Legal Guidance Through Insurance Coverage Claims

Last updated on May 16, 2025

Insurance coverage actions are typically between an insurer and their insured. When an insured party wishes for the insurance company to pay for damages, it is essential that there are no issues with their specific policy’s coverage. Insurance coverage actions can be complex and common disputes may be related to issues such as primary or excess coverage, reinsurance, or other. In most cases, the specific language of the policy will be the point of contention, and you’ll need an experienced insurance attorney who has the support of a solid firm behind her or him.

At The McMillan Law Firm, APC, I help my clients hold insurance companies accountable for their responsibilities under the policy agreements. I take the time to review the details of every case I take to ensure I am providing the representation my clients deserve.

Common Types Of Insurance Coverage Disputes

Insurance policies are complex contracts that pose significant financial implications when disputes arise. Over my years of practice in Southern California, I have identified several recurring patterns in how insurance companies attempt to limit or avoid their payment obligations. Understanding these dispute categories can help you recognize when your insurer may not be treating you fairly under the terms of your policy.

• Claim denial disputes: When insurers reject claims outright, they often cite policy exclusions that may not actually apply to your situation. I frequently see denials based on mischaracterized events, such as categorizing storm damage as “flood damage” when your policy covers one but not the other. These denials often rely on technical interpretations that contradict the reasonable expectations you had when purchasing the policy
• Delayed settlement practices: Insurance companies sometimes employ deliberate delay tactics, knowing that financial pressure may force you to accept less than you deserve. This might include unnecessarily prolonged investigations, repeated requests for already-provided documentation or extended periods without communication. These tactics compound the hardship you face after suffering a covered loss
• Coverage scope disagreements: Policy language interpretation forms the core of many disputes. Terms like “sudden and accidental,” “reasonable repair” or “pre-existing condition” can become battlegrounds for determining coverage. Insurers often apply narrow interpretations of these terms, while courts typically hold that ambiguous language should favor the policyholder who had no role in drafting the contract
• Claim valuation conflicts: Insurers frequently undervalue claims by applying excessive depreciation, using inadequate pricing models for repairs or overlooking certain damages altogether. For property claims, they might offer to repair items that should be replaced or use lower-quality materials than what you originally had. These practices shift costs from the insurer to you
• Policy rescission actions: In particularly concerning cases, insurers attempt to void policies entirely by alleging application misrepresentations, sometimes years after issuing coverage. These efforts can involve minor application details that had no bearing on your current claim. California law provides specific protections against improper rescission, but enforcing these rights requires legal intervention

By recognizing these common dispute patterns, you can better prepare yourself to challenge unfair insurance practices. As your attorney, I thoroughly investigate the specific circumstances of your case, identify applicable legal protections, and develop strategic approaches to overcome insurer resistance. My goal is always to secure the full coverage you purchased and deserve.

Pursue The Coverage You Deserve

If you are seeking an insurance attorney in La Mesa or any community in Southern California, for an insurance-related issue, call me at 619-577-4533 or email me here to schedule your initial consultation with me today.