Insurance Broker Malpractice FAQs

Fri Jan 17th, 2020 on     FAQs,    

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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.

We can help.

Here at Ver Ploeg & Marino, P.A., our attorneys have decades of experience working with insurance policyholders who are involved in a dispute with agents and/or brokers, whether that dispute centers around malpractice or some other misconduct.  Our focus on insurance litigation ensures that we are well-equipped to navigate the dynamics of a dispute and secure a favorable result on the client’s behalf.

Contact us to request a consultation with a seasoned Miami insurance litigation lawyer at VPM today.  We look forward to speaking with you further.

In the meantime, we hope that you’ll read ahead and get acquainted with some of the basic questions that many clients have as they explore the possibility of insurance malpractice litigation.

Let’s take a brief look.

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Do insurance brokers have a fiduciary duty under Florida law?

Yes, under prevailing Florida law, insurance brokers have a fiduciary duty to the insured policyholder.  This duty imposes a responsibility on the broker to explain the nature of any coverage requested by the policyholder, and to notify and advise the policyholder as to any updates to such coverage.  If, for example, the broker is requested to secure a policy that has falls within a certain price range and that provides up to $500,000 in loss coverage for motorcycle accidents regardless of fault, then the broker must fully explain the coverage to the policyholder.  Failure to do so could qualify as professional negligence.

It’s important to understand that this duty applies only to coverage secured at the direction of the policyholder.  This duty does not impose any additional responsibilities with respect to advising the policyholder on other, preferable policies (and whether those would meet their insurance needs better).

Do insurance brokers have a duty to advise prospective policyholders as to what sort of policy best fits their insurance needs?

In certain circumstances, yes.

Under Florida law, if a special relationship exists between the broker and the policyholder, then an additional affirmative duty arises: the duty to recommend coverage that meets the policyholder’s insurance needs.  As this is a broader duty, it’s easier to prove malpractice if you can establish that a special relationship existed between you — the policyholder — and the broker.

Florida courts have identified the following circumstances as clear examples of a special relationship between broker and policyholder:

  • When the broker misrepresents the extent and nature of the insurance coverage, and this leads to reliance on that misrepresentation
  • When the broker voluntarily shoulders the responsibility for choosing a policy that meets the policyholder’s needs
  • When the broker holds themselves out as having special expertise in a particular insurance context, and the policyholder relies on that expertise
  • When the broker is involved in the policyholder’s business affairs, or otherwise consistently gave advisory services to the policyholder regarding insurance coverage

Contact an experienced Miami insurance litigation lawyer for assistance.

How can I impose liability on the broker if a special relationship exists?  Is there a bright line rule or is it just based on the particular circumstances at issue?

If you bring up the special relationship argument, then you still have to show — through circumstantial evidence — that the broker acted in a manner justifying the imposition of the special relationship duties and that they violated those duties.

For example, if you relied on the unique expertise of the broker with respect to business interruption insurance, the policy was not comprehensive and the company denies your subsequent claims, and it turns out that they were not actually experienced in handling business interruption insurance policies, then you’d very likely have an actionable malpractice claim.  To prove that the special relationship existed and that the broker violated the duties therein, you’d have to introduce evidence of the broker making such representations.

Can I recover punitive damages for the insurance broker’s/agent’s malpractice?

Yes, you can recover punitive damages for malpractice, but punitive damages are not always available.  Whether you may be awarded such damages depends on the particular nature of the broker/agent malpractice at-issue.

In Florida, plaintiffs are awarded punitive damages at the discretion of the court, and that too only if the defendant acted maliciously, willfully, or otherwise egregiously (so as to justify the imposition of punitive damages).  Punitive damages multiply the compensatory damages amount — up to seven times — and as such, are only infrequently awarded.

n the broker/agent malpractice context, punitive damages may only be awarded if the malpractice was reckless or intentional in nature.  For example, if the broker was merely negligent in failing to inform you about a particular policy exclusion, then that would not rise to the level of willfulness necessary for an award of punitive damages.  Typically, malpractice that involves intentional fraud (i.e., the broker lied to you about the exclusions applicable to your insurance policy so as to induce you into signing onto the plan) is more likely to give rise to a punitive damages award.

A Miami Insurance Litigation Lawyer is Here to Help

If you still have questions or concerns about your specific situation, we are here to help. Call us today at 305-577-3996 to discuss your legal options.

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