News & Resources

In Florida, where hurricanes, tropical storms, and other natural disasters are a regular feature of life, property insurance claims frequently involve “loss of use” coverage issues.  Standard property insurance coverage does not necessarily cover all the various losses suffered by a policyholder.  Loss of use coverage — which may be its own separate policy, or simply a provision built into an existing homeowner’s insurance or renter’s insurance policy — helps fill in the gaps, so […]

If you are covered by business interruption insurance, then you may find yourself in a particularly vulnerable situation when some event occurs that interrupts the normal flow of business and thus leads to unexpected losses.  A significant enough interruption to business can cause irreparable damage to one’s brand and reputation.  Depending on the nature and extent of the damage, submitting an insurance claim and successfully obtaining benefits may be fundamental to the continuance of the […]

In Florida, as is the case in other states, recipients of disability benefits — whether through private disability insurance or through a public program like SSDI — must reasonably follow the treatment plans required by their physicians, and must regularly update their insurer as to their condition.  Failure to do so could result in a loss of benefits (through premature termination of benefits), or a reassessment of disability benefits that reduces the amount you receive […]

In some cases, your insurer may deny your claim due to a specific misrepresentation in your insurance application — even if the misrepresentation at issue was not intentional and was merely a mistake borne of a simple misunderstanding. Material Misrepresentation as a Defense Insurers can use a material misrepresentation defense to avoid having to pay out for your legitimate insurance claims.  Oftentimes, an insurer will discover some mistake in your application and will anchor their […]

In Florida, and elsewhere, health insurance policyholders are entitled to appeal adverse determinations by their insurer — such as a denial of coverage — and thereby request that the insurer conduct a full review of their original decision. The appeals process is the first of several steps in challenging the determination made by your health insurer.  After you have exhausted the internal appeals process, you can move forward with an external, third-party review of the […]

In Florida, insurers have a duty of good faith that they must adhere to.  Simply put, insurers must act fairly, honestly, and with due regard towards the interests of their policyholders.  If they fail to do so — for example, by wrongfully denying a claim, unreasonably delaying the handling of a claim, or otherwise interfering with the policyholder’s ability to recover the damages to which they are entitled — then they may be held liable […]

Usually, property loss does not involve exclusive damage to the dwelling unit itself — there may also be damage to other, non-dwelling structures (such as a fence around the property), or more commonly, to items of personal property that also reside within the dwelling.  In some cases, the personal property of the policyholder may be of significant value, and as such, their loss may expose the policyholder to unexpected financial vulnerability. For example, suppose that […]

As a general rule, insurers will act to avoid or otherwise minimize their liabilities under their insurance contract with a policyholder.  Sometimes, however, the actions taken by an insurer clearly violate their duty of good faith, and thus give the policyholder an opportunity to sue and recover damages pursuant to a bad faith claim.  Actions giving rise to bad faith claims include those that involve unreasonable delays in handling, resolving, and processing an insurance claim […]

As a business owner, CGL insurance coverage is fundamental to effectively running your business in a highly-litigious society.  When a improperly mopped floor can result in hundreds of thousands of dollars, or even millions, in potential liability to injured third-parties, the value of CGL insurance skyrockets — CGL insurance provides the “peace of mind” necessary for a business to successfully operate. This reliance on CGL insurance can lead to challenging situations when the insurer wrongfully […]

If you are challenging the wrongful denial of your property insurance claim, the insurer is likely to assert that the language in the insurance contract is rather ambiguous, and that it should be interpreted in a manner that favors them. For example, suppose that your property insurance contract includes various provisions that exclude lightning damage from coverage.  A tree near your house is hit by lightning, which results in a fire.  The fire then spreads […]