Tel: (310) 201-0010

Mediator

Margaret Levy, Esq.

INSURANCE

REPRESENTATIVE CASES

  • Plaintiff’s wife purchased a $500,000 life insurance policy and represented on the application that she had not smoked cigarettes during the 24 months before the application. She did not disclose that she had been treated for gestational diabetes. She died suddenly at the age of 38, leaving behind her husband (the beneficiary) and two young children. The insurance company denied her husband’s claim for the life insurance benefits and rescinded the policy, claiming that the insured misrepresented her smoking history and her medical history in her application. Plaintiff sued for breach of contract and bad faith.

  • Plaintiffs sued their former homeowner's insurance company seeking coverage for claims against them by the buyer of their home for negligence, negligent non-disclosure, and breach of contract for failure to disclose numerous water leaks and unsuccessful attempts to repair the leaks. The insurer denied coverage, and the buyer obtained an arbitration award against the sellers. The sellers sued their former insurer for breach of the duty to defend, breach of the duty to indemnify, and bad faith.

  • Plaintiff Estate sued for fraud, conspiracy to defraud, financial elder abuse, violation of Insurance Code section 785, and violation of Business and Professions Code section 17200, in connection with an alleged schedule to sell annuities to a senior, and assist him in transferring assets to a trust in order to become eligible for Veterans Aid and Attendance benefits. The Veterans Administration later determined that the decedent was ineligible for the benefits and filed a claim against the estate for all benefits paid.

  • Plaintiff sued to recover benefits under an accidental death policy insuring her daughter. Her daughter died of a pulmonary embolism shortly after she collapsed while getting off a plane in Taipei after a 14-hour flight. Plaintiff claimed that her death was a covered accident. Defendant insurance company denied the claim on the basis that there was no accident and the death resulted from a sickness or disease, which was excluded from coverage. Plaintiff also sued bad faith and financial elder abuse.

  • Outpatient surgical center sued health insurer for alleged underpayment of claims under ERISA.  Insurer asserted various defenses, including statue of limitations, failure to exhaust administrative remedies under ERISA, lack of standing due to anti-assignment provisions in health plans, and that all benefits due under the contracts were paid.

  • Insurance bad faith lawsuit for denial of long term disability benefits, failure to reasonably accommodate plaintiff employee in a new position, and wrongful termination.

  • Insurance bad faith termination of long term disability benefits based on the mental illness limitation in a long term disability policy and dispute over whether the disability was a mental or physical illness.

  • Bad faith lawsuit for improper offsets of Social Security benefits against long term disability benefits and denial of short term disability benefits.

  • Insurance coverage dispute over claim for water intrusion that allegedly occurred during high winds and a rain storm at a sound stage and post production studio including whether policy exclusions for defective maintenance, age-related deterioration, wear and tear, and failure to mitigate damages barred coverage under the Policy.

  • Claim for bad faith denial of long term care benefits and financial elder abuse arising from the denial of a claim for benefits under a long term care policy where the issue was whether the claimant satisfied the policy definition of a “Chronically Ill Individual.”

  • Insurance bad faith action for denial of claim for property damage to rental property from vandalism.

  • Interpleader action regarding a dispute between the insured’s children and the insured’s spouse (the children’s stepfather) over entitlement to life insurance benefits.

  • Suit to recover additional retirement benefits under a retiree supplemental health plan.