Insurance Coverage

CLICK HERE TO SEE IF YOU QUALIFY FOR COMPENSATION 

Insurance policies are supposed to provide peace of mind. You pay your premiums faithfully, trusting that your insurer will stand by you when disaster strikes. But all too often, when policyholders file a claim, they find themselves facing denial letters, delay tactics, or disputes over coverage.

Insurance coverage disputes can feel overwhelming. Policies are written with complex language and exclusions that favor the insurance company. Carriers often interpret these terms narrowly, leaving policyholders without the protection they believed they purchased. For individuals and businesses alike, a denied claim can mean crushing financial loss.

At Timothy D. McGonigle, PC, we represent policyholders across California in complex insurance coverage disputes. With over 40 years of trial and appellate experience, Timothy has built a reputation for holding insurers accountable and forcing them to honor the promises made in their policies.

Fighting Denials and Exclusions

When an insurance company denies coverage, it often points to exclusions buried in the fine print of the policy. These exclusions are frequently misapplied or interpreted far too broadly. Timothy has successfully challenged these tactics in court, proving that carriers cannot twist language to avoid their obligations.

Some of the most common insurance coverage disputes involve:

• Property Damage Claims – Fires, water damage, mold, or natural disasters.
  

• Liability Coverage Disputes – Whether an insurer must defend or indemnify the policyholder in lawsuits.
  

• Business Insurance Claims – Coverage disputes for commercial property, liability, or business interruption.
  

• Homeowners’ Insurance Issues – Denials of coverage for structural damage, theft, or hidden defects.
  

• Exclusion Disputes – Fighting back when insurers rely on exclusions for mold, workmanship, or “wear and tear” to deny coverage.
  

Landmark Case: Thompson v. Fireman’s Fund Insurance Company

One of Timothy’s most notable successes came in the case of Thompson v. Fireman’s Fund Insurance Company, a matter of first impression in California. Fireman’s Fund attempted to deny coverage by relying on a mold exclusion, arguing that damages caused by water and resulting mold were excluded from the policy.

Timothy successfully argued that the exclusion could not be applied so broadly. The court ruled that the mold exclusion did not bar coverage for damages caused by defective workmanship on the policyholder’s roof, which led to water intrusion and mold growth. This groundbreaking case clarified coverage law in California and established stronger protections for policyholders facing similar disputes.

This result exemplifies Timothy’s ability to push back against powerful carriers and create precedent-setting victories that benefit policyholders across the state.

Why Choose Timothy D. McGonigle for Insurance Coverage Disputes

Insurance companies have deep pockets, teams of lawyers, and a financial incentive to limit claims. Most policyholders feel outnumbered and overwhelmed when their coverage is denied. Timothy levels the playing field.

• 40+ Years of Experience: A veteran litigator who has battled major carriers in high-stakes disputes.
  

• Proven Track Record: Landmark case results, including first-impression rulings in California insurance law.
  

• Policyholder-Focused: Dedicated to protecting individuals, families, and businesses—not insurers.
  

• Trial-Ready Approach: Always prepared to take disputes into the courtroom if carriers refuse to act in good faith.
  

Take the Next Step

If your insurance company has denied coverage, delayed your claim, or relied on exclusions to avoid payment, you don’t have to accept their decision. With the right legal advocate, you can challenge unfair denials and enforce your rights.

👉 Contact our Los Angeles office today to schedule a confidential consultation with a California insurance coverage lawyer who knows how to take on powerful insurance companies—and win.

CLICK HERE TO SEE IF YOU QUALIFY FOR COMPENSATION 

Frequently Asked Questions About Insurance Coverage Disputes

Q1: What is an insurance coverage dispute?
An insurance coverage dispute arises when an insurer denies, limits, or delays payment under a policy. Disputes often involve disagreements over exclusions, scope of coverage, or the amount owed.

Q2: Why do insurance companies deny coverage?
Carriers often cite exclusions in the policy, claim there is no “covered loss,” or argue that damages were caused by something not included in the policy. Many of these denials are improper and can be challenged.

Q3: What types of coverage disputes are most common in California?
The most frequent disputes involve property damage (fire, water, mold), liability coverage, business interruption, homeowners’ insurance claims, and exclusion challenges.

Q4: What does it mean if my insurer relies on an “exclusion”?
Exclusions limit coverage under certain conditions. However, insurers often misapply or stretch exclusions to avoid paying. Courts have ruled that exclusions cannot be used to deny coverage more broadly than intended.

Q5: Can I challenge a denied claim?
Yes. Policyholders have the right to appeal a denial, file a bad faith claim, or sue the insurance company for breach of contract. Many denials are overturned once challenged.

Q6: How long do I have to file an insurance coverage lawsuit in California?
The statute of limitations depends on the type of claim, but many coverage disputes must be filed within two to four years. It’s best to act quickly to protect your rights.

Q7: What was the significance of Thompson v. Fireman’s Fund?
In this case, Timothy McGonigle successfully argued that a mold exclusion could not be used to deny coverage for damages caused by defective workmanship. It set an important precedent for policyholders across California.

Q8: What damages can I recover if my insurer acted in bad faith?
You may recover the benefits owed under your policy, interest, attorney’s fees, damages for emotional distress, and in some cases punitive damages to punish the insurer’s misconduct.

Q9: Do I need a lawyer to fight an insurance coverage denial?
While you can appeal on your own, insurers are more likely to settle fairly when you have an experienced lawyer. A skilled attorney ensures deadlines are met, arguments are strong, and insurers are held accountable.

Q10: Will suing my insurance company affect my policy?
No. You have the right to enforce your policy and pursue legal remedies. Retaliation by an insurer is illegal in California.

Q11: How can I prove my claim is valid?
Strong documentation—photos, receipts, contracts, expert reports, and communication records—are critical. Our firm helps clients gather and present compelling evidence.

Q12: How do I know if I have a strong insurance coverage case?
The best way is through a consultation. Timothy McGonigle reviews the policy language, the denial letter, and the facts of your case to determine the best strategy for recovery.