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INSURANCE BAD FAITH. By: Charles S. LiMandri, Esq. PROFILE FOR CHARLES S. LiMANDRI
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INSURANCE BAD FAITH By: Charles S. LiMandri, Esq.
PROFILE FOR CHARLES S. LiMANDRI Charles S. LiMandri is a native San Diegan who has been representing insurance companies and insureds in coverage and bad faith litigation since graduating from Georgetown University Law Center in 1983. He is one of a select few California attorneys who are members of both the American Board of Trial Advocates and the National Board of Trial Advocacy, as well as the District of Columbia Bar and the U.S. Supreme Court Bar. He has successfully prosecuted and defended numerous civil cases in State and Federal court, including fire loss claims. He is a member of the Board of Editors of the California Insurance Litigation Reporter and the California Tort Reporter, published by West Group. Mr. LiMandri has also authored several articles on insurance coverage issues and he has lectured to insurance professionals and attorneys locally, nationally, and internationally. His firm includes a licensed architect/attorney specializing in construction related cases. The firm has handled hundreds of insurance coverage and bad faith claims. Mr. LiMandri also represented the City of San Diego, pro bono, in the highly successful Mt. Soledad Cross litigation. His firm is located in Rancho Santa Fe, California, and can be visited at www.limandri.com.http://www.limandri.com.
Three Tier Analysis: 1. Coverage 2. Bad Faith 3. Punitive Damages
Coverage: 1. Structures 2. Personal Property 3. Additional Living Expenses 4. Prejudgment Interest (Liquidated Amounts)
Bad Faith Analysis: 1. Requires Coverage 2. Not More Mistakes 3. Unreasonable Conduct 4. Not Genuine Dispute
Bad Faith Damages: 1. Attorneys’ Fees 2. Emotional Distress 3. Punitive Damages
Punitive Damages: 1. Malice 2. Oppression 3. Fraud 4. Amount: 4 to 9 times Compensatory Damages
Examples of Bad Faith: 1. Overly restrictive interpretation of policy 2. Wrongful denial of policy benefits 3. Failure to fully and fairly investigate claim 4. Delay in paying policy benefits 5. Failure to pay undisputed amount due 6. Unreasonable demands for Proof of Claim
STANDARDS FOR ADJUSTING CLAIM: 1. Respond to written inquires in writing within 15 days 2. Upon receiving Proof of Claim accept or deny claim within 40 calendar days 3. If claim is denied in whole or part, cite facts and policy provisions applicable to denial
Duties Owed By Insurer: 1. Good faith and fair dealing 2. Prompt response to claim 3. Use of superior knowledge of policy and damages 4. Seek out and offer benefits 5. Timely investigation, decision and payment 6. Willingness to keep an open mind 7. Willingness to reconsider 8. Use of independent investigators 9. Misrepresenting coverage 10. Hostile attitude and threats
Insurer Defenses: 1. Contractual limitations period (tolling) 2. Statute of limitations 3. Effect of insured’s conduct - No comparative bad faith 4. Advice of counsel - Attorney as adjuster 5. Offer of appraisal 6. Settlement and release
Appraisal: 1. Not required in disasters 2. Determination of actual cash value 3. No coverage questions 4. Avoidance of bad faith 5. Prerequisites to appraisal 6. Obtain claim-related documents
Claim Related Documents: 1. Repair and replacement estimates and bids 2. Appraisals 3. Scopes of loss 4. Drawings 5. Plans 6. Reports 7. Third party findings on the amount of loss 8. Covered damages 9. Cost of repairs 10. And all other valuation, measurement, and loss adjustment calculations of the amount of loss, covered damages, and cost of repairs
Advice to Insureds: 1. Be truthful 2. Don’t overstate damages 3. Be courteous 4. Keep copies of all correspondence 5. Keep journal of all telephone calls 6. Do chronology of key events
Litigation With Insurer: 1. Duty of good faith and fair dealing continues 2. Low-ball settlement offers 3. Litigation conduct privileged 4. Use of claim file 5. Use of claims manual 6. Juror attitudes
Closing: Thank you. Law Offices of Charles S. LiMandri, APC Website: www.limandrilaw.com