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Author: VPM Legal

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5 Reasons for a Life Insurance Claim Denial

Wed Mar 31st, 2021 on     Insurance Claims,    

Our Miami Insurance Claim Lawyer Is Here to Assist If you’re the beneficiary of a life insurance policy and have had your life insurance claim denied by the insurer, then you may be entitled to challenge that denial by resubmitting a claim or by pursuing a lawsuit to secure compensation. Life insurance claim denials are infrequent, but when they do occur, they can cause a great deal of anxiety. After all, the beneficiary might have been expecting to receive a payout, and the denial can put them in an incredibly vulnerable position from a financial perspective. It’s important to understand that you need not accept the adverse decision of the life insurance company.  Though the insurer may have denied the application on one of several different bases, these justifications are not always supported by the facts of the case. If you’d like to speak to an experienced Miami insurance claim lawyer (about the denial of what you believe to be a legitimate life insurance claim), we encourage you to contact our team here at Ver Ploeg & Marino, P.A.  We look forward to speaking to you about what you can do to obtain the benefits you deserve. For now, let’s take a closer look at some of the reasons used by insurers to deny a life insurance claim.  Consider the following. 1) Misrepresentations on the Insurance Application If the life insurance policyholder misrepresented the facts on their insurance application, the insurer could deny a claim made by the beneficiaries.  It’s […]

Insurance Contract Interpretation: Is Your Policy Fair?

Wed Mar 17th, 2021 on     Insurance Claims,    

Work With an Experienced Miami Insurance Claim Lawyer   Insurers often deny or undervalue claims on the basis of provisions in the insurance contract that are written ambiguously, or that are written in a way that significantly advantages the insurance company.  As the policyholder, it may feel as though you have been put in an incredibly vulnerable position due to the way that the contract was written. Fortunately, all is not lost.  Under Florida law, there are a number of mechanisms through which unfair or ambiguous insurance contracts can be interpreted in your favor (as the policyholder). If you believe that your insurer is incorrectly interpreting the policy, or has created a fundamentally unfair policy, then you may be entitled to challenge that — but you’ll need the assistance of an experienced attorney to navigate the dispute effectively and put forth an effective legal argument.  Here at Ver Ploeg & Marino, P.A., we encourage you to contact a skilled Miami insurance claim lawyer at our firm for guidance on how to proceed. Let’s take a closer look. Ambiguity is Interpreted in Favor of the Policyholder In Florida, ambiguous contract provisions — including provisions in insurance contracts — are interpreted in favor of the policyholder. How does this work? Suppose that you have signed onto health insurance coverage that has an extremely vague definition of “medically necessary.”  If your insurer refuses to cover a particular treatment on the basis that your treatment was not medically necessary, you might be able to […]

Medical Necessity in Florida Health Insurance

Fri Feb 26th, 2021 on     Health Insurance,    

Let an Experienced Miami Insurance Claim Lawyer Help Oftentimes, people acquire health insurance coverage thinking that they can rest easy knowing that they won’t have to worry about their insurer “paying out” in the event of serious illness or injury.  This is unfortunately not the case in reality, however — insurers are incentivized to avoid acknowledging coverage in borderline cases, and they may write in ambiguous terms and provisions to give themselves the opportunity to deny otherwise legitimate claims. Nowhere is this more of an obvious problem than with alternative medicine and experimental medicine treatment options. Simply put, health insurance policies do not cover every possible type of treatment that you could receive.  Instead, they define the borders of coverage with a term: “medical necessity.”  If treatment is not medically necessary, then it will not be covered by the policy. This can lead to some adverse results.  Even if you receive alternative medicine treatment that significantly benefits you and improves your quality of life, your insurer might decide that it was not “medically necessary” and may deny coverage, putting you in a financially vulnerable position. Here at Ver Ploeg & Marino, P.A., our team is experienced in handling these nuanced coverage issues in the healthcare context.  We understand just how frustrating it can be to not have your insurer be an ally during such a vulnerable time — and we’re ready and willing to hold them to their promises.  Contact an experienced Miami insurance claim lawyer at our firm for […]

