PMRK Law, LLPPMRK Law, LLP2026-04-30T16:38:08Zhttps://www.pmrklaw.com/feed/atom/WordPress/wp-content/uploads/sites/1503733/2022/08/cropped-pmrk-fav-icon-32x32.pngOn Behalf of PMRK Law, LLP<![CDATA[Challenging an insurance claim denial]]>https://www.pmrklaw.com/?p=470042023-08-02T17:53:52Z2023-08-14T17:52:44ZDenial reasons
There are several reasons an insurance company may deny a claim. One of the most common reasons is that the policy does not provide coverage for the event that caused the claim. Also, if the policyholder did not pay their premiums on time and in full, it can cause the policy to lapse. This means that a claim made after the policy lapses will be denied.
If the claim is not filed in a timely manner or if it is missing documentation, it may be denied. A claim may be partially denied if the claim exceeds the coverage limits. The insurance company may pay up to the limit in the policy and deny the remaining amount.
Challenging the denial
When a claim is denied, the insurance company will issue a letter explaining why it was not covered. It’s helpful to review the policy to understand the denial reason.
The policyholder can contact the insurance company and ask whether they received all relevant documents for the claim and ask about their appeals process. The policyholder can submit a formal appeal to the insurance company with a statement of disagreement and supporting information.
Under some circumstances, there may be an option to request an external review if the internal appeals process with the insurance company is not successful. There is support available for policyholders who need help with the appeals process.]]>On Behalf of PMRK Law, LLP<![CDATA[Can my spouse’s life insurance payout be denied?]]>https://www.pmrklaw.com/?p=470032023-08-01T21:41:44Z2023-08-09T21:18:11ZThe answer depends on several factors.
Type of policy
The type of life insurance policy you have can affect whether your spouse’s payout can be denied. Term life policies provide coverage for a specific period of time, such as 10, 20 or 30 years. Permanent life policies provide coverage for your entire life.
If you have a term life policy, your spouse’s payout can be denied if you die after the term expires or if you stop paying the premiums during the term. If you have a permanent life policy, your spouse’s payout can be denied if you stop paying the premiums or if you withdraw or borrow too much from the cash value.
Beneficiary designation
The beneficiary designation is the person or entity that you name to receive the death benefits from your life insurance policy. You can name anyone as your beneficiary, such as your spouse, children, relatives, friends or even a charity. You can also name multiple beneficiaries and specify how the benefits will be divided among them.
However, naming your spouse as your beneficiary does not guarantee that he or she will receive the payout. There are some situations where your beneficiary designation can be challenged or invalidated by the life insurance company or by other parties.
For example, if you name your spouse as your beneficiary and then get divorced, your ex-spouse may still be entitled to the payout. This is because California does not have a law that automatically revokes an ex-spouse as a beneficiary after divorce, unlike some other states.
Another example is if you name your spouse as your beneficiary and then die within 2 years of buying the policy. In this case, the life insurance company may investigate. This is because most policies have a contestability period of 2 years, during which the company can deny or reduce the payout if they find that you lied or omitted important information on your application.
California law
In California, all property acquired during marriage belongs to both spouses equally. This applies to life insurance policies with a cash value component, such as whole life or universal life policies. If you bought such a policy during marriage with community funds, then your spouse may have a right to half of the cash value and half of the death benefits, regardless of who you name as your beneficiary.]]>On Behalf of PMRK Law, LLP<![CDATA[Insurance companies must deal fairly with those they serve]]>https://www.pmrklaw.com/?p=470022023-07-19T05:48:28Z2023-08-01T05:47:20ZCalifornia’s insurance laws require and prohibit:
Insurance companies may not play a waiting game. They must instead move forward with a prompt investigation and communicate regularly with the person making the claim.
They may not make low-ball offers with the idea that the insured does not have the time or resources to take the insurance carrier to court or to demand more.
They have to be completely upfront and honest in what they tell people making claims.
While the insurance company may ask reasonable questions, they may not bury a person with irrelevant or repetitive information requests or requirements.
They may not unreasonably refuse to settle a claim.
Insurance companies have other obligations as well.
