The Importance of Life Insurance Company Communications
Are you getting Prompt, Honest & Complete Communications from your Life Insurance Company? You are entitled to such Life Insurance Company Communications. The company (and all its representatives) must respond to your communications within “15 calendar days” with “a complete response based on the facts then known.” Any question you ask, and any request you make must be responded to by the insurer within 15 calendar days.
You Must Make a Written Record of all Your Life Insurance Company Communications
You must get in the habit of sending your insurer letters or emails, and create a written record of who said exactly what and when. That doesn’t mean you should stop talking to your adjuster. If you request copies of your current policy and policy history, including previous policies, policy upgrades, notices of changes, etc. (something we highly recommend that you request in writing), your insurer must respond to your request within 15 calendar days. [California Code of Regulations section 2695]
Your Insurer Must Tell You About All Deadlines That Apply to Your Claim.
Including the fact that there is a deadline for filing a lawsuit against them. [Insurance Code 2071 and California Code of Regulations 2695.7]
Once that deadline passes, you lose the right to sue them, even if they have broken the law and cheated you. That deadline is called a “statute of limitations” and its purpose is to provide finality and keep things moving forward. There is one deadline for suing an insurance agent and a different one for suing an insurance company, but to find out exactly what yours is – you’ll need to consult with an attorney before the one-year anniversary of your loss. Why? Because in the state of California it’s tricky. There’s something called “tolling”. Your deadline is “tolled” (postponed) as long as your claim is still being processed but once they deny it – the clock starts again. An insurer cannot mislead you about this but it’s a common source of confusion. [California Insurance Code section 790.03]
Unless specified in your policy, you do not have to use the exact forms provided by your insurer to do your contents list. A neat (hopefully, typed) list with replacement prices should work – and an insurer cannot ask for unreasonable “proofs of loss” such as secondary proofs. For example, if you provide photographs or video of items in your home, you cannot then be compelled to provide receipts as well if they contain essentially the same information. [California Insurance Code section 790.03]
You have a right to receive a copy of every claim-related document in your file.
An insurer shall “notify every claimant that they may obtain, upon request, copies of claim-related documents…” including construction estimates, photographs and the documentation backing up their estimates and “all other valuation”. This shows how your contents and construction estimates may have been depreciated. [See “Requirements in case loss occurs” in California Insurance Code section 2071.] The only thing you are not entitled to receive is attorney-client privileged communications and their attorney work. This means that valuations, photographs, measurements, adjustor notes and reports, contents depreciation schedules, construction depreciation schedules, materials estimates, etc. are all part of your claims process, and you are entitled to receive complete copies of these so you can review them.
Keep in mind, the insurer has a responsibility to gather as much information as needed to fulfill their end of the claims process and you have a responsibility to cooperate in their investigation. You do not have a responsibility to cooperate with unreasonable requests for information or harassing tactics. However, you are obligated to answer claim-related questions about your loss. Instead of doing a telephone interview, you may ask for written questions from the insurer’s investigator to be sent to you and to answer them in writing.
Have you suffered the unexpected loss of a loved one, only to have a claim for life insurance benefits delayed, or denied? Do you get the feeling that the life insurance company is doing everything it can to avoid paying the claim? Has the life insurance company sent you a letter stating that they are rescinding the policy, claiming Application Misrepresentation, or just sending back the premiums paid? Especially if your loved one had the policy for less than two years before passing away, the life insurance company can become very aggressive at seeking to avoid the policy payment. Rescission is a favored strategy of the life insurance company, if the policy was issued less than two years before the death.