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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 […]

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 […]

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 […]

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 […]

How to Maximize Your Recovery for Hurricane Damage

Fri May 17th, 2019 on     Insurance Claims,    

Most homes have homeowners policies covering wind damage, but insurers have been steadily increasing hurricane wind coverage deductibles and imposing other sometimes draconian policy limitations.  In addition, homeowners’ policies do not cover flood, earthquake, tree removal (unless the tree damages the house) or food spoilage from power failures.  As a Miami insurance recovery attorney can tell you, in the wake of a storm, homeowners must be vigilant with their insurance companies throughout the claims process to ensure that they receive a full and fair settlement.  Your claim is unique and should be treated as such by your insurance company.  Here are some important tips and considerations as you go through the claims process.    Tips for Filing Flood and Wind Claims First, If you have a legitimate claim, do not hesitate to file it.  Insurers should not raise your rate for filing a claim or fail to renew your policy as a result.  Second, once your claim is reported, be sure to make a note of your claim number.  Third, maintain receipts for any expenditures related to immediate repairs you had to make to secure your home or any living expenses (hotel, meals) if you could not return to your home following the storm.  These may be reimbursable under the “Additional Living Expense” portion of your homeowners’ policy.  Forth, many insurance companies have repair programs in which they offer to send out one of their approved contractors to estimate your property damage.  While you may wish to obtain an estimate […]

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