If an insurance company does not act in good faith, a victim has options
In some situations, a person who suspects their insurance carrier is dealing in bad faith can contact the California Department of Insurance and get assistance.
There are other cases though where an insurance carrier might hold out on defending their insured from a liability claim or paying out on a claim and their actions hurt policyholders.
In these cases, a policyholder might be able to recover compensation for their losses, even if those losses are more than the limits of their insurance policies.
]]>On Behalf of PMRK Law, LLP<![CDATA[Damages and the business decision of potential settlement]]>https://www.pmrklaw.com/?p=470012023-07-12T17:18:42Z2023-07-26T17:03:53Zalleged damages in any given lawsuit can vary widely, oftentimes depending on the type of lawsuit and the claims involved.
For example, contract disputes will usually involve different types of damages than insurance claims.
What is the business decision?
The types of damages and the amounts sought can be crucial factors when decision-makers are trying to make the business decision of whether or not to settle a case.
Our readers may know that a very high percentage of civil lawsuits are settled out of court, sometimes through direct negotiations or even through mediation, among other potential methods. These days, only a small percentage of civil lawsuits actually go to trial.
When the potential for a settlement comes up in litigation, the idea of making a business decision about the case and the damages is usually a topic of discussion.
What does that mean? Typically, it means: Is the cost of settlement going to be less than the cost of continuing in litigation?
Litigation oftentimes moves towards a rather uncertain end, for both parties. In essence, is it better for business to just settle the case and move on?
That decision will be unique for any given company or organization in California, depending on the case. But, as you weigh that decision, hopefully you are receiving the best information about your litigation options. Without the right information, it is hard for business leaders to make the right decision.]]>On Behalf of PMRK Law, LLP<![CDATA[Wildfire insurance coverage in California might be harder to get]]>https://www.pmrklaw.com/?p=470002023-07-07T07:02:55Z2023-07-17T07:02:06ZTwo insurers will no longer provide wildfire insurance coverage
Two major insurance companies, State Farm and Allstate, have recently announced they will no longer offer new homeowner's insurance policies in California, citing the threat of wildfires that destroy homes, increasing the costs these companies incur.
These changes will certainly affect new homeowners in California. Some new homeowners may find it is more challenging to purchase property if they cannot obtain insurance to cover damage to said property. Some new homeowners might choose to purchase property without any homeowner's insurance, increasing the risk that they will be entirely responsible for any damage to their new home.
Some organizations are challenging the legality of these insurers' withdrawal from the state. They argue the insurers did not seek the approval of the California insurance commissioner to do so, as required by the law.
Wildfire insurance coverage in California
Still, wildfire coverage has been controversial for a while, especially given the increasing number of wildfires in California. Most standard homeowner's insurance policies do not cover certain natural disasters, including damage caused by wildfires. Residents are encouraged to purchase separate wildfire coverage in the event their property is destroyed by wildfires, the costs of which can vary based on where a California resident resides.
Some California residents can apply for California's Fair Access to Insurance Requirements (FAIR) Plan. This is a state program that offers insurance coverage for those who live in areas of the state that are especially at risk for wildfires.
However, to qualify for the program, residents must be unable to obtain insurance on the commercial market. Moreover, there are limits to what types of damage a FAIR Plan will cover.
That being said, it is good for California residents to ensure they are able to obtain wildfire insurance coverage. Many factors are leading to an increase in the number of wildfires in the state. It is important to be prepared for the possibility that one of these fires could occur near your home.
]]>On Behalf of PMRK Law, LLP<![CDATA[How can you identify signs of trademark infringement?]]>https://www.pmrklaw.com/?p=469992023-06-27T19:17:07Z2023-07-11T19:15:34ZHow do you identify trademark infringement?
Trademark infringement might seem straightforward, but it’s actually nuanced and complicated.
As you police your marks, you might want to be on the lookout for the following signs of actionable trademark infringement:
Has someone actually misappropriated your mark?
If it’s not a direct use of your mark, how similar are the two marks in question?
Has the mark been used in commerce?
Is your mark fanciful or arbitrary, or is it merely a description of the goods or services being sold?
