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Let Our Miami Insurance Law Firm Work For You Insurers are fundamentally profit-motivated.  Though this is a truism that most policyholders accept and understand, it’s often forgotten when it comes time for the policyholder to make an insurance claim — after all, one would assume that the insurance provider would act with some semblance of “honor” and live up to their promises. The grim reality is that many insurers will do anything and everything — even violating basic good faith conduct — to avoid having to pay out damages in accordance with the coverage sought. Though insurers can naturally be expected to take a position that is in opposition to the policyholder (i.e., that they do not have to cover the claim due to interpreting the insurance policy differently), they also engage in potentially violative conduct: inadequately investigating the facts surrounding a claim, denying claims without a reasonable basis for doing so, delaying the processing of a claim unreasonably and undervaluing a claim to force an exhausted and vulnerable policyholder to simply resign themselves to the reduced payout. Florida law does provide some protection to policyholders and others who find themselves subject to this type of misconduct — specifically, this type of insurance misconduct may give rise to a bad faith claim. If you believe that an insurer has acted in bad faith, then it’s worth exploring your legal options.  Here at Ver Ploeg & Marino, P.A., we encourage you to contact our Miami insurance law firm to schedule a […]

If your insurance company has denied your claim or resolved it unsatisfactorily, you may be able to bring a bad faith claim against them in court.  Of course, not every denial constitutes bad faith. As Miami insurance claim lawyers, we are experienced in determining whether an insurer has handled a claim appropriately and in recognizing bad faith insurance practices.  For a policyholder, the first step is to educate yourself as to what your insurance company is obligated to do.  The law requires insurers to act in good faith and to engage in fair deals.  Specifically, they are obligated to: Recognize your claim; Investigate in a prompt manner; Respond quickly to your communications; Not slow down the progression with unnecessary forms; and Offer actual reasons for denial of your claim or delays in the process. There are Two Types of Bad Faith Claims A “first-party” bad faith claim arises when an insurance company unreasonably refuses to pay a claim or to properly investigate a claim.  A “third-party” bad faith claim is when an insurance company unreasonably fails to defend, indemnify or settle a claim within policy limits or to investigate a claim for a different-party, such as when the insured (the first party, you) buys insurance from the insurance company to protect against claims from another (the third party).  Florida Law on Bad Faith Claims The good news for bad faith claimants in Florida is that the law is quite clear.  The statute provides that “any person may bring a civil […]

In Florida, insurance litigation disputes — often involving over-broad and unexpected policy exclusions — may lead one to question the liability of their insurance agent.  After all, if the insurance agent obtained the policy on your behalf, it’s possible that they have not satisfied their obligations and have somehow misled you into entering into an insurance agreement that did not adequately meet your needs. In the event that your insurance agent failed to adhere to their duties, you may be entitled to sue them for negligence (and thereby recover damages for the losses over which your insurer has refused to extend coverage).  There are, of course, limits to consider — the law does not grant you an absolute right of action against your insurance agent.  Arguably, every dispute over a denied insurance claim is (to some degree) unexpected, or else you would not have agreed to it in the first place. Duties Owed by the Insurance Agent Insurance agents in Florida owe a number of duties to the insured (their client).  Pursuant to currently-applicable case law, they must: Exercise reasonable care in securing insurance coverage that the client has specifically requested, and notify the client as to any issues regarding its availability; Properly consider the explicitly-defined needs of the client when obtaining insurance coverage; and Inform and explain the coverage that has been secured at the client’s direction. This can be difficult to take in all at once!  Consider the following example for clarity. Suppose that you engage with an […]

In Florida, insurers have a duty of good faith that they must adhere to.  Simply put, insurers must act fairly, honestly, and with due regard towards the interests of their policyholders.  If they fail to do so — for example, by wrongfully denying a claim, unreasonably delaying the handling of a claim, or otherwise interfering with the policyholder’s ability to recover the damages to which they are entitled — then they may be held liable pursuant to Florida bad faith insurance law. Bad faith disputes can be multi-layered and complicated.  In order to prove that the defendant-insurer has committed bad faith, you’ll have to show that they acted unfairly or dishonestly, or that they acted without due regard to your interests.  This is a “holistic” determination that depends on the total circumstances surrounding your claim.  You’ll have to prove that — given the circumstances — the insurer violated their duty of good faith.  Doing so is not always easy, but our Miami bad faith insurance lawyers are here to help. The insurer will almost certainly fight tooth-and-nail to avoid bad faith liability.  When you bring a bad faith claim, in Florida or elsewhere, the insurer will expose the weak points in your arguments.  For example, an insurer might argue that the circumstances justified a delay to give them time to investigate the insurance claim further, given that there was not sufficient evidence in the original submission for them to determine whether to payout. Potential Weaknesses to Avoid When Bringing Your […]

As a general rule, insurers will act to avoid or otherwise minimize their liabilities under their insurance contract with a policyholder.  Sometimes, however, the actions taken by an insurer clearly violate their duty of good faith, and thus give the policyholder an opportunity to sue and recover damages pursuant to a bad faith claim.  Actions giving rise to bad faith claims include those that involve unreasonable delays in handling, resolving, and processing an insurance claim submitted by the policyholder. Bad faith claims can be somewhat confusing for those who are unfamiliar with the push-and-pull typical of many insurance disputes — as such, you’ll likely want professional guidance to help you navigate the challenges and complexities of bad faith litigation.  Get in touch with a qualified Miami bad faith insurance lawyer for assistance. Insurers Have a General Duty to Act in Good Faith In Florida, insurance companies owe a general duty of good faith towards their policyholders.  Essentially, the duty of good faith requires that the insurer act fairly and honestly towards one of their policyholders, with due regard of the interests of the policyholder.  In determining whether the insurer acted in bad faith, Florida courts must consider the totality of the circumstances surrounding the unreasonable delay at-issue. Suppose, for example, that you have submitted a claim, but the insurer continues to delay their decision on whether they will pay.  After investigating further, your attorney discovers that the insurer did not properly investigate and evaluate your insurance claim, and further, that […]

