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Your Property is Damaged, Now You Need to Make an Insurance Claim

property damage.jpgYou own a property that was blown away by a recent hurricane, and another property that had a significant pipe burst that flooded the whole house. What do you do?

You think you have has insurance coverage to help you cope with the financial devastation for these losses, but you’re not sure what to do.

Check Your Insurance Policy for All Conditions and Obligations Necessary to Make a Proper Claim

The first thing you need to do is to track down a copy of the current insurance policy and find out the name of the insurance company. Now that you have the insurance policy, and know the name of the insurance company, you can then begin the process of navigating those two insurance claims.

You need to then immediately notify the insurance company of the claim. Failure to do so promptly may jeopardize the insurance claim, and make the claim process a nightmare for you and your client.

Every insurance policy written in Florida contains numerous conditions that are imposed on the policy holder/insured. The policy holder must adhere to those conditions before the insurance company will make an offer to settle the claim, and before the insured can even file a lawsuit against the insurance company. Those conditions are intended to permit an insurance company to promptly investigate a claim after its occurrence.

The conditions typically involve providing “immediate” notice to an insurance company of the loss. That means you or your client will have to call the insurance company to report the loss as soon as possible.

You will typically need to allow the insurance company an opportunity to inspect the loss and conduct an investigation. If you wait months, or even years, to report the claim to the insurance company, then the insurance company will likely deny the claim on grounds that it was “prejudiced” in its ability to promptly perform an investigation.

You may also be required to sit for an examination under oath, and may also be required to submit a sworn proof of loss. The insurance company should also be afforded the opportunity to inspect the loss as well as photograph/video tape it. Any repairs that may have been made need to be properly documented. Make sure to keep all receipts and photograph of all repairs.

What Happens Next.

The claims process can be an exceedingly frustrating experience. And often times it may even result in litigation against the insurance company. But before that lawsuit is filed, it is imperative that you comply with all of the requests made by the insurance company. The insurance company will likely not make an offer to resolve the claim if their investigation was hindered in any way. Also, a premature rush to the courthouse may also result in a dismissal of the lawsuit if the insurance company can demonstrate that the insured failed to comply and cooperate with the insurance company during its investigation.

Your Insurance Company Denied Your Claim, and You’re Mad – Is It Time to Sue Them in Court?

insurance-claim-denied.jpgYou come home one day from your 14 day vacation in Europe only to discover that your septic tank ruptured. The mess is everywhere, and that rare China your Grandmother gave you on your wedding is smashed as a result of your frustration.

You immediately get on the phone with your insurance agent and your insurance company. But yet they inexplicably deny your claim.

You want to sue the insurance company, and you want justice.

But before you commit to taking your case to court, make sure this is a battle for which you’re truly prepared.

Lawsuits can be very costly in terms of time and energy, and they will also take an emotional toll too. So don’t enter into litigation lightly. If there is a chance of resolving the dispute amicably, consider that option.

You may never have gone to court before, but insurance companies do it all the time. Their lawyers know the ins and outs of the legal system. So it is important that you do wish to file suit, that you hire an attorney that is familiar with the courthouse and with battling insurance companies on a daily basis.

Here are steps you can take before resting your fate on the scales of justice.

1. Understand your duties and obligations as set forth in your insurance policy.

How do you do that exactly? Well, it may sound so obvious, but the first thing you need to do is to read and completely understand your insurance policy.

Often times insurance companies aggressively defend lawsuits not on the actual merits of the loss, but rather on conditions and obligations that the insured failed to do. It would be very unfortunate to be in such a situation. Especially when you consider that an insurance policy is a contractual relationship that binds both parties to certain obligations.

It is therefore critical that you, the insured, understand each and every one of those conditions. It doesn’t matter what your agent told you or what you heard on TV; the rules that must be followed are contained and found within the document you signed and in the insurance policy. And if you failed to follow those rules, and conditions, your lawsuit will likely fail.

If you don’t have a copy of your insurance policy, contact your agent. If you don’t understand your insurance policy, contact your agent or an attorney to help explain it to you.

2. What are the Odds that you Can Actually Beat the Insurance Company in Court?

Like with every important decision you ever make, you need to balance the pros and cons and perform a cost benefit analysis.

Never go to court unless you believe you have a very good chance of winning. The legal process is too costly to use merely to prove a point or assert your rights. If you file a suit to punish your insurer for things that went wrong during the claims process, you may end up being the one who is punished by wasting time and money.

3. Work with, not against, your insurance company during the claims process.

If your insurance company calls you, call them back. If your insurance company wants to inspect the property, let them do so. If your insurance company wants you to give a sworn statement, hire a lawyer and then make sure to appear for the sworn statement.

