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Category: Insurance Law

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Challenges Facing Policyholders in the Context of Business Interruption Insurance

Thu Oct 31st, 2019 on     Insurance Law,    

Experienced Insurance Law Attorneys in Miami, FL Business Interruption (BI) insurance pays out for losses due to certain covered events, typically large-scale disasters, such as floods and fires.  BI coverage is absolutely critical for businesses operating in disaster-prone states like Florida — even where the risk of a natural or manmade disaster is low, however, comprehensive BI insurance coverage can protect you in the wake of an event that might otherwise have the cumulative effect of shuttering or relocating the business itself. As with all insurance coverage, BI providers are quick to look for “outs” in the policy language (or in the circumstances surrounding the disastrous event) so that they can avoid having to payout, or at the very least, so that they can minimize their expected payout.  This is particularly common in the BI insurance context, however, as the losses tend to be more ambiguous in nature — insurers attempt to gain leverage by underestimating their liabilities whenever possible. Here at Ver Ploeg & Marino, P.A., we have extensive experience handling BI insurance coverage disputes on behalf of policyholders.  We are detail-oriented litigators who invest significant time and attention towards investigating the circumstances central to the coverage dispute, which gives us a significant edge in the BI insurance context (where the determination of a business interruption loss demands a comprehensive assessment of financial records, tax returns, and projected income).  If you’d like to learn more about your case and what the next steps might be, we encourage you to […]

Product Liability Lawsuit FAQs

Mon Sep 30th, 2019 on     Insurance Law,    

Experienced Insurance Litigation Lawyer in Miami, FL If you are operating a business in which you could be sued, or have been sued, for distributing a defective product, then you may be facing significant liability.  In fact, product liability disputes are so disruptive that they can bring business to a standstill if you are unprepared for defending against potentially hundreds of claims. Typically, businesses purchase comprehensive insurance plans that cover their commercial products.  The mere fact that you’ve purchased such a plan is not necessarily a guarantee of real-world coverage, however.  Particularly in cases where the insurer could be exposed to significant costs for handling the defense, the insurer will look for various “outs” to avoid having to engage their duties under the policy.  They may argue that a coverage exclusion applies, for example, or that your policy was not active at the time of the incident. We understand that product liability disputes can be confusing, and as such, we encourage you to contact Ver Ploeg & Marino, P.A. to consult with an experienced Miami insurance litigation lawyer at our firm. Before you speak to one of our attorneys, however, you may have some questions about product liability and insurance denials.  Let’s take a brief look at some common concerns that clients have. Frequently Asked Questions Q: What is the difference between a Claims-Based and an Occurrence-Based policy? Your insurance policy will either be claims-based or occurrence-based, and this could have a significant impact on whether you are eligible for […]

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 […]

What Does Directors and Officers Liability Insurance Cover?

Fri May 24th, 2019 on     FAQs,    

Directors and officers liability insurance, often referred to as “D&O” insurance, is designed to protect the personal assets of the company’s leaders and comes into play if they are personally sued for actions taken on behalf of the company.  As Miami insurance law attorneys, we are experienced in representing our clients in Directors and Officers Liability Insurance Disputes.  Company leaders can be sued for a variety of reasons ranging from allegations of financial mismanagement to negligent business decisions, and are frequent targets when shareholders, customers, vendors, suppliers, employees, creditors and other parties are displeased with the company’s actions. Individual Director and Officer Coverage and Corporate Entity Coverage A typical D&O policy includes several elements (referred to as “sides”).  Side A protects a corporation’s directors and officers for loss arising from claims against them when the company cannot indemnify them.  Side B reimburses the company when it indemnifies the individuals.  Side C, also known as “entity coverage,” eliminates disputes over coverage allocation when both the directors and officers and the insured organization are named as co-defendants in a securities lawsuit. Claims That May Target Company Leadership Business leaders can be held responsible for a company’s failure to comply with regulations and to provide a safe and secure workplace.  Additionally, if a company is found liable for losses because of operational failure and mismanagement, directors and officers may be exposed to liability as well.  Types of claims include: Shareholder suits over company or stock performance; Creditor or investor suits over mismanagement or […]

What You Need to Know About Cyber Insurance

Fri Apr 12th, 2019 on     Insurance Law,    

The potential impact of technology on the business of insurance cannot be overstated. Although “InsurTech” is relatively new, the sector has drawn significant attention from investors, as well as from established insurers, who are beginning to change their service models.  In response to changing consumer habits, especially for tech-savvy millennials, new innovations are emerging every day, with the goal of offering simpler products tailored to specific needs and a streamlined customer experience.  As Miami insurance law attorneys, we are following the InsurTech explosion with interest, both for its potential benefits to policyholders, as well as for the resulting industry disruption. What is InsurTech? The term “InsurTech” encompasses the innovative use of technology in insurance.  It is a subset of financial technology, or “FinTech,” which has transformed the banking world.  InsurTech is the technology that lies behind the creation, distribution and administration of insurance.  Smartphone apps, wearables, claims processing tools, online policy handling and automated processing are all InsurTech.  Much of the current InsurTech market involves start-ups targeting millennials, who are accustomed to instant gratification, by focusing on speed, efficiency, and cost reduction.  Examples include: Lemonade, whose motto is “instant everything,” Slice (“instant coverage for all”), and Hippo (“modern home insurance”). The success of these and other start-ups also relies on the demand for greater customization of insurance products, as well as the prevalence of the sharing economy.  For example, Airbnb hosts have created the need for limited commercial coverage, as opposed to a comprehensive commercial policy.  Pay-per-mile automobile insurance caters […]