As a business owner, CGL insurance coverage is fundamental to effectively running your business in a highly-litigious society.  When a improperly mopped floor can result in hundreds of thousands of dollars, or even millions, in potential liability to injured third-parties, the value of CGL insurance skyrockets — CGL insurance provides the “peace of mind” necessary for a business to successfully operate. This reliance on CGL insurance can lead to challenging situations when the insurer wrongfully denies a legitimate insurance claim, or otherwise fails to step in and adhere to their duties under the contract.  Businesses facing millions in potential liability are put in an exceedingly vulnerable position, and insurers often take advantage of this power dynamic to undervalue claims and deny coverage.  Fortunately, Florida law entitles CGL policyholders to sue and recover damages on the basis of bad faith. Consider the following. Wrongful Denial In Florida, bad faith requires that insurers conduct a reasonable investigation of the facts surrounding the insurance claim at-issue, that the insurer not misrepresent the extent and nature of coverage, and that the insurer not wrongfully deny a legitimate insurance claim (i.e., without reasonable justification for such denial).  If your CGL insurance claim has been wrongfully denied, and you can prove that the defendant-insurer did not have reasonable justification for the denial, you could potentially recover damages for bad faith. Failure to Defend CGL insurance requires that the insurer step in and defend you in the event that an injured third-party makes a claim against you […]

If you believe that you have been wronged by your insurer in Florida, you may be entitled to bring a bad faith insurance claim against them and thus recover compensation for the losses you suffered.  In Florida, insurers have a duty to their policyholders to act in good faith in settling claims, and to act fairly and honestly (with due regard for the policyholder’s interests) when doing so. Bad faith insurance claims can be either first-party or third-party.  Policyholders who are new litigants may be unfamiliar with insurance litigation at-large may recognize the terms “first-party” and “third-party” in the bad faith insurance lawsuit context, but may not be entirely familiar with the differences between such claims. Let’s take a brief look. First-Party Bad Faith First-party bad faith insurance claims are brought pursuant to section 624.155 of the Florida Statutes (which, incidentally, has additional procedural requirements that include giving written notice of the purported violation of good faith within 60 days of the violation).  Essentially, a first-party bad faith insurance action is brought by the policyholder against their insurer on the basis of the insurer’s wrongful denial, delay, or underestimated payout of your submitted insurance claim. For example, suppose that you are covered by private disability insurance, and you suffer an injury that renders you physically disabled and unable to work.  You subsequently file an insurance claim for disability benefits, but your insurer denies your claim.  If you can show that the insurer wrongfully denied your claim, then you may have […]

In Florida, if an insurer does not settle a claim within the insured’s policy limits (whether the claim is first-party or third-party), the insurer may be exposed to liability in excess of the policy limits on the basis of having violated their duty of good faith.  This mechanism lies at the center of some controversy in the state of Florida, as legislators have actively debated whether allowing claimants to bring a bad faith action against the insurer and thus controvert the coverage limits of their insurance plan is beneficial as a matter of public policy. Bad Faith Liability Florida courts have generally held that, in the context of reaching a settlement, insurers must initiate settlement negotiations when the liability of the insured is clear and it is likely that there will be a judgment in excess of the policy limits.  In the event that settlement negotiations fall through, the insurer must prove that there was no reasonable prospect of settling within the policy limits.  The fact that an insurer does not reach a settlement (and that there is a later judgment in excess of the policy limits) is not itself proof of bad faith, however.  If the liability of the insured is unclear and if it is not reasonably certain that the judgment would be in excess of the policy limits, the insurer’s failure to reach a settlement cannot necessarily be deemed bad faith conduct. What constitutes bad faith conduct? In Florida, when negotiating a settlement, the insurer’s duty of […]

In Florida, insurers owe their policyholders a duty of good faith to refrain from acting on exclusively on the basis of their own self-interest in handling a claim and in their decision-making surrounding a settlement.  The insurer is required by Florida law to handle claims brought against their policyholders with the degree of care and diligence that would have been exercised by a reasonably prudent person in managing their own business. If you are a policyholder and believe that your insurer may have violated their duty to act in good faith when handling your claims, you may be entitled to bring a bad faith insurance claim against your insurer.  Let’s take a look at some of the basics. Bad Faith Conduct Section 624.155 of the Florida Statutes provides policyholders with a civil remedy when their insurer has, among various other acts: Not attempted in good faith to settle claims when it would have done so (given the circumstances) had the insurer acted with due regard for the policyholder’s interests; or Failed to settle claims in a timely manner when the obligation to settle a claim has become reasonably clear. Florida law also establishes various common law violations giving rise to bad faith insurance claims, including but not limited to: Failure to initiate settlement negotiations when liability is reasonably certain and damages are substantial. Failure to disclose policy limits. Failure to accept a reasonable settlement demand. Failure to keep policyholders reasonably informed of the claims process. Failure to adequately investigate claims. […]

Last time, our blog began discussing how many businesses make the strategic decision to purchase directors and officers liability insurance, otherwise known as D&O insurance, to insulate their corporate leaders from liability for claims made against them while serving in this official capacity.

Specifically, we examined how the D&O insurance purchased by everyone from privately held firms and for-profit businesses to non-profit organizations and educational institutions is comprised of elements known as “Sides.” We’ll continue our examination of this topic in today’s post.