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You have a consumer advocate, so why do you need a lawyer?

Wed Jun 17th, 2015 on     Insurance Claims,    

The Office of the Insurance Consumer Advocate is celebrating its unofficial 25th anniversary this year. The Florida Insurance Commissioner originally created the office in 1990. The Legislature, however, did not adopt the governing statutes until 1992. The advocate is now appointed by and reports to the state’s Chief Financial Officer but operates, as the position always has, as an independent entity.

The advocate does look out for consumer interests. The office, however, does not represent individual consumers in disputes with their insurers. Rather, the advocate’s job is to represent all Floridians in insurance matters addressed at the state level. The consumer advocate deals with Florida’s “big picture” insurance issues.

For example, the advocate analyzes proposed insurance regulations and statutes from the consumer’s perspective and presents his findings to the Office of Insurance Regulation. The advocate looks for trends in consumers’ experiences with the insurance industry and state regulators and, again, presents those findings and recommendations to regulatory bodies. He also works with consumers to educate them about the state’s insurance climate.

While the advocate’s website states that he also works with consumers on insurance issues, the advocate does not field consumer complaints. The state instead established the Division of Consumer Services, also part of the CFO’s organization, to do that.

Consumer services will work with consumers to resolve claim denials, for example. The division will investigate the insurance company’s action and determine if the company has followed its own and the state’s policies and procedures. The division cannot, however, do what a civil suit, usually brought on a consumer’s behalf by an insurance attorney, can do.

Consumer services cannot obtain damages for a complainant. The division acknowledges itself that some issues are better resolved in court.

An insurance attorney is your personal advocate, your personal consumer protection representative. A friend of ours suggested that the Florida Insurance Consumer Advocate is an advocate with a capital A, while an attorney is a lower-case A advocate, but we disagree.

We think it’s the other way around.

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