Holding Insurers Accountable for Paying Their Policyholders

You pay your insurance premiums for a reason. The whole point of an insurance policy is to financially protect you if disaster strikes. However, your policy only protects you if your insurer honors its obligations. 

Unfortunately, insurers are companies like any other, and financial incentives push them to pay as little as possible. Unscrupulous insurers may attempt to underpay, deny, or otherwise fail to fulfill claims that should be fully covered. 

If your insurer is trying to avoid paying you for your claim, you can get help. The attorneys at Oksenendler Law, P.C. in San Francisco handle all aspects of insurance-related litigation, including disputes over whether insurance coverage applies to particular first-party and third-party claims and the unique issues involving professional malpractice insurance. Get in touch with our skilled insurance lawyers to learn how we can help you during your insurance dispute. 

What You Can Do During an Insurance Dispute?

1st Party Insurance Claims

When dealing with a first-party insurance claim, you are seeking payment directly from your own insurer under your policy for losses you have sustained. Common examples include property damage claims or medical expense coverage. Many first-party insurance disputes arise when the insurer determines that the loss is not covered under your policy. If this happens, we can analyze your policy to determine if the denial was appropriate. If we believe the insurer is mistaken, we may seek a declaratory judgment in court. This legal action can compel a judge to order the insurer to fulfill its obligations under the policy.

In first-party claims, you often only need to prove that there is a potential for coverage under your policy to secure a favorable judgment. This can force the insurer to honor its commitments and provide the benefits you are entitled to receive. However, further litigation may still be necessary if the insurer continues to deny full payment or improperly evaluates your claim.

3rd Party Insurance Claims

Third-party insurance claims involve situations where someone else’s insurer is expected to cover damages or defend you in a liability claim. For example, this can occur in auto accidents or liability disputes where another party alleges you caused harm or damage. In these cases, your insurer may agree to defend you under a “reservation of rights.” This means the insurer will handle your defense while maintaining the right to later assert that the claim is not covered under your policy.

If the insurer ultimately denies coverage after a judgment is entered against you, further litigation may be required to hold them accountable for their duties under the policy. In some cases, obtaining a declaratory judgment can clarify the insurer’s obligations and force them to defend and indemnify you as required. This process often hinges on demonstrating that a potential for coverage exists under the terms of the policy.

Whether your dispute involves a first-party or third-party insurance claim, understanding the nuances of your policy and your insurer’s obligations is critical. Our team is here to help analyze your policy, protect your rights, and pursue the coverage you deserve.

Providing Skilled Insurance Coverage Analysis and Litigation in the Bay Area

If your insurer has denied or offered an unreasonably low settlement for your insurance claim, the expert insurance lawyers at Oksenendler Law, P.C. are prepared to advocate for you. Our office handles cases dealing with all types of coverage, including:

• Auto Insurance
• Commercial Policies
• Condo and Renters’ Insurance
• Disability Coverage
• Homeowners Insurance
• Life Insurance
• Health Coverage

We also handle professional malpractice insurance issues for doctors, lawyers, dentists, accountants, and other professionals. Our lawyers understand the many distinctions and peculiarities unique to reporting malpractice claims, such as:

• Consent — Some policies allow the insurance company to settle without the policyholder’s consent or even over the policyholder’s objection.
• Hammer Clause — A policyholder who objects to a settlement and forces a trial may be held liable for attorneys’ fees and any adverse judgment amount in excess of the earlier settlement offer.
• Wasting Asset/Declining Limits Policy — The policy limits that would be used to pay any adverse judgment are reduced by the amount of attorneys’ fees and costs expended in defending the lawsuit.

We are dedicated to helping our clients fight back against unscrupulous insurers. Whether you are struggling with consumer, business, or professional malpractice insurance, we can help you successfully resolve your dispute through negotiation or litigation. 

The Experienced Legal Representation You Need for Your Insurance Dispute

No matter what coverage or policy you hold, our lawyers have the background and skill to analyze your situation and assist you in resolving your insurance policy dispute. Contact Oksenendler Law, P.C. today for a consultation with one of our experienced insurance law attorneys. Reach our firm by calling (415) 733-1050 or sending us an email.