Are Insurance Companies Committing Fraud to Deny Legitimate Insurance Claims? According to a Recent Lawsuit Filed against Argus Fire & Casualty Company, it Happens Everyday

February 13, 2011
By Hugo V. Alvarez on February 13, 2011 1:15 PM |

house on fire.jpgAnyone who has ever filed a claim with their homeowners insurance company, or any insurance company, for that matter, knows it can be quite an ordeal.

As part of basically every insurance contract the party paying all the insurance premiums in exchange for insurance coverage must fully cooperate with the insurance company during the course of the insurance company's investigation once a claim is reported. If you don't then the insurance company can deny coverage. The basis being that even though you have paid all those insurance premiums, you are in breach of contract by failing to adhere to the "cooperation clause" of your insurance contract with the insurance company.

Cooperating often entails producing any and all paper work related to the claim and handing over photos and videos of damage. The insurance company could also ask for claimants to show up at an examination under oath (EUO). Failing to show up to the EUO will allow an insurance company to deny your claim regardless of the damages and despite having paid all your premiums on time.

At an EUO the homeowner is often asked to show up at the insurers lawyers' office and are asked questions under oath. Often times, our clients ask us, "Why are they making me do all of this? Do they think I'm making all of this up?" Unfortunately, insurance companies often think just that, and some times they even think that their policy holders are committing fraud.

However, it's also a possibility that the insurance company is simply fishing for a reason to deny a wholly legitimate claim. In fact, they may be the ones who are making things up.

Its recently come to light in a whistle blower lawsuit that Argus Fire & Casualty Company may be inventing reasons to deny or delay legitimate claims. And the insurance company's motive is no doubt greed and often driven exclusively by money. Put differently, and even though insurance companies gladly accept your premiums, and rake in millions and billions of dollars yearly, they often times don't want to pay the smallest of claims in an effort to ensure that they keep all that money they raked in for themselves.

Susan Varela, a former adjuster for Argus Fire & Casualty Company, claims she was fired after blowing the whistle on the insurance company's practice of denying claims that should have been covered. She's also alleging that Argus has been defrauding reinsurers by submitting their very own false claims. Talk about irony - an insurance company denying claims submitted by their insureds but yet turning around and submitting false claims to the insurance company that insures the insurance company, the re-insurers.

If you have ever had to deal with an insurance company, then none of this should be surprising. Insurance companies are often times about as trustworthy as automobile salesmen: You had better read the fine print lest the deal could come back to kick you in the junk.

Consider Your Options. Contact Us Today.

Before opening our law firm in 2006, our attorneys worked for some of the state's, and nation's, largest law firms, and worked representing the insurance companies for years. Our attorneys are now uniquely positioned to use that experience to assist individuals and businesses alike throughout Florida with their insurance claims. As a result, our attorneys are well versed in the impact insurance has on businesses, condominiums, and individuals alike. Our insurance litigation practice group is prepared to tackle your insurance claim.

Given our extensive experience litigating for, and against, insurance companies, our insurance litigation practice group is prepared to provide aggressive, efficient and effective representation on a broad spectrum of insurance claims in Florida for local, national, and international clients. We are prepared to advocate insurance claims at the pre-suit stage, trial, appellate and arbitration levels.

If you are facing a dispute over an insurance claim in Florida, contact Alvarez & Barbara, LLP for a free and confidential consultation to discuss your rights.

Call us today toll free at 1-866-518-2913 or at 305-263-7700.