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Category: Insurance Claims

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Florida Insurers and Their Duty to Defend

Wed Sep 30th, 2020 on     Insurance Claims,    

Work With Our Miami Insurance Coverage Lawyer Today In Florida, if a policyholder is potentially liable to a third-party (i.e., a liability claim has been brought against them and that claim is covered by the underlying insurance policy), then the insurer has a duty to defend the policyholder in the ensuing litigation.  As with most liability disputes, these disputes are likely to resolve through pre-litigation settlement — but the insurer must still adhere to their duties and take control of the defense. Unfortunately, many insurers will take steps to avoid having to invest the funds and resources towards defending a policyholder in litigation, even if they are required to do so.  The insurer may argue that the underlying issues do not involve claims that would be covered by the insurance policy, for example, and use this argument to avoid their “duty to defend.” This can pose significant challenges for a cash-strapped policyholder-defendant, as the policyholder would have to sustain additional costs by hiring an independent attorney to represent them in the liability dispute.  Quite obviously, this more costly path is not something the policyholder would have contemplated when purchasing insurance coverage — they no doubt purchased insurance with the assumption that it would lead to a reliable defense in the event of a lawsuit. If you are being sued by a third-party and believe that the lawsuit is covered by your insurance policy, it’s important that you get in touch with a qualified Miami insurance coverage lawyer for guidance on […]

Bad Faith Insurance Claims in Florida

Wed Sep 16th, 2020 on     Bad Faith Insurance,    

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 […]

Boat Insurance — Common Coverage Issues

Thu Apr 30th, 2020 on     Insurance Claims,    

Experienced Insurance Law Firm in Miami, FL Florida has the second-longest coastline in the United States, and — in conjunction with its year-round warm weather — has become a hotspot of marine activity, particularly personal watercraft: small boats, yachts, and more. The high volume of seaborne traffic, as well as the nature of watercraft use in Florida (i.e., highly tourist-oriented) makes it rather dangerous to operate a boat without sufficient insurance coverage. Despite the fact that responsible Florida boat owners may purchase and maintain boat insurance coverage, they often find that the policy once marketed as “comprehensive” is more limited than they originally thought.  This is certainly not helped by the fact that boat insurance providers are known to engage in underhanded tactics to avoid having to payout — they will interpret ambiguous language in a way that narrows coverage, or will underestimate the damages. Given the financial risks posed to boat insurance policyholders by an insurance denial (or even an underpaid claim), it’s important that they consult with a leading firm for guidance on how to secure the benefits they are owed under their policy. We encourage you to contact Ver Ploeg & Marino, P.A. for assistance.  We are a Miami insurance law firm with extensive experience helping boat insurance policyholders fight back against insurance companies. Specific “Perils” May Not Be Covered Boat insurance coverage can differ significantly from plan-to-plan.  Though some plans are considered “all risk” plans — in other words, they cover all perils that could potentially […]

What Qualifies as a “Business Interruption” for Insurance Purposes?

Tue Mar 31st, 2020 on     Insurance Claims,    

If you’ve purchased business interruption (BI) insurance and are planning to submit a claim for benefits — or have already submitted a claim and have been denied — then you may be feeling somewhat confused by the ambiguity of coverage, and how that can be used by the insurance company to deny your claim. For example, you might have initially believed that your insurance covered you for man-made disasters (i.e., an arsonist-caused fire), only to discover that the plan only covers natural disasters. Quite simply, when policyholders sign up to business interruption insurance plans, they often perceive the coverage to be broader and more comprehensive than the narrow definitions that the insurance company later applies.  In part, this information disparity is intentional.  By marketing basic plans as more comprehensive than they actually are, the insurance company can sell a plan to budget-strapped customer. It’s important to recognize that you do not have to accept the adverse determinations made by an insurance company.  In many cases, insurers deny, delay, or undervalue claims in the hopes that the policyholder will be too pre-occupied (recovering from the disaster and the business interruption itself) and will therefore resign themselves to the decision. We can help you secure the benefits you’re owed.  Here at Ver Ploeg & Marino, P.A., our team is committed to pursuing any and all potential avenues for benefits recovery, whether through an internal claims appeal process or trial litigation.  Contact our experienced Miami insurance law firm for guidance. Business interruption coverage […]