6 Ways Insurers Act in Bad Faith

Fri Feb 12th, 2021 on     Bad Faith Insurance,    

Hire an Experienced Miami Bad Faith Insurance Attorney   If you’ve submitted a claim for insurance benefits and have had those benefits denied, undervalued, or delayed (or have perhaps had the insurer refuse to step in and defend you against third-party litigation), then you may be entitled to challenge the insurer’s decision under Florida law. In some cases, the insurer has violated its obligations to you — the policyholder — to such an extent that it qualifies as bad faith misconduct.  Bad faith claims can give rise to independent compensation, and even bonus punitive damages.  If you believe that your insurer has acted in bad faith, it’s worth exploring your legal options. Here at Ver Ploeg & Marino, P.A., we encourage you to contact an experienced Miami bad faith insurance attorney at our firm to schedule a consultation. For now, let’s explore some ways in which insurers act in bad faith. Insurer Had No Reasonable Basis for Their Denial Insurers may not be held liable for bad faith if they simply made a mistake.  As such, the mere fact that they “denied” your claim is not justification for a bad faith lawsuit.  Instead, you will have to show that they had no reasonable basis for denying your claim. This can be a bit of a challenge. For example, an insurer who denies your claim on the basis that you did not submit sufficient evidence may have reasonably denied it, even if your claim is legitimate — once you provide the […]

Common Boat Insurance Exclusions

Fri Jan 29th, 2021 on     Insurance Claims,    

Contact a Miami Insurance Claim Lawyer For Immediate Assistance Boat insurance coverage may seem comprehensive at first glance, but many policyholders find that despite the expense of their policy, the insurer denies their claims on the basis of an exclusion that may not have been obvious at the time of signing. For this reason, it’s critical that policyholders fully evaluate their insurance policy before moving forward.  By understanding your coverage in detail, you’ll be equipped to counter the insurer’s assertions about coverage exclusions, and potentially secure the compensation you’re looking for. If you’ve sustained damages to your boat and would like to submit a claim to your insurer, or have already submitted a claim and have had that claim denied, undervalued, or otherwise adversely affected, then we encourage you to contact a Miami insurance claim lawyer at Ver Ploeg & Marino, P.A. for legal assistance. Our team has decades of experience working with insurance policyholders, including those that are struggling to secure compensation on the basis of their boat insurance policy.  It is our belief that effective advocacy requires client-centered, thorough representation.  If you’d like to speak to a qualified Miami insurance claim lawyer about your case, contact our team directly to schedule a consultation. As a policyholder, it’s important to understand the basic issues that you are likely to encounter as you navigate the claim dispute.  Though every boat insurance policy will be somewhat different, there are certain commonalities that tend to crop-up — such as common exclusions that […]

Uninsured Boater Coverage

Fri Jan 15th, 2021 on     Insurance Claims,    

Get Help From an Experienced Miami Insurance Claim Lawyer Boating accidents are not uncommon, particularly in Florida, which is a boating paradise for both tourists and locals alike.  In fact, Florida leads the nation in boating accidents, deaths, and injuries — in 2018 alone, a U.S. Coast Guard survey revealed that there were 607 boating accidents resulting in 57 deaths, 297 injuries, and more than $7 million in property damage. As one can reasonably ascertain, protecting oneself against loss is critical given the relatively high likelihood of a boating accident in Florida.  However, doing so may require that you purchase uninsured boater insurance coverage.  Many boaters simply do not purchase liability insurance, and as such, when they cause collision accidents with other boaters, they may not be able to cover the losses.  This can put you in a vulnerable position if you’re involved in a boating accident with an uninsured boater — unless, of course, you purchase uninsured boater insurance coverage. If you’ve been injured in a boating accident, it’s important that you consult with a lawyer for guidance on how to submit a marine claim that will be accepted by the insurer — further, in the event of a claim denial, your attorney can help you challenge the decision and secure the payment you deserve. For now, let’s take a closer look at some issues commonly encountered with uninsured boater coverage.  After all, just because you’ve purchased uninsured boater insurance doesn’t necessarily mean that the insurer will cover the […]

Prompt Notice Issues in Property Insurance Claims

Thu Dec 31st, 2020 on     Property Insurance,    

Let our Experienced Miami Insurance Claim Lawyer Help Today In many cases, property insurance claims are denied because the insurance carrier argues that the policyholder failed to provide “timely notice of the loss” — even in extreme situations involving hurricane damage.  Lack of prompt notice is a common excuse justifying claim denial, but it can be somewhat confusing and stressful for policyholders — after all, at what point does a delay go from reasonable-to-unreasonable? Given the complexity of prompt notice issues, we encourage you to contact an experienced Miami insurance claim lawyer here at Ver Ploeg & Marino, P.A. for guidance.  We are committed to thorough, client-focused advocacy.  Our team will help you navigate the dispute and secure the benefits you deserve. It’s worth noting that Florida law is relatively policyholder-friendly.  Though you should always seek to provide notice without delay, minor (and sometimes even major) delays do not necessarily justify a claim denial.  There are a number of persuasive arguments you can make to overcome the insurance carrier’s excuses. Let’s take a closer look at prompt notice as a concept under Florida law. Prompt Notice Requirements Under Florida Law In Florida, property insurance policies require prompt notice of the claim to the insurance carrier.  Failure to provide prompt notice will result in a forfeiture of benefits that might otherwise have been available. There are two aspects to a violation of the prompt notice requirement: Lack of timely notice of the claim to the insurance carrier, and The insurance carrier […]