And even if you do everything the insurance company asks of you, it is possible that the insurance company will still deny your claim. But if they do, try to resolve the claim one more time before filing suit.

Litigation should be a tool of last resort, not first. Explore all potential settlement options prior to filing suit.

4. Find a lawyer that has experience fighting the insurance companies.

If you decide to go forward with your lawsuit, you may need to find an attorney who will work on a contingency basis, taking his or her pay out of any settlement you win. If you agree to pay your lawyer this way, the fee will be a percentage of whatever is awarded. In highly adversarial insurance disputes, lawsuits can drag on for years, however.

Find an advocate who isn’t afraid to go up against the big guys. You need someone who has a track record fighting and winning against the insurance companies.

5. Be patient, lawsuits take time.

Lawsuits often become waiting games. It easily can take a year or more to resolve a case. Attorneys representing insurance companies sometimes use delaying tactics to throw their opponents off their game or build up their own hourly fees. Expect these kinds of legal maneuvers and don’t let them shake you.
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Our Miami insurance dispute lawyers handle insurance claims for homeowners. Our attorneys represented insurance companies before 2006, when we opened a firm dedicated to fighting for the rights of consumers. We understand how insurance companies work. And we have the knowledge and experience necessary to represent homeowners in disputes over an insurance claim.

Is Your Insurance Claim Barred If You Fail To Comply With All Of The Conditions Set Forth In Your Insurance Policy Prior To Filing a Lawsuit?

insurance5.jpgEvery insurance policy written in Florida contains numerous conditions that are imposed on the policy holder/insured. The policy holder must adhere to those conditions precedent before it can file a lawsuit against the insurance company. Those conditions are present so as to permit an insurance company to properly and timely investigate a claim.

The conditions typically involve providing “immediate” notice to an insurance company of the loss. An insured will typically need to allow the insurance company an opportunity to inspect the loss. The insured may be required to sit for an examination under oath, and may also be required to submit a sworn proof of loss. These are just but a few examples of the many conditions precedent found in an insurance policy.

Sometimes an insured may rush to court and file a lawsuit when the conditions precedent may have not all been satisfied. Or the lawsuit may have been filed after a delay in notifying the insurance company of the loss.

If you are in doubt regarding your legal rights under the insurance policy, or you are in need of assistance with your insurance claim, please feel free to call us today to discuss your claim.

Nonetheless, insurance companies typically attack such lawsuits on grounds that the insured failed to follow all the terms and conditions found in the insurance policy prior to filing the lawsuit.

Under Florida law, where an insured delayed in notifying an insurer of a potential claim, the insured must rebut the presumption that the delay prejudiced the insurer. Tiedtke v. Fid. & Cas. Co. of New York, 222 So.2d 206, 209 (Fla. 1969); XL Ins. America, Inc. v. Ortiz, 673 F. Supp. 2d 1331 (S.D. Fla. 2009); Keenan Hopkins Schmidt and Stowell Contractors, Inc. v. Continental Cas. Co., 653 F. Supp. 2d 1255 (M.D. 2009).

Therefore, Florida law provides that the failure to give timely notice creates a rebuttable presumption of prejudice to the insurer. However, that presumption may be overcome by the introduction of evidence tending to show that the insurer was in fact not prejudiced by the late notice.

Simply stated, although prejudice is presumed, this does not preclude recovery if the insured can show an actual lack of prejudice. National Gypsum Co. v. Travelers Indem. Co., 417 So. 2d 254 (Fla. 1982). Put differently, such presumption that the Defendant was prejudiced is overcome by a showing that the insurer was not deprived of an opportunity to investigate the facts of the incident at issue. Bankers Ins. Co. v. Macias, 475 So.2d 1216 (Fla. 1985).

In Haiman v. Federal Insurance Co., 798 So.2d 811 (Fla. 4th DCA 2001), the Fourth District Court of Appeal stated:

A total failure to comply with policy provisions made a prerequisite to suit under the policy may constitute a breach precluding recovery from the insurer as a matter of law. If, however, the insured cooperates to some degree or provides an explanation for its noncompliance, a fact question is presented for resolution by a jury.

As set forth above, if a policy holder cooperates to “some degree” or “provides an explanation for its noncompliance”, then the policy holder’s claim may not be barred as a matter of law.

On the other hand, if there was no cooperation of any kind then the claim may be barred all together. Take, for example, the case of Edwards v. State Farm, 64 So.3d 730 (Fla. 3d 2011). In Edwards, the Third District Court of Appeal concluded that: (1) the insurance company made requests for specific, basic documents relating to the loss that were never provided; (2) Edwards knew that, on numerous occasions, the insurance company requested Edwards submit to an examination under oath at a mutually convenient place and time, and he did not; and (3) Edwards never submitted any documents relating to the costs he alleges he expended to repair his roof.

