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Liability Insurers Have a Duty to Defend

Thu Jan 31st, 2019 on     Insurance Law,    

Miami Insurance Law Firm Liability insurance coverage is purchased to avoid the significant risks associated with a lawsuit, but insurance coverage does not always work out in a way that the policyholder might expect.  Insurers maximize their profits by minimizing their time investment and other costs.  It should therefore come as no surprise that liability insurers frequently deny coverage and skirt their plan-based responsibilities.  This can put the policyholder in an incredibly vulnerable position, particularly […]

Medical Devices and Health Insurance Denial

Thu Jan 24th, 2019 on     Health Insurance,    

Miami Health Insurance Lawyer Though healthcare insurance denials are common, many policyholders are shocked when they are denied benefits for having received a medical device at the behest of their treating physician.  In truth, healthcare insurers are built to deny as many claims as they can reasonably justify.  They profit and thrive on the expectation that you will not challenge their decision and that they will “get away” with not having to pay out the […]

Intentional Misconduct is Not Covered by Commercial General Liability Insurance

Thu Jan 17th, 2019 on     Insurance Law,    

Miami Insurance Law Firm If you’re being sued by a third-party due to them having suffered injuries in an accident that could implicate your commercial general liability (CGL) insurance coverage, then you may find yourself facing new and unexpected challenges. Insurers have a tendency to deny claims when they can just barely justify doing so, even if they are making bold and unsupported assumptions.  In the CGL insurance context, this often happens with regard to […]

Concurrent Causation in Property Insurance Disputes

Thu Jan 10th, 2019 on     Property Insurance,    

Miami Property Insurance Lawyer In Florida, and elsewhere, property insurance policyholders frequently have their claims denied due to the existence of “concurrent causes” of loss.  A concurrent cause is one of multiple causes that contributed to the damages at-issue.  For example, if your house is damaged in a severe tropical storm, some of the losses may be due to water, and some due to wind.  The wind conditions and the water damage might each be […]

Experimental Treatments and Health Insurance Coverage

Fri Dec 28th, 2018 on     Health Insurance,    

Health insurance policyholders who are suffering from catastrophic or even life-threatening injuries, illness, and other medical conditions may find that their insurance carrier is not necessarily amenable to extending coverage to experimental treatments.  Though the outcome of an experimental treatment may not be certain, and though there may be concerns about efficacy, safety, and long-term health, there are many patients who are left with no other recourse. If your insurer has denied coverage for an […]

Common Justifications for Homeowner’s Insurance Claim Denial

Fri Dec 21st, 2018 on     Property Insurance,    

In the homeowner’s insurance context, insurers deny claims for a variety of reasons, some reasonable, some not so reasonable.  Fundamentally, insurers are incentivized to deny claims and minimize their payouts.  For example, if you are entitled to recover $100,000 in a homeowner’s insurance claim, but the insurer’s initial denial convinces you not to bother pursuing the insurance claim, then the insurer will have saved a substantial amount of money by simply acting adversely to your […]

Intentional Conduct May Be Excluded from CGL Insurance Coverage

Fri Dec 14th, 2018 on     Insurance Claims,    

Businesses purchase expensive CGL coverage in order to prevent — or at the very least, to minimize — the damaging impact of a lawsuit on their continued commercial operations. For example, a grocery store might purchase CGL insurance so that they are covered if a shelf falls on a customer or if a customer slips-and-falls and injures themselves.  In the event of a lawsuit for such injuries, the store would be defended by their insurer […]

Fundamental Unfairness in an Insurance Contract

Fri Dec 7th, 2018 on     Insurance Claims,    

Let a Miami Insurance Litigation Lawyer Help All too often, insurance policyholders find themselves beholden to policies that are fundamentally unfair.  Perhaps the insurance contract includes a mandatory arbitration provision that is not explained properly.  In the alternative, perhaps the insurance contract includes a rather odd and unexpected provision such as indemnity for costs in the event of a challenge. If you’ve had a legitimate claim for insurance benefits denied on the basis of a […]

Insurance Agents Do Not Have a Duty to Advise Policyholder With Regard to Coverage

Fri Nov 30th, 2018 on     Insurance Claims,    

If you’re experiencing issues with regard to making an insurance claim, then you might be wondering about the liability of the insurance agent who marketed and brokered the contract in the first place.  In the event that you were misled or otherwise misinformed by your insurance agent, Florida law may entitle you to bring an action against them for damages as compensation for your losses.  Under certain (limited) circumstances, a failure to advise you as […]

What is an Appraisal Clause and How Does it Work?

Fri Nov 23rd, 2018 on     Property Insurance,    

In Florida — as in other states — attempting to recover fully for your property losses can be quite a challenge.  Insurers understand that you may be in a vulnerable position, and they may take advantage by undervaluing your property losses or by otherwise appraising the property at issue in a way that creates an even more lopsided dynamic. If you find yourself disagreeing with your insurer over the value of your property losses, then […]

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