Common Coverage Exclusions in Professional E&O Policies

Thu Dec 17th, 2020 on     Insurance Claims,    

Work With a Skilled Miami Insurance Claim Lawyer   Professional negligence is a serious and career-long concern for licensed professionals, in Florida and elsewhere.  In order to avoid the potentially catastrophic financial risks posed by a lawsuit, professionals typically purchase errors and omissions insurance coverage (E&O) to protect them in the event of a lawsuit. Unfortunately, it’s easy to assume that this protection will apply when you need it most — but insurance carriers often deny E&O claims, leaving the professional policyholder in a vulnerable position. If you’re a licensed professional who has been sued for malpractice, then you may be feeling overwhelmed, anxious, and unsure of how to proceed — even if you have comprehensive E&O coverage. We can help. Here at Ver Ploeg & Marino, P.A., our team has decades of experience working with professionals throughout the state of Florida, helping them to submit successful insurance claims under their E&O policies.  When a claim is denied, we advocate relentlessly for our clients, working with them to challenge the decision of their insurance carrier and secure the coverage they deserve. Ready to speak to an experienced Miami insurance claim lawyer at our firm?  Call us at 305-577-3996 or contact us online to schedule a consultation.  We look forward to speaking with you. Before you move forward, however, you may be wondering what justifications the insurance carrier might use to try and deny your claim.  Oftentimes, the insurance carrier will argue on the basis of an exclusion. These exclusions do […]

A Florida Insurer’s Duty to Defend — Frequently Asked Questions

Mon Nov 30th, 2020 on     FAQs,    

Let Our Miami Insurance Coverage Lawyer Help If you are a Commercial General Liability (CGL) policyholder, then you may be feeling a bit lost if your insurer has refused to defend you in the underlying litigation.  After all, you purchased insurance coverage in the hopes that — should a third-party sue — you would have a reliable ally to defend you and cover your losses. In Florida, CGL insurers have a duty to defend their policyholders when the underlying litigation involves covered claims.  Despite this broad duty to defend, insurers often take the position that they are not required to step in to defend the policyholder — they are likely to argue that the claims are not covered by the policy. This can put the policyholder in a vulnerable position.  They may not have the financial resources necessary to pay for legal assistance out-of-pocket, and may therefore be resigned to an unfavorable settlement with the plaintiff.  Worse still, paying for CGL insurance coverage would have been a waste. Fortunately, an insurer’s refusal to defend you in the underlying litigation can be challenged with the help of an experienced Miami insurance coverage lawyer. Here at Ver Ploeg & Marino, our team has decades of experience working with policyholders to secure their rights — including their right to have their insurer step in and defend them in the underlying litigation.  We are committed to client-focused representation and work closely with our clients at every step of litigation to meet their needs and […]

Common Issues in Fidelity Bond Coverage

Mon Nov 16th, 2020 on     Insurance Law,    

Seek Guidance From a Skilled Miami Insurance Coverage Lawyer   Fidelity bonds are a form of insurance coverage that pays out for losses caused by crimes perpetrated by employees (and other related individuals/entities) against your business.  For example, fidelity bond insurance coverage would pay out for losses caused by an accountant who commits fraud while working at your company. Fidelity bonds are an important tool, not only to protect your business from employees and others who could undermine the business but also to avoid the serious interruption to business operations that might occur if you’re forced to pursue recovery directly from the problematic employee. Unfortunately, despite the fact that fidelity bond coverage is intended to “kick in” at a time when the business owner may be financially vulnerable and feeling betrayed by their employees, insurers may deny or undervalue claims.  You need not resign yourself to this underwhelming or adverse result, however — with assistance, you can challenge the decision and obtain the benefits to which you’re entitled. If you would like to get in touch with a qualified Miami insurance coverage lawyer, we encourage you to contact the team here at Ver Ploeg & Marino to schedule a consultation at your earliest convenience.  Coverage disputes are common, and can put immense financial and psychological pressure on the policyholder — after all, you no doubt purchased insurance coverage under the impression that you could “rest easy” and rely on it to cover the losses you sustained. Here at VPM Law, […]

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