Hurricane Preparedness: State and Federal Government Resources

Fri Feb 21st, 2020 on     Homeowners Insurance,    

The 2020 Atlantic hurricane season will soon be upon us and it is important for homeowners to be prepared. As we’ve learned in past years, it only takes one storm to cause widespread devastation, and homeowners who take steps to get ready will be in the best position to begin the recovery process as quickly possible. Are you ready? Here are seven hurricane preparedness resources from the State of Florida, various U.S. federal government agencies and the National Hurricane Survival Initiative: 7 Free Hurricane Preparedness Resources 1. Federal Emergency Management Administration (FEMA) Hurricane Preparedness Tools FEMA’s website provides a number of tools that homeowners can use to prepare for hurricane season. From creating an emergency communication plan to checking your insurance coverage, these tools provide practical tips for making sure you are ready. 2. National Weather Service Hurricane Preparedness Information The National Weather Service maintains current hurricane forecast information on its website as well as information about hurricane safety and resources for putting together a personalized disaster preparedness plan. 3. U.S. Coast Guard: Make Your Safety Plans in Advance The U.S. Coast Guard is urging all homeowners to make safety plans in advance, and has published a number of useful, easy-to-ready graphics that homeowners can use to make sure they have taken the necessary steps to prepare for a potential hurricane. 4. Ready.gov Hurricane Seasonal Preparedness Digital Toolkit Ready.gov is the official disaster preparedness website of the U.S. Department of Homeland Security. Here, you will find a comprehensive toolkit which […]

Seven Tips for Filing a Business Interruption Insurance Claim

Fri Feb 14th, 2020 on     Insurance Claims,    

When a hurricane, fire or other disaster damages your business, filing a business interruption insurance claim may be your only option to cover your company’s expenses during the repairs. If you cannot sell because your systems are down or your facilities are inaccessible, business interruption insurance can provide the income replacement you need to stay afloat you go through the rebuilding process. If you purchased “extended” coverage, your policy will cover your business losses for a period after you reopen as well. So, you purchased business interruption insurance, and now you need to use it. What do you do? 1. Contact Your Insurance Company. First, you should file a claim with your business interruption insurer right away. Generally speaking, you want to get your claim on file as soon as possible after the interruption occurs – so it is clear that all ensuing losses relate to the interruption and not another, non-insured issue. 2. Make Sure You Know What is Covered. At this point, you need to sit down with your business interruption insurance policy and make sure you know what is covered. Read through your policy carefully, and seek legal advice where you have questions. Insureds often run into issues with their insurers denying valid claims or misrepresenting the terms of their policies, and you do not want to let bad-faith insurance practices get in the way of your business’s recovery. 3. Take Appropriate Steps to Mitigate the Damage. This can get tricky with business interruption insurance; but, after […]

Insuring the Gig Economy

Fri Aug 30th, 2019 on     Insurance Claims,    

Experienced Insurance Coverage Lawyer in Miami, FL On an annual basis, the “gig economy” is growing significantly across the United States and the world at-large, spearheaded by big-tech efforts such as Uber and Fiverr, among other applications that connect independent contractors with those in need of a one-time service.  In fact, industry observers estimate that nearly 40 percent of the United States will be employed as independent contractors by 2020 (though of course many will be engaged in longer-term project-based arrangements, and not necessarily the gig economy). Though “gigs” have created an incredible way for many Americans to supplement and grow their income, the work can be somewhat risky.  If you work “gigs” independently, whether through a specific app or not, then you may find yourself in a situation where you’re facing liability or other losses that are sufficiently extensive to warrant insurance coverage — even if you are covered by a pre-existing policy, however, there’s a good chance that your insurer will deny your claims.  They may use a number of justifications to explain the denial, such as a coverage exclusion. An insurance denial is not final.  You have the right to challenge the adverse decision and potentially even sue to recover compensation.  We therefore encourage gig workers to consult an attorney for details on how to proceed.  Contact us at Ver Ploeg & Marino, P.A. to learn more. Coverage-Related Issues Faced by Gig Economy Workers Commercial Policies vs. Personal Policies As a gig worker, your personal policy may […]

Insurance Coverage: Do Agents Have a Duty to Advise Customers on What They Should Buy?