Are the goods or services being sold similar to those that you’re selling?
Can you demonstrate that consumers are confused by the infringing use of your mark?
What’s the other party’s intent when using your mark?
What’s the geographical scope of the two marks’ use?
You can probably see where the answers to these questions are going. If the marks are similar, your mark is strong, the products are similar, and the use of your mark is likely to cause confusion, then you’ve got a solid argument that infringement has occurred. These questions are a huge part of the infringement test.
Do you need help addressing the nuances of your case?
Each of the questions above can result in a highly fact-specific analysis that can be difficult to address. Yet, if you want to build a strong infringement case, then you need to know how to competently address these legal nuances.
That’s why learning as much as you can about this area of the law and figuring out the best way to take legal action is in your best interests.]]>On Behalf of PMRK Law, LLP<![CDATA[Can you avoid a partnership dispute on the front end?]]>https://www.pmrklaw.com/?p=469982025-04-28T18:20:47Z2023-07-07T19:09:25Zpartnership disputes are able to be hashed out informally. Others are so conflictual that they threaten the viability of the business.
If you want to avoid that outcome, then you should put in work on the front end of your business’s creation to protect your business interests.
Ways you can try to avoid partnership disputes
If you want to avoid the hardships associated with a partnership dispute, then you should focus on what you can do on the front end to avoid conflict. Here are some ideas that we hope you’ll find useful:
Focus on values: Before entering into a partnership, it might be helpful to sit down with your prospective partners to gain a deep understanding of each other’s priorities and values. By doing so, you can identify differences that could lead to a dispute, thereby allowing you to hash them out before the partnership agreement goes into effect.
Be thorough in your partnership agreement: Your partnership agreement can be as detailed as you want it to be. And it’s a good idea to address as many potential issues as possible in this agreement. By taking the time necessary to think through some of these potential problems, you might save yourself a lot of headaches in the future.
Draft and utilize a decision matrix: A lot of partnership disputes are triggered by disagreements over key business decisions. But you can minimize the potential conflict over these decisions if you have a decision matrix that helps walk you and your partners through the decision-making process. This way you’re consistent in your approach and the outcomes are fair. In turn, this may significantly reduce the risk of a partnership dispute.
Clearly identify roles and authority: Although the partners in your business may share ownership, their roles don’t have to be the same or even similar. But if each partner’s role and authority is unclear, then you can see disagreements that are spurred by power struggles. So, make sure that you clearly define these roles so that each partner has a distinct understanding of where they fit into the business and how they’re expected to contribute.
What if you still end up facing a dispute?
If you still end up facing a partnership dispute, then you’re going to have to find a way to get through it. You might be able to sort it out through informal conversations, or you may need to turn to alternative dispute resolution like mediation.
However, if you suspect that a partner is operating in an illegal fashion, then taking legal action may be the only way to protect your financial interests and the viability of your business.
But suing your partner can be an uncomfortable prospect. That’s why you might be looking for a way to carefully handle your case. Learn as much about the process as possible before moving forward with your case.
]]>On Behalf of PMRK Law, LLP<![CDATA[Tips for resolving your partnership dispute]]>https://www.pmrklaw.com/?p=469972023-06-21T17:31:20Z2023-07-03T17:29:26ZAddress disputes in your partnership agreement
One of the best ways to increase your chance of resolving your partnership dispute is to address the situation in your partnership agreement. Many partnerships choose to use mediation or another form of alternative dispute resolution to resolve disputes and include language in their agreement requiring this prior to filing a lawsuit.
Keep the unique needs of your business in mind when drafting this language. Using boilerplate language that is not tailored to your business can lead to confusion or additional disagreements.
Plan a time to thoroughly discuss the dispute
You can still choose to mediate without being required to in your agreement, or you can informally discuss the issue. Whatever you do, give yourself plenty of time. Do not talk about the issue while one of you is focused on other things or try to quickly discuss it during short breaks during the workday.
Set aside a specific day and time to talk only about the dispute and give yourself a couple of hours. If you have not resolved it after that, take a break and come back another time.
