California Disability Insurance Claims
We are a healthcare/professional disability insurance law firm with a national reputation for obtaining successful results for our clients. Our firm has represented physicians, dentists, lawyers, executives and other professionals throughout the country, with the goal of securing and protecting their entitlement to benefits on own-occupation disability insurance policies.
We work with physicians, dentists, attorneys and business executives filing disability claims throughout California, including the Los Angeles, San Diego, San Jose, San Francisco, Fresno, and Sacramento areas.
Below are some resources for policyholders filing disability insurance claims in California. If you’d like to discuss your particular claim with our attorneys, we are happy to set up a free consultation.
Does California Recognize Insurance Bad Faith?
California recognizes bad faith, sometimes also referred to as a breach of the “duty of good faith and fair dealing.” As explained by the California Supreme Court, “[i]t has long been recognized in California that ‘[t]here is an implied covenant of good faith and fair dealing in every contract that neither party will do anything which will injure the right of the other to receive the benefits of the agreement.’” Kransco v. Am. Empire Surplus Lines Ins. Co., 23 Cal. 4th 390, 400, 2 P.3d 1, 8 (2000), as modified (July 26, 2000) (internal citations omitted).
This applies to insurance policies—a type of contract. In California, breach of the covenant of good faith and fair dealing “is limited to contract rather than tort remedies.” Id. However, there is an exception for insurance contracts, because “[t]he availability of tort remedies in the limited context of an insurer’s breach of the covenant advances the social policy of safeguarding an insured in an inferior bargaining position who contracts for calamity protection, not commercial advantage.” Id.
The case excerpts above are not meant to be a comprehensive discussion of each state’s first-party bad faith or disability insurance law. They are merely meant to act as a resource/starting point for those interested in learning more about how insurance bad faith works in their state.
You should always speak with an attorney before making any legal arguments relating to your disability claim.
Notable California Disability Insurance Cases
Pak v. Guardian Life Ins. Co., No. 21-cv-05032-WHO (N.D. Cal. Feb. 10, 2022) (California anesthesiologist became disabled due to migraines; Guardian argued that he had two occupations—pediatric anesthesiology and anesthesiology—based on CPT code analysis; court determined that how much time Dr. Pak spent performing the work of a pediatric anesthesiologist was a question best left for the jury).
Jue v. Unum Group, Case No. 19-CV-08299-WHO (N.D. Cal. Feb. 8, 2021) (Dentist diagnosed with De Quervain’s Tenosynovitis opted for conservative treatment instead of surgery; Unum paid benefits for 15 years but then told Dr. Jue that she had 90 days to schedule her surgery or they would deny the claim due to a lack of appropriate medical treatment).
Fleming v. Unum Life Ins. Co. of America, Case No. SACV 17-01576-CJC (JDEx) (C.D. Cal. Nov. 20, 2018) (California litigation attorney became disabled after a serious car accident that left her with severe injuries to her neck and thoracic spine; court found that Unum improperly overemphasized the significance of surveillance footage it relied on to deny claim).
Hangarter v. The Paul Revere Life Ins. Co., 236 F. Supp. 2d 1069, 1088 (N.D. Cal. 2002) (California chiropractor became disabled from epicondylitis, cervical intervertebral disk syndrome and tendinitis; denial was improper and court held that that “the performance of tasks incidental to one’s profession does not demonstrate that an individual is not ‘totally disabled.’”).
Fitzgerald v. Globe Indemnity Co. of New York, 84 Cal.App. 689 (1927) (A California physician/surgeon and walnut grower became disabled due to chronic nephritis; court ultimately found he was disabled from both occupations but suggested that inability to perform one of two distinct occupations would entitle the insured to partial but not total disability benefits).
Common Disability Claim Questions
What should I expect when filing a disability claim?
What issues am I most likely to face handling my disability insurance claim alone?
My disability claim was just denied. What should I do now?
What can my insurance company do when it is investigating my claim?
Do insurance companies conduct surveillance and, if so, when are they watching?
Why does my insurer want to conduct a field interview?
How can I tell if I have a true own-occupation policy?
What are the different types of disability policies?
California Federal District Court Locations
Professional disability claims are often filed in, or removed to, Federal Court given the amounts in controversy. Below is a list of the primary Federal Courthouses in California, but there may be other courthouses that are closer to where you live.
Los Angeles: 350 W 1st Street, Suite 4311, Los Angeles, CA 90012-4565; 255 East Temple Street, Los Angeles, CA 90012-3332.
San Diego: 221 West Broadway San Diego, CA 92101; 333 West Broadway, San Diego, CA 92101.
San Jose: 280 South 1st Street, Room 2112, San Jose, CA 95113.
San Francisco: 450 Golden Gate Avenue, San Francisco, CA 94102.
