize their own interests.

If your ERISA claim is improperly denied, we are prepared to help you appeal or litigate the insurance company’s decision and inform you of any deadlines that must be met. If successful, you may be able to recover your benefits, interest on the benefits due, and attorneys’ fees.

Examples of Abuse of Discretion in ERISA Claims

If the plan administrator abuses its discretion, its decision may be overturned. A plan administrator may abuse its discretion by:

• Placing greater weight on a “paper review” of the insured’s medical records than the reports of treating physicians.
• Relying on an exclusionary clause which is not conspicuous, plain, and clear to the insured.
• Requiring “objective” medical evidence of complaints that are inherently subjective (like pain or certain mental health conditions).
• Discontinuing disability benefits without substantial evidence of improvement.
• Ignoring the Social Security Administration’s finding of disability.
• Failing to engage in a “meaningful dialogue” with the claimant by explaining the denial in clear language with specific references to the plan provisions that form the basis of its decision.

Seasoned Attorneys In Life Insurance Bad Faith Cases

Life insurance policies promise financial security after a loved one dies. However, insurance companies often deny life insurance claims, inflicting additional stress on beneficiaries during a difficult time.

If your life insurance claim is denied in bad faith, you may be able to recover not only the benefits but also significant damages, including:

• Punitive Damages
• Consequential Damages
• Emotional Distress Damages
• Pre-judgment Interest
• Attorneys’ Fees

When a Life Insurer May Be Acting in Bad Faith

As experienced litigators, we know what to expect when insurance companies improperly deny a life claim. In our decades of experience, we know that insurance companies may be acting in bad faith by:

• Imposing a standard of eligibility for benefits not expressed in the policy or plan, which results in an unwarranted and arbitrary construction of the contract.
• Applying an “arbitrary or unreasonable” policy interpretation.
• Denying coverage despite an agent’s negligent misrepresentations of coverage at the time of sale.

If you suspect your insurance claim was denied in bad faith, reach out to our law firm immediately because the law or the terms in your insurance policy may limit when you can file a suit. Our experienced life insurance litigation attorneys will keep you apprised of any applicable deadlines.

Talk To Us During A Free Consultation

For more than 30 years, we have represented clients from throughout Southern California and the state. Our attorneys have been recognized as among the top in the nation regarding insurance bad faith cases and are nationally recognized in understanding ERISA.

Contact McKennon Law in Newport Beach today. For a free initial consultation, please fill out our online form or call 949-504-5381 to schedule your free strategy session.