In Daneman v. Guardian Life Ins. Co. of Am., 2019 U.S. Dist. LEXIS 42881 (C.D. Cal. March 11, 2019), the U.S. District Court for the Central District of California held that an insurer's statement in a claim denial letter that it would reconsider the claim should the claimant submit additional information that did not render the denial "equivocal."
The Daneman claimant ("Daneman") filed a claim under an individual disability policy in 2013, asserting his disability began in 2006. The insurer, Guardian Life Insurance Company of America ("Guardian Life") denied the claim based on Daneman's failure to receive medical care, and because the coverage had lapsed. Thereafter, Daneman repeatedly provided additional support for his claim; Guardian Life repeatedly denied the claim, each time expressing a willingness to review additional information.
After Daneman sued, Guardian Life filed a summary judgment motion, based in part on Daneman's violation of the statute of limitations. Daneman argued that the carrier's stated willingness to reconsider its denial rendered the rejection of the claim equivocal, which prevented the limitations period from running.
The court rejected Daneman's argument, finding that a statement of willingness to consider does not render a denial equivocal. In doing so, the court cited case law establishing that an insurers' use of language such as defending a denial "based upon the information available to us at this time," referring to the right of the insured to seek a review by the California Department of Insurance, or a general invitation to submit "any other information that might affect the decision," did not render a denial equivocal.
[View source.]