Don’t give up too early
Expect that you might not resolve the dispute in one meeting. Sometimes it could take a series of meetings. Use the time in between meetings to reflect on what occurred at the last one and carefully think things through.
There are times when disputes simply cannot be resolved. At that point, think about the next steps, which could mean business litigation or dissolving your partnership.]]>On Behalf of PMRK Law, LLP<![CDATA[Tech giant Apple takes a bite out other apple-based trademarks]]>https://www.pmrklaw.com/?p=469962023-06-19T21:15:25Z2023-06-28T20:39:39ZWhen is an apple just an apple?
A recent story details Apple's dispute with the Fruit Union Suisse, a 111-year-old guild of fruit growers in Switzerland. For generations, the fruit company's logo has shown a white apple on a red background, in a visual reference to the Swiss national flag. Recently, Apple Inc. has tried to argue that its trademark rights are so strong that the Swiss farmers can no longer use their logo.
In recent years, Apple has taken similar actions against individuals and organizations all over the world, in all types of industries, including a meal kit company, a musician and a school district. Not all of the tech company's efforts have been successful, but some have. Few individuals or businesses have the resources to take on a legal dispute with a corporation as deep-pocketed as Apple Inc.
The limits of trademarks
Ordinarily, trademark rights are limited to certain areas of commerce. For instance, a rock band that has a registered trademark on the name Chair might have have the right to use that name in the music industry, on T-shirt designs and similar items, but would not be able to prevent a totally unrelated business, such as a furniture manufacturer, from using the word "chair."
Likewise, Apple Inc. has the right to use the name "Apple" within the technology industry, but can't prevent other businesses from using the word "apple" when they are selling fruit.
Things can get trickier when dealing with symbols, such as Apple Inc.'s famous bitten-apple logo. But still, there are only so many ways to depict an apple. One might ask, "Does any depiction of an apple infringe on Apple's trademark rights? When is an apple just an apple?"
]]>On Behalf of PMRK Law, LLP<![CDATA[How to resolve a partnership dispute without trial]]>https://www.pmrklaw.com/?p=469952023-06-07T15:45:25Z2023-06-19T15:43:30Zeffective processes that afford a higher degree of privacy, and are faster, cheaper, and generally more pleasant.
Not all cases are supported well by ADRs, but many are, and there are different approaches available. The following ADRS are available in California.
Arbitration
Arbitration resembles a trial in that the two sides present evidence to a neutral party, the arbitrator, who makes a decision. If the parties have agreed to a binding decision, they’re bound by it and it cannot be appealed. If they’ve entered into nonbinding arbitration, going to trial afterward remains open to them.
Mediation
With mediation, the opposing parties control the outcome of the case, a win that arbitration doesn’t provide.
A trained mediator may caucus with the two parties privately and confidentially and/or together, and will steadfastly not take sides. The mediator’s role is to facilitate full communication and clarity, helping the disputants reach a meeting ground.
If talks come to an impasse, trial is a next step. But if the parties reach a settlement, it’s an agreement they both own. It has a good chance, then, of standing the test of time.
Rent-a-judge
The parties can work with a retired judge who hears their case the way an arbitrator would. The judge, though, uses normal trial court procedures, and the decision has the status of a real court judgment.
This differs from real court in that it’s private and because the judge is retired, it’s relatively easy to get on his calendar.
Summary jury trial
This is litigation-lite. It’s a small jury, short opening statements and evidence summaries, brief rebuttals and then closing arguments.
It lasts a day, maybe two.
After the jury verdict is returned (which unbeknownst to the jury, is not binding), the parties enter into settlement talks. The win here is the value of jury feedback, very useful when the two parties have quite different perceptions of the strength of their case.
Minitrial
This is part mediation/settlement/adjudication. A panel of three is convened: one neutral advisor and one executive from each side to the dispute. The panel hears the case and is free to question the presenters from both sides.
Then, having received comments from the neutral advisor, the two executives head into settlement talks.
ADR is an evolving landscape. These methods are malleable and can be adjusted to suit the case at hand. The methods adopted are constrained only by the limitations of the parties’ ingenuity and their commitment to the process.]]>