What do I do if the insurance company is not paying benefits and they’re giving me the runaround?

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What do I do if the insurance company is not paying benefits and they’re giving me the runaround?

My wife was placed on bedrest at the beginning of the year. We pay a premium to
American Fidelity for Disability benefits, and they owe us 4,000, but it is now
March 7, two months since we filed for disability. Every time we call, they tell
us that it’s being processed or that we’ll receive the check within 3-5 days, but
that period comes and goes, and they still have not deposited the money into our
account. What do we do at this point?

Thank you for your help.

Asked on March 7, 2018 under Insurance Law, California

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 3 years ago | Contributor

An insurance policy is a contract; like any other contract, it is enforceable at need in the courts. If the insurer is not paying when, under the terms of the policy/contract, they should, they are committing "breach" (or violation) of contract and you could sue them for the money/benefits they should be paying. You might first warn them (e.g. in writing, sent some way that you can prove delivery) that you will take legal action if the money is not paid within, say, 10 days; in the letter, receite the history & timeline of nonpayment and broken promises. Then, if the don't pay, you could sue.


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