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Category: Insurance Law

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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, […]

Fidelity and Crime Insurance Coverage: Our Miami Insurance Litigation Lawyer Answers Your Questions

Mon Aug 17th, 2020 on     Insurance Law,    

Crime insurance is critical for many businesses to “cover the gaps” in the event that they are subject to losses caused by dishonest employees or third-parties.  After all, systemic fraud committed by an employee can seriously disrupt a business, possibly even sending it into bankruptcy. If you operate a business and have been affected by the commission of a crime — whether by an employee or a third-party — then you may be entitled to submit a claim with your insurance company under your crime insurance policy.  Unfortunately, insurers will use any excuse available to minimize coverage and avoid having to payout. We can help. Here at Ver Ploeg & Marino, P.A., our attorneys have decades of experience working with insurance policyholders, helping them navigate the complexities of submitting a claim and (in the event of an adverse decision) appealing that decision or even bringing a lawsuit.  Our focus on insurance disputes has given us valuable insight into what it takes to secure a favorable result, whether through negotiation or litigation. In truth, successful insurance litigation is a team effort.  Over the years, we have developed a trusted network of experts and other professionals who can provide expertise throughout the process. Interested in speaking with a Miami insurance litigation lawyer at VPM Law?  Contact us to schedule a consultation. Frequently Asked Questions (FAQs) What is the difference between a crime insurance policy and a fidelity bond? Crime insurance coverage describes the broader insurance policy that pays out benefits if your […]

5 Common Reasons Why Disability Insurers Deny Claims

Fri Jul 31st, 2020 on     Insurance Law,    

Experienced Insurance Law Firm in Miami, FL If you’ve submitted a claim for disability benefits in Florida and have had your claim denied (or if you are planning on submitting a claim for benefits), then you may be feeling confused and overwhelmed.  In truth, policyholders are not powerless — so long as they understand the strategies that the insurer is likely to employ. Let’s take a look at some of the common reasons for a disability claim denial. Insurer Believes That You Can Still Work Definitions of “disability” vary from plan-to-plan.  Generally, a policyholder will be considered disabled if they cannot perform the primary responsibilities of a job. Some plans have a narrower construction of “disability,” requiring that you show that you cannot perform the primary responsibilities of any-occupation.  In other words, you must prove that you cannot do any sort of work for which you’re reasonably qualified. Other plans have a broader construction of “disability,” requiring that you show that you cannot perform the primary responsibilities of your own-occupation.  In other words, you must prove that you cannot continue to work in your chosen career path. Failure to Follow-Through on Medical Care As a disabled policyholder, it’s critical that you follow-through with medical care, and that you do so in a timely manner.  Failure to do so could lead to a denial of your claim for benefits, and such denial would likely be upheld by a Florida court. How does this justification work? Suppose that you are injured in […]

Business Interruption Insurance Disputes — Frequently Asked Questions

Fri Jul 17th, 2020 on     Insurance Law,    

Experienced Insurance Law Firm in Miami, FL Business interruption (BI) coverage is an essential form of insurance that is meant to shield businesses from the inherent risks associated with a disruptive event (however that is defined by the policy).  For example, if a natural disaster impacts your community’s economy, and as a consequence disrupts the business, then your BI coverage might pay out benefits to cover the associated losses. Still, there are a number of challenges that policyholders face when attempting to secure a payout under their BI policy.  In many cases, policyholders are led to believe that the insurance has broader coverage, when there are actually multiple exclusions (or the existence of policy language meant to be interpreted narrowly).  This can be rather confusing for those policyholders who were not expecting a hostile claim process. As BI insurance coverage can be quite complicated — and unintuitive — it’s worth exploring some of the more commonly-encountered complexities in more detail.  This will hopefully give you a deeper appreciation of the issues, and insight into how your BI dispute is likely to develop. Let’s take a closer look. Frequently Asked Questions (FAQs) Q: What is a covered peril, and how does it relate to my BI insurance coverage? A: In Florida, and elsewhere, the typical BI insurance plan covers losses that occur due to a cessation in normal business operations.  The cessation may require a complete shutdown, a partial shutdown, or may even only require a slowdown in business operations — […]

Insurers Have a Duty to Defend Covered Claims

Tue Jun 30th, 2020 on     Insurance Law,    

Leading Insurance Law Firm in Miami, FL Policyholders — in Florida and throughout the country — often do not realize the extent of their legal rights accorded by their insurance coverage.  If you have been sued by a third-party pursuant to a claim that is (potentially) covered by your policy, then Florida law may require that your insurer step in and defend you in the litigation at issue. This is a very useful mechanism, of course, as it shields you from the substantial out-of-pocket costs associated with defending a complex legal dispute.  When the insurer steps in to defend you a lawsuit, they take on the costs of such litigation. Perhaps unsurprisingly, many insurers refuse to make good on their “duty to defend” the policyholder, and instead reject the duty altogether on several bases — for example, they may attempt to argue that the allegations do not involve a claim covered by the insured’s actual policy. There’s no need to accept this outcome, however — we encourage you to get in touch with the team here at Ver Ploeg & Marino for assistance.  We are an experienced Miami insurance law firm that will help you move forward and secure the defense that you are entitled to under Florida law. What is the Duty to Defend, and When Does it Activate? Insurers have a duty to defend an insured in litigation when the “alleged basis of the action against the insurer” falls within the policy’s coverage.  It’s important to understand that […]

