News & Resources

Depending on your insurance coverage, you may be eligible to submit an insurance claim for either total or partial disability.  Too often, however, insurers wrongfully deny, delay, or undervalue disabled policyholders’ claims so as to minimize their liabilities.  In the disability insurance context, for example, an insurer might define your disability as merely partial, when in fact the disability is totally debilitating with respect to your ability to work and earn a living.  If your […]

If you are making or have filed an insurance claim (whether for health benefits, disability benefits, liability coverage, etc.), your claim will be evaluated and ultimately processed by an adjuster.  Insurance claims adjusters generally work with teams of specialists to evaluate claims from beginning-to-end — the adjuster will then deny the claim, delay processing, or make an offer. It’s important to note that insurance claims adjusters are not on your side.  In fact, one could […]

If you believe that you have been wronged by your insurer in Florida, you may be entitled to bring a bad faith insurance claim against them and thus recover compensation for the losses you suffered.  In Florida, insurers have a duty to their policyholders to act in good faith in settling claims, and to act fairly and honestly (with due regard for the policyholder’s interests) when doing so. Bad faith insurance claims can be either […]

The Employment Retirement Income Security Act (ERISA) was enacted with the intention of protecting the fund assets of policyholders — in qualified, covered plans — from plan mismanagement and other violations of fiduciary duty by those with authority over the plan and its assets.  Fiduciaries include trustees, administrators, and investment committee members, among various other authority figures who are tasked with management of the plan and its assets. Fiduciary Duties ERISA plan fiduciaries owe a […]

In Florida, if an insurer does not settle a claim within the insured’s policy limits (whether the claim is first-party or third-party), the insurer may be exposed to liability in excess of the policy limits on the basis of having violated their duty of good faith.  This mechanism lies at the center of some controversy in the state of Florida, as legislators have actively debated whether allowing claimants to bring a bad faith action against […]

If you are covered by an employee benefit plan (life insurance, pension, health, retirement benefits, etc.), and you work for a private industry employer, then in all likelihood, your plan is governed by ERISA regulation.  ERISA can have important ramifications for your insurance claims and the process by which you can seek proper recourse in the event that your claims are wrongfully denied. What is ERISA? The Employee Retirement Income Security Act (ERISA) was enacted […]

In Florida, insurers owe their policyholders a duty of good faith to refrain from acting on exclusively on the basis of their own self-interest in handling a claim and in their decision-making surrounding a settlement.  The insurer is required by Florida law to handle claims brought against their policyholders with the degree of care and diligence that would have been exercised by a reasonably prudent person in managing their own business. If you are a […]

Whether you are injured in an accident in which there is an at-fault third-party and are attempting to recover damages through the third-party’s liability insurance, or whether you’re making a first-party claim with your own health insurer, the presence of a pre-existing condition could complicate recovery somewhat. Injury Must Be Distinct or Aggravated In Florida, you may recover for injuries that are either distinct from a pre-existing injury, or that have simply aggravated a pre-existing […]

Most people — and especially in Florida, where tropical storms and hurricanes are a regular threat — purchase home insurance under the assumption that their insurer will make reasonable attempts to compensate them when something goes wrong and they suffer property damage.  The unfortunate reality, however, is that insurers (even in the homeowner insurance context) are in the business of minimizing their claim payouts.  If you’ve suffered property losses to your home, you may find […]

In Florida, as is the case in other states, disability benefits may be denied for a number of different reasons.  Insurers often act wrongfully when denying benefits, however.  If you believe that you have legitimate reason to challenge the denial of your benefits, you may appeal the denial and — having exhausted the administrative process — you may even bring a lawsuit against your insurer for wrongful denial. On what basis do insurers justify the […]