Legal Question in Insurance Law in California

Re: Problem with AD&D Policy

You sue. Sorry to hear about your wife.

Re: Problem with AD&D Policy

You can sue both the insurance carrier and perhaps the doctor for medical malpractice if the overdose was at a medical facility. You might want to have an expert review her medical records before you do so, though, to make sure that the coroner just didn't forget to put in the head injury. I'm sorry to hear about your wife's death.

Re: Problem with AD&D Policy

Same answer as the others - unfortunately - you have to sue the insurer. Look for an attorney who has experience with bad faith claims,as well as med mal and perhaps products liability.

Re: Problem with AD&D Policy

Insurance companies have become bolder in denying claims with the current political climate. They have lobbied legislators to pass laws that restricts their losses (malpractice caps passed long ago in California that have remained the same while inflation has caused the cap to be less than half value of what it was when passed are being urged on the national level). They have lobbied for fewer penalties when that act arbitrarily when unjustly denying claims (workers compensation laws in California passed in 2004 took away meaningful penalties and substituted penalties that lawyers for injured workers cannot afford to proceed with because the amount at stake is too small. The penalties were never supposed to be allowed to be computed in the rates.)

Legislation passed in California reversing the consequences of some case law. (Royal Globe was a case that required good faith in investigating and negotiating and the insurance industry lobbied and got that to not be an enforceable claim under the insurance code by a private person.)

That being said there still is a requirement of good faith and fair dealing on what is called a first party claim. You should consult with a lawyer and it would be good if the lawyer was knowledgeable about insurance, drugs and medical care.