In that case, the Court threw out Edwards’s claim for failing to comply with all the conditions precedent, and failing to even cooperate to “some degree” and failing to “provide an explanation for its noncompliance.”
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In sum, the best practice is ensure strict and complete compliance with all of the insurance policy’s conditions prior to filing a lawsuit. This will allow you to pursue your claim on the merits of your loss as opposed to fighting with the insurance company on issues immaterial to your loss.

If you are in doubt regarding your legal rights under the insurance policy, or you are in need of assistance with your insurance claim, please feel free to call us today to discuss your claim.

Lawsuit Filed Challenging the Constitutionality of Laws Passed by Florida Legislators that Help Insurance Companies Raise the Rates of Homeowners Insurance While Preventing Small Businesses from Competing in the Marketplace to Aid Homeowners in Need

lawsuit.jpgLast year our Florida legislators decided to restrict the ability of many small businesses in the State of Florida from earning a decent wage, and restricting their ability to market their services. Our legislators sided with the insurance companies over hard working Floridians still feeling the effects of the worst recession of our generation.

On the other hand, our legislators made it easier for insurance companies to raise the rates of your homeowners policy despite the unprecedented run of 6 straight years without a hurricane strike in the State of Florida. Indeed, insurance rates are going up for Floridians despite a record 6 Hurricane free years.

Insurance companies are raising rates, and our legislators have made it easier for them to raise rates, because insurance companies have complained for years that public adjusters are simply getting too much money from the insurance companies when they submit a claim as opposed to what they pay when a homeowner submits a claim without the assistance of a public adjuster.

As part of a sweeping law that Florida’s legislators passed, public adjusters who represent Citizens policy holders are prohibited from getting paid for their services until Citizens actually makes an offer. The law also limits what public adjusters can charge after that initial offered is received.

Public adjusters are hired by policyholders to prepare, file or complete claims. The new law restricts fees for public adjusters representing Citizens policyholders to 10 percent over the original amount the insurer offered for a claim.

A lawsuit was recently filed challenging that law. One of the reasons for the challenge is that the law in question is vague. It is vague because the law does not define an “original offer.” However, Citizens has apparently taken the position it is a written offer after the insurer has adjusted and investigated the claim.

In other words, the law does not permit public adjusters to get paid for performing inherent and necessary tasks until Citizens has made a nebulous, vague and undefined “original offer.”

The same law also restricts and caps the fees a public adjuster can charge for their services on claims involving Citizens. But those restrictions on fees do not apply to claims against other insurance companies.
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Our Miami insurance dispute lawyers handle insurance claims for homeowners. Our attorneys represented insurance companies before 2006, when we opened a firm dedicated to fighting for the rights of consumers. We understand how insurance companies work. And we have the knowledge and experience necessary to represent homeowners in disputes over an insurance claim.

Rain Rain Go Away. Has All This Rain Caused Damage To Your Roof, Property, or Business? Call Us Today To Discuss.

rain_fall.jpgSouth Floridians have not seen the sun in days due to all this rain. It has been raining non-stop in South Florida since the weekend.

The consistent and persistent rain that has been hounding South Florida over the past several days has taken its toll. The ground is saturated and there are puddles and standing water nearly everywhere.

There is also the potential for widespread flooding and a flood advisory is in effect for the Florida Keys extending into the South Florida mainland.

Given the uncertain weather conditions, we could find development of isolated tornadoes and waterspouts.

Weather reports indicate that Wednesday should be the last day of all this nasty wet and wild weather for South Florida. An approaching cold front will push all of this moisture away and bring cooler temperatures.

The heavy rains, flash flooding, and tornadoes, may have also caused damage to your property. Water damage is one of the most commonly cited reasons in claims on home insurance. After heavy rains such as the ones we are experiencing currently, and experienced a few weekends ago, may result in some form of damage to your property.

The first signs of water damage might seem trivial. But warnings like water stains on the ceilings or a leak under the kitchen sink can lead to real problems, like a weakened roof or rotten floorboards. A burst pipe can even damage your furniture and other personal possessions.
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Consider Your Options. Contact Us Today.

If you are facing a dispute over an insurance claim in Florida, contact Alvarez & Barbara, LLP at 305-263-7700 or toll free at 866-518-2913 for a free and confidential consultation to discuss your rights.

An Appellate Court Chastised an Insurance Company for its Conduct during an Examination Under Oath and Awarded Attorney Fees to the Insured

interrogation.jpgAn insurance company was chastised by the Third District Court of Appeal for its conduct during an examination under oath.

An examination under oath is a common condition precedent to the filing a lawsuit against an insurance company that is found in just about every insurance policy. Should an insured fail to sit for an examination under oath then the insured jeopardizes potential insurance coverage for the loss.