Wed Jul 31st, 2019 on     Insurance Claims,    

Generally speaking, an insurance agent has no obligation to, on its own, evaluate a customer’s particular insurance needs or give the customer advice regarding the coverage the customer should purchase. That said, insurance agents do have a duty to take the appropriate steps to protect their policyholders from potential risks and liabilities. If you think you have a claim for insurance agent or broker malpractice, a Miami insurance coverage lawyer can assist you. Importantly, if you can show that a “special relationship” existed with your insurance agent, his or her duty may be expanded to include advice on the insurance necessary to fulfill your needs.  Basic Duties of Insurance Agents and Brokers Insurance brokers are required to exercise good faith and reasonable skill, care and diligence in procuring insurance requested in accordance with the client’s instructions.  They are also obligated to obtain: Coverage that is not materially deficient Coverage undertaken to be supplied at the requested limits Requested coverage within a reasonable time (or inform client of inability to do so). No General Duty to Advise Regarding Coverage Deficiencies or Needs If the agent has contracted to provide “standard” brokerage services, then the agent has not agreed to evaluate the customer’s needs or to give the customer advice regarding the coverage the customer should have. This is because insurance agents and brokers are not seen by the law as personal financial counselors or risk manages.  A general request for “full coverage” or the “best policy” does not broaden the broker’s […]

Challenges to the Insurance Industry in 2019

Wed Jul 17th, 2019 on     Insurance Claims,    

Over the past decade there has been an explosion of technological, economic and cultural innovation, dramatically changing how we do business and live our lives. Many of these developments have disrupted the traditional approach to insurance. As a Miami insurance law firm, we stay up-to-date on trends that impact our industry. From the gig economy to driverless cars and the internet of things, insurance companies are racing to find creative, cost-effective solutions that match the innovation of today. Gig Economy Essentially, the “gig economy” is a labor market based on short-term contracts or freelance work, as opposed to permanent jobs. Current examples include ride-sharing apps, food delivery services, and online marketplaces such as Airbnb and Rover. The underlying principle in the gig or “sharing” economy is that individuals can provide or obtain a paid personal service while operating outside of conventional business regulations and employment law. Because the agreements for these services do not fall exclusively into either the personal or commercial categories, insurance companies have had to determine whether personal liability plans will cover such services. Many insurers have responded to the challenge by excluding quasi-commercial uses from personal policies and replacing them with specific add-on options. For example, in the context of a standard personal auto policy insurance companies are requiring additional commercial coverage to provide protection when driving for a rideshare service.  Driverless Cars While the majority of “autonomous” cars today are still partially under driver control, the challenge for insurers will be the issue of who […]

Understanding Business Interruption Insurance

Fri May 31st, 2019 on     Insurance Claims,    

Many commercial property policies, as well as business owner’s policies (package policy for small businesses, often referred to as a “BOP”), include business interruption coverage.  It is designed to protect your business from a loss in income caused by an insurable event.  As Miami insurance coverage attorneys, we are experienced in helping our clients to maximize their recovery when a fire, hurricane or other disaster causes an interruption in business operations.  There are four important elements of business interruption insurance.  First, it is only triggered in three limited circumstances: Physical damages to the premises of such magnitude that the business must suspend its operations; Physical damage to other property caused by an insurable loss and that prevents customers or employees from gaining access to the business; or The government shuts down in an area due to property damage caused by an insurable event that prevents customers or employees from gaining access to the business. Most Policies Have a Waiting Period A second critical element is that even after a covered event occurs, most policies have a waiting period of several days before business interruption kicks in.  Once it does, coverage will not be retroactive to the day of the event. Business Interruption Coverage is Limited Third, after the waiting period ends, coverage will be provided for lost net income, temporary relocation expenses (designed to reduce overall costs), and ongoing expenses such as payroll that enable businesses to continue paying employees rather than laying them off. Importantly, business interruption coverage is […]

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