What You Need to Know About Cyber Insurance

Fri Apr 5th, 2019 on     Insurance Law,    

It is impossible to turn on the news today without hearing about cyber security.  Data breaches and cyberattacks have become almost a constant threat.  As a Miami Insurance Law Firm, we have seen an increase in cyber liability.  And it is not just huge corporations that are targeted by cybercriminals.  Small businesses are also susceptible to events that can damage reputations and put customers and employees at risk.  One of a company’s most valuable assets is its data, and it is important to know that there are specific insurance products available that can not only provide the traditional risk transfer function but can also help your business identify cybersecurity gaps and opportunities for improvement. How is Cyber Liability Covered While many cyber liability claims are submitted under commercial general liability (CGL) policies, such claims can also trigger directors and officers (D&O), errors and omissions (E&O) and other policy types.  Typically, insurance companies argue that cyber liability, such as claims arising from data breaches involving sensitive customer information, is excluded from coverage under general liability policies.  Some insurers are adding cyber-specific exclusions to traditional insurance products.  Some courts have concluded that traditional polices do not cover cyber losses. Today, many insurance companies offer risk-specific cyber insurance policies designed to protect policyholders against data breaches and other cyber-related risks.  Roughly 30% of companies currently have some form of cyber insurance.  Coverage can protect against first party losses (direct losses to the policyholder) and third-party claims (policyholder liabilities to third parties).  First party […]

Recent Court Decisions Could Impact the Insurance Industry

Fri Mar 29th, 2019 on     Insurance Law,    

In two recent decisions, Florida’s highest court has issued significant rulings relating to insurance law.  In both cases, the Supreme Court reversed the decisions of the lower appellate court and upheld the decisions of the trial court, which were favorable to the policyholders.  As Miami insurance law attorneys, it is our job to stay up-to-date on important legal and regulatory developments in the industry, particularly those that may impact our insurance law practice. Court Supports Jury’s Finding of Bad Faith Against Insurer Harvey v. GEICO involved the application of the law of bad faith, which imposes a fiduciary obligation on an insurer to protect its insured from a judgment that exceeds the limits of the insured’s policy.  The case arose from a fatal car accident in which the insured driver had limited coverage ($100,000) under his liability policy.  GEICO resolved the liability issue against the insured and tendered the policy within days of the accident but failed to promptly cooperate with the request of the victim’s attorney for a statement from the driver concerning the extent of his assets.  The estate of the victim returned GEICO’s check and sued the driver for wrongful death, resulting in an $8 million verdict against the driver.  Mr. Harvey then brought a bad faith action against GEICO. During the bad faith trial, the lawyer for the estate testified that had he known that the driver’s only other asset was a business account worth approximately $85,000, he would not have filed suit and would have […]

How To Communicate With Your Insurance Company

Fri Mar 8th, 2019 on     Insurance Law,    

Communicating with your insurance company can be challenging, particularly if you are in the middle of a crisis and need to report a claim.  Your emotions may be running high and you may not remember everything that is said in your initial conversation with the adjuster. What is more, you may say things about your claim in the heat of the moment that may be inaccurate or uninformed, as you may not have received any damage estimates.  Keep in mind that your calls with your insurance company are most likely recorded, so you want to avoid coming across as too emotional or too eager to settle under the insurer’s terms.  As Miami insurance law attorneys, we know how insurance companies work.  From documenting all your communications, to having the right attitude, how you communicate with your insurance company can impact how your claim is resolved.  Document Your Communications The most important thing to remember is to document every communication with your insurance company in a notebook or folder so you can easily keep track of the status of your claim.  Start collecting receipts and damage estimates as well and keep all of your notes and documents together in one place.  You should also create a paper trial by confirming what your insurance company has said by sending them a quick follow-up e-mail or letter.  This helps to avoid any misunderstandings about representations or promises made, whether about timing of the claims process or more substantive discussions about damage estimates and […]

Homeowner Claims: Know Your Basic Rights

Thu Feb 28th, 2019 on     Insurance Law,    

You may not know it, but if you have a Florida homeowner insurance policy, you have certain rights, as defined by the Florida Office of Insurance Regulation.  The FLOIR Bill of Rights sets forth a timeline for the claims process, as well as certain services you are entitled to.  The Bill of Rights also contains useful advice for claimants.  As a Miami Insurance law firm dedicated to representing the interests of policyholders, we are familiar with the Bill of Rights and the protections it outlines.  When to Expect a Response From Your Insurance Company When you report a claim to your insurance company, you have a right to receive an acknowledgment of the claim within 14 days.  Within 30 days after you submit a complete proof-of-loss statement to your insurance company, you have a right, upon written request, to receive confirmation that your claim is covered in full, partially covered, or denied, or receive a written statement that your claim is being investigated. Within 90 days, you have a right to receive full settlement payment for your claim or payment of the undisputed portion of your claim, or your insurance company’s denial of your claim. The Bill of Rights does state that there are exceptions to the timelines when conditions are “beyond your insurance company’s control.” What Services are Available to Assist You With Your Claim? Under most circumstances and subject to certain restrictions, you are entitled to free mediation of your disputed claim by the Florida Department of Financial […]

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