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Florida Insurers and Their Duty to Defend

Wed Sep 30th, 2020 on     Insurance Claims,    

Work With Our Miami Insurance Coverage Lawyer Today In Florida, if a policyholder is potentially liable to a third-party (i.e., a liability claim has been brought against them and that claim is covered by the underlying insurance policy), then the insurer has a duty to defend the policyholder in the ensuing litigation.  As with most liability disputes, these disputes are likely to resolve through pre-litigation settlement — but the insurer must still adhere to their duties and take control of the defense. Unfortunately, many insurers will take steps to avoid having to invest the funds and resources towards defending a policyholder in litigation, even if they are required to do so.  The insurer may argue that the underlying issues do not involve claims that would be covered by the insurance policy, for example, and use this argument to avoid their “duty to defend.” This can pose significant challenges for a cash-strapped policyholder-defendant, as the policyholder would have to sustain additional costs by hiring an independent attorney to represent them in the liability dispute.  Quite obviously, this more costly path is not something the policyholder would have contemplated when purchasing insurance coverage — they no doubt purchased insurance with the assumption that it would lead to a reliable defense in the event of a lawsuit. If you are being sued by a third-party and believe that the lawsuit is covered by your insurance policy, it’s important that you get in touch with a qualified Miami insurance coverage lawyer for guidance on […]

Bad Faith Insurance Claims in Florida

Wed Sep 16th, 2020 on     Bad Faith Insurance,    

Let Our Miami Insurance Law Firm Work For You Insurers are fundamentally profit-motivated.  Though this is a truism that most policyholders accept and understand, it’s often forgotten when it comes time for the policyholder to make an insurance claim — after all, one would assume that the insurance provider would act with some semblance of “honor” and live up to their promises. The grim reality is that many insurers will do anything and everything — even violating basic good faith conduct — to avoid having to pay out damages in accordance with the coverage sought. Though insurers can naturally be expected to take a position that is in opposition to the policyholder (i.e., that they do not have to cover the claim due to interpreting the insurance policy differently), they also engage in potentially violative conduct: inadequately investigating the facts surrounding a claim, denying claims without a reasonable basis for doing so, delaying the processing of a claim unreasonably and undervaluing a claim to force an exhausted and vulnerable policyholder to simply resign themselves to the reduced payout. Florida law does provide some protection to policyholders and others who find themselves subject to this type of misconduct — specifically, this type of insurance misconduct may give rise to a bad faith claim. If you believe that an insurer has acted in bad faith, then it’s worth exploring your legal options.  Here at Ver Ploeg & Marino, P.A., we encourage you to contact our Miami insurance law firm to schedule a […]

5 Justifications for Homeowner Insurance Denial

Mon Aug 31st, 2020 on     Homeowners Insurance,    

Experienced Miami Insurance Litigation Lawyer   As a general rule, homeowners purchase property insurance with a level of optimism — they tend to operate under the assumption that, in the event their property is seriously damaged, they will be covered by the purchased policy, and that submitting a claim (and receiving the necessary payout) will be fairly straightforward. Unfortunately, homeowners often find that the truth is quite a bit messier than they might have originally thought. Insurance companies will deny — or if necessary, undervalue — homeowner’s insurance claims where possible to do so, even if they do not have a particularly strong argument.  They count on the fact that many homeowners are too preoccupied with other issues (namely, fixing the property and the various demands of everyday life) to pursue the claim. That’s where we come in. If you would like to speak to an experienced Miami insurance litigation lawyer about your homeowners’ insurance claim, we encourage you to contact Ver Ploeg & Marino, P.A. as soon as possible to schedule a consultation. Curious about what justifications insurers use to deny (or undervalue) legitimate homeowner’s insurance claims?  Consider the following. Third-Party Misconduct Led to the Property Damage Homeowners’ insurance policies do not generally cover third-party misconduct — instead, those third-parties must be held liable for property damage caused.  Your insurer will likely not be willing to pay out for damages caused by a third-party. Homeowners’ insurance is primarily meant to cover property damage that was caused by a natural […]

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 […]

Common Roadblocks to Securing a Payout Under Your Disability Insurance Policy

Fri Jun 19th, 2020 on     Disability Insurance,    

Experienced Disability Insurance Lawyer in Miami, FL If you have suffered an injury, illness, or other condition that has rendered you disabled, then it’s likely you are entitled to benefits pursuant to your disability insurance policy.  In reality, however, most insurers attempt to avoid having to payout disability benefits (even if you are reasonably entitled to such benefits) by rejecting initial claims. To successfully obtain disability benefits, then, we encourage you to consult with an experienced Miami disability insurance lawyer here at Ver Ploeg & Marino for guidance. We understand the challenges facing disability claimants, and the steps necessary for securing the benefits to which you’re entitled.  When a disability insurer denies your claim, we work tirelessly to challenge the adverse outcome and go through the processes — both internal and litigation-based — to resolve the matter favorably. Pre-Existing Condition Issues Perhaps the most common roadblock to securing disability benefits is the limitation on pre-existing conditions.  If you had a pre-existing condition linked to the disability at-issue when you signed on for disability insurance coverage, then that will preclude you from the receipt of benefits for the disability at-issue. Further, if you did not disclose the presence of a pre-existing condition, insurers will look back (from six months to a year, or more) at your medical records prior to the insurance coverage to determine whether you had the pre-existing condition and simply did not report it when signing on to the disability insurance policy. If they discover that you were […]

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. […]

Boat Insurance — Common Coverage Issues

Thu Apr 30th, 2020 on     Insurance Claims,    

Experienced Insurance Law Firm in Miami, FL Florida has the second-longest coastline in the United States, and — in conjunction with its year-round warm weather — has become a hotspot of marine activity, particularly personal watercraft: small boats, yachts, and more. The high volume of seaborne traffic, as well as the nature of watercraft use in Florida (i.e., highly tourist-oriented) makes it rather dangerous to operate a boat without sufficient insurance coverage. Despite the fact that responsible Florida boat owners may purchase and maintain boat insurance coverage, they often find that the policy once marketed as “comprehensive” is more limited than they originally thought.  This is certainly not helped by the fact that boat insurance providers are known to engage in underhanded tactics to avoid having to payout — they will interpret ambiguous language in a way that narrows coverage, or will underestimate the damages. Given the financial risks posed to boat insurance policyholders by an insurance denial (or even an underpaid claim), it’s important that they consult with a leading firm for guidance on how to secure the benefits they are owed under their policy. We encourage you to contact Ver Ploeg & Marino, P.A. for assistance.  We are a Miami insurance law firm with extensive experience helping boat insurance policyholders fight back against insurance companies. Specific “Perils” May Not Be Covered Boat insurance coverage can differ significantly from plan-to-plan.  Though some plans are considered “all risk” plans — in other words, they cover all perils that could potentially […]

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