Cyber Liability Insurance Coverage — the Basics

Fri May 29th, 2020 on     Insurance Law,    

Leading Insurance Law Firm in Miami, FL In today’s technologically-driven world, cybersecurity has become an increasingly critical concern for businesses that store, manage, and distribute consumer data — sensitive and otherwise. Over the past decade, a number of significant data breaches — including the infamous “Sony hack” and the “Equifax incident” — have disseminated the data of hundreds of millions of customers to the world, exposing said customers to both privacy violations and potential personal/financial risks. Though companies are increasingly developing internal mechanisms to prevent large-scale breaches (and subsequent cyber liability), they are also taking steps to insure themselves against liability should another event occur. Unfortunately — as is typical of insurance coverage — companies are finding that their policies may not be as comprehensive as they originally thought.  In many cases, insurers are denying claims on the basis of complicated policy exceptions and ambiguous coverage language. Here at Ver Ploeg & Marino, P.A., our team of attorneys works closely with policyholders who have submitted claims and were unfairly denied or who received a payout that is less than expected under their policy.  We encourage you to contact our Miami insurance law firm directly to learn more about how we can assist your business. Commercial General Liability (CGL) Policies and Cyber Liability Most companies do not have specific cyber insurance policies and instead rely on patchwork CGL and E&O coverage.  This can lead to several challenges, as insurers may deny claims due to certain coverage ambiguities built into the plan. […]

Insurance Broker Malpractice FAQs

Fri Jan 17th, 2020 on     FAQs,    

Work With a Skilled Miami Insurance Litigation Lawyer   Insurance claim denials often come as a surprise to policyholders who were led to believe that their coverage is more comprehensive than it is in reality.  In fact, this is not an uncommon scenario — an insurance policyholder is attempting to secure benefits on a claim when they discover that some exclusion (or other provision) in the insurance plan prevents recovery.  If the policyholder obtained such coverage through an insurance agent or broker who misled them somehow, whether through an incorrect disclosure or through a failure to disclose certain information, then an actionable claim may arise under the law. As a policyholder — lacking a detailed understanding of the various plan offerings and how they differ from one another — it can be frustrating to put your trust into an insurance broker or agent, only to discover that they were negligent in their responsibilities, or worse, that they intentionally misrepresented information so as to induce you into signing up for an insurance plan. This informational asymmetry — whether created by mere negligence or out of an intentional desire to defraud the policyholder — happens a lot more often than the public may realize.  In the event that you find yourself having been taken advantage of by an insurance broker, it’s important to understand that you are not without legal options.  Florida law protects policyholders who have suffered losses (i.e., claim denial) due to the misconduct of an insurance broker or agent. […]

Commercial General Liability Policies and the Duty to Defend

Tue Dec 31st, 2019 on     Insurance Law,    

Experienced Insurance Litigation Lawyer in Miami, FL Many Commercial General Liability (CGL) policyholders assume that their insurer will necessarily jump to their defense and provide the services that are required under their CGL policy.  The reality can be sobering.  Insurers will do everything they can to avoid additional losses, and this includes aggressive attempts to avoid having to engage their duty to defend the policyholder against third-party claims.  If the insurer is successful, this can put the policyholder in an unenviable position, forcing them to pay out-of-pocket for their own defense in the ensuing lawsuit. CGL policies typically include a duty-to-defend provision that compels the insurer to step in and handle your defense in the event of third-party litigation.  But how do these obligations work, exactly? Understanding the Duty to Defend CGL insurers (where the policy includes a duty-to-defend) are obligated to handle their policyholder’s defense, and in some cases, to indemnify the policyholder if the case leads to damages. In many cases, however, insurers fail these obligations: The insurer may argue that the claims at-issue are not entitled to coverage under the policy, and may refrain from providing a defense on that basis; or The insurer may handle your defense but may not perform their obligations reasonably under the circumstances. With respect to (a), it’s worth noting that an insurer’s obligation to defend is based on the allegations in a lawsuit.  The insurer must provide a defense in the lawsuit even if there is only one allegation that is […]

Issues in Professional E&O Insurance Coverage

Fri Nov 15th, 2019 on     Insurance Law,    

Experienced Insurance Litigation Lawyer in Miami, FL If you’ve been sued for professional malpractice and are presumably covered by a professional errors & omissions (E&O) insurance plan, then you may be surprised to discover that — in the wake of the aforementioned third-party lawsuit — your insurer is engaged in various attempts to avoid having to payout for your liabilities, and to avoid having to possibly defend you in the underlying action.  This can put you in a rather vulnerable position, as the financial ramifications could put a serious damper on your continued professional success, and a loss in the malpractice suit could have long-term consequences for your reputation in your particular industry. It’s critical that you consult a qualified attorney for guidance on how to proceed, so that you can secure that which you are entitled to.  Contact an experienced Miami insurance litigation lawyer here at Ver Ploeg & Marino, P.A., who can help you take action against the insurance company and compel them to follow-through on their obligations under the E&O policy. As you explore the possibility of litigation, it’s worth exploring some of the more common issues faced by policyholders in E&O insurance disputes.  Identifying the issues will enable you and your attorney to develop a solid strategic plan at an early stage. Claim Timing and Reporting Conditions Most E&O policies require that the covered third-party malpractice claim be made during the policy period itself (and some require additional procedural conditions, such as serving notice to the […]

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