Sacramento: 501 I Street, Room 4-200, Sacramento, CA 95814.
Fresno: 2500 Tulare Street, Room 1501, Fresno, CA 93721.
Who Do Your Disability Insurance Attorneys Represent?
The lists below provide a representative overview of the types of professionals we represent, the disability companies we file claims with and litigate against, and a non-exhaustive list of some of the disabling conditions our prior clients have had.
Professionals
Anesthesiologists | Attorneys | Cardiologists | Chief Medical Directors | Chiropractors | Commercial Real Estate Brokers | Corporate Executives | Emergency Medicine | Endodontists | Gastroenterologists | General Dentists | Gynecologists | Internal Medicine | Neurologists | Neurosurgeons | Obstetricians | Ophthalmologists | Oral Surgeons | Orthodontists | Orthopedic Surgeons | Otolaryngologists | Physical Therapists | Podiatrists | Professional Athletes | Prosthodontists | Psychiatrists | Psychologists | Pulmonologists | Radiation Oncologists | Radiologists | Rheumatologists | Veterinarians
Physician Claims & Resources | Dentist Claims & Resources
Disability Insurance Companies
Aetna | AIG | Allstate | Anthem | American General | Ameritas | Berkshire Insurance Group | Boston Mutual | Cigna/LINA | Colonial Life | Connecticut General | Davies Life & Health/Disability Management Services, Inc. | Disability Reinsurance Management | First Unum | Fortis | Great West | Guardian Life | Hartford | Jefferson | John Hancock | Liberty Mutual | Lloyd’s of London | Mass Casualty | Mass Mutual | MetLife | Monarch | Mutual of Omaha | National Life of Vermont | New York Life | New England Life | Northwestern Mutual Life | Ohio National | Paul Revere | Penn Mutual | Phoenix Life Insurance | Principal Life | Provident | Prudential | Reassurance America | Reliance | Reliance Standard | Sedgwick | Standard | Sun Life | The Equitable Life | Transamerica | Trustmark | Trustmark Disability Advisors | Union Central | Unum | UnumProvident
Disabling Conditions
Aneurysms | Anxiety/Panic Attacks | Angina Pectoris/Ischemia | Arthritis (Osteo, Psoriatic, Rheumatoid) | Atrial Fibrillation (AF) | Autoimmune Disorders | Bipolar Disorder | Brachial Plexus Injuries | Bulging Discs (Cervical/Lumbar) | Bursitis | Cancer | Carpal Tunnel Syndrome (CTS) | Cervical/Neck Pain | Crohn’s Disease/IBD | Complex Regional Pain Syndrome | Congestive Heart Failure | Coronary Artery Disease | Deep Vein Thrombosis (DVT) | Degenerative Disc Disease (DDD) | Dislocated Elbow/Shoulder | Dislocated Hip/Hip Replacement | Epstein-Barr Virus (EBV) | Essential Tremors | Focal Dystonia | Ganglion Cysts | Glaucoma | Hand/Arm Pain – NOS | Head Trauma/Cognitive Difficulties | Hearing Loss | Herniated Discs (Cervical/Lumbar) | Ligament Tears | Long-Haul COVID | Lumbar/Back Pain | Lyme Disease | Major Depressive Disorder (MDD) | Macular Degeneration | Meniere’s Disease | Migraines | Multiple Sclerosis (MS) | Musculoskeletal Disorders | Myasthenia Gravis (MG) | Myelopathy (Cervical/Lumbar) | Myofascial Pain Syndrome | Nerve Impingement/Entrapment | Neuroma | Orthostatic Hypertension/Hypotension | Osteoarthritis | Paresthesia/Dysesthesia | Parkinson’s Disease | Posterior Tibial Tendon Dysfunction | Post-Traumatic Stress Disorder (PTSD) | Posterior Tibial Tendon Dysfunction | Posterior Vitreous Detachment (PVD) | Radiculopathy (Cervical/Lumbar) | Repetitive Stress Injuries | Retinal Detachment/Floaters | Rotator Cuff Injury/Tears | Sciatica | Scoliosis | Serotonin Syndrome | Shoulder/Back/Neck Pain – NOS | Sleep Apnea | Spondylolisthesis | Spondylosis | Stenosis (Spinal/Foraminal) | Stroke | Thoracic Outlet Syndrome (TOS) | Traumatic Injuries | Tumors | Ulnar Neuropathy | Vertigo/BPPV | Visual Impairment
The information provided above is offered purely for informational purposes. It is not intended to create or promote an attorney-client relationship, and does not constitute and should not be relied upon as legal advice.
Every claim is unique and the discussion above is only a limited summary of information that may be relevant to your claim. An experienced disability insurance attorney can help you assess your particular disability claim, or potential disability claim, and determine what options are available to you.