Along those same lines, it is not uncommon for an insurance company to deny coverage even after the insured appears for an examination under oath but fails to answer certain questions asked during the examination. Often times the insured appears at an examination under oath without the presence of an attorney. In such circumstances it is not uncommon for the attorney hired by the insurance company to attempt to bully and intimidate the insured into either not answering certain questions by inquiring into areas that are simply not material to the claim, or by intimidating the insured into dropping the claim out right.

In light of such tactics it is of paramount importance to be represented by legal counsel prior to sitting for an examination under oath. At our firm, we worked for the insurance companies prior to opening our doors for business. We know the tactics that an insurance company will use to stonewall and delay your claim. Better to contact us today and before an examination under oath to ensure that your claim is properly handled and to maximize the potential recovery from the insurance company.

Court Ruling Taking an Insurance Company’s Conduct to Task

In a case decided by the Third District Court of Appeal, the appellate court admonished an insurance company for its conduct during an examination under oath.

In that case, a truck owner had his truck stolen. The truck owner had prior unrelated criminal convictions on his record. The truck owner then made a claim with his insurance company seeking reimbursement for his stolen truck.

The insurance company then required the truck owner to come and sit for an examination under oath. The truck owner did just that, but without an attorney.

The truck owner felt so intimidated by the insurance company’s attorney during the examination under oath that he walked out. The reason being is because the attorney for the insurance company spent almost the entire examination focusing on the truck owner’s prior criminal convictions and spent very little time discussing the actual loss.

The truck owner then retained the services of an attorney, and filed a lawsuit against the insurance company. The insurance company ultimately paid the full amount of the claim. However, and despite obtaining a successful result from the insurance company, the trial court denied the truck owner’s claim for attorney fees. The truck owner then filed an appeal with the third District Court of Appeal.

The Third District Court of Appeal concluded that the trial court was wrong and that the truck owner was entitled to attorney fees. In so ruling, the Third District Court of Appeal placed boundaries on the appropriate conduct during an examination under oath. Indeed, the Third District Court of Appeal concluded that the insurance company had unfortunately “decided to use the usual policy provision requiring a sworn statement as a license to make unwarranted and intrusive inquiries into the personal life of any insured who has the temerity to make a claim against it.” The court also found that when the insurance company “invited [the truck driver] to withdraw his claim in lieu of responding” to questions was improper and harassing.

In light of those circumstances, the Third District Court of Appeal found that it was necessary for the truck driver to resort to litigation in order to resolve his claim. Reasoning that the “statute was enacted for the very purpose presented in this case – to discourage the games insurance companies play,” the Third District Court of Appeal concluded that the trial court “improperly employed” the statute and that the insurance company could not “escape the consequences of what it tried to get away with in this case.”

As such, the truck owner was awarded attorney fees to be paid by the insurance company.
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Consider Your Options. Contact Us Today.

This case should serve as a reminder that insurance companies will try just about anything in an effort to not pay on a certain claim. Therefore, if you are facing a dispute over an insurance claim in Florida, contact Alvarez & Barbara, LLP at 305-263-7700 or toll free at 866-518-2913 for a free and confidential consultation to discuss your rights.

Will Insurance Companies be Permitted to Use Facebook and Twitter to Raise Your Insurance Rates?

fb.jpgInvestigators for both the police and insurance companies are using Facebook and Twitter to obtain information in the ongoing battle against fraud.

But insurance companies are also apparently trying to use that same information obtained from such popular social media websites such as Facebook and Twitter to calculate insurance premium increases.

In other words, insurance companies are contemplating using social media to assess risk. Simply put, it will allow an insurance company to create a profile of how risky, or unrisky, a particular person or property may be to insure. It will allow an insurance company to collect information at a much more detailed level.

Today, insurance companies are barred from using social media to help set rates. But regulations change, and in the not to distant future it may become common practice for an insurance company to check your facebook site to help set your insurance rates. Indeed, many states used to bar insurance companies from using your credit score to set rates. But today, such practice is common place.

It should be noted that even if a policyholder’s social media profile is private, a court can approve an order allowing access to the profile for a limited time.

So the lesson to be learned here is that if you don’t want an insurance company – or anyone for that matter – to learn something about you, then don’t post it on your social media website. As you can see, insurance companies are trying to find out as much information as possible about you in order to assess its risk exposure.
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EXTENDED BODY:
Consider Your Options. Contact Us Today.

If you are facing a dispute over an insurance claim in Florida, contact Alvarez & Barbara, LLP at 305-263-7700 or toll free at 866-518-2913 for a free and confidential consultation to discuss your rights.

Will Your Insurance Company Cover You If You Or Your Property Are Struck By A Satellite From Space?

A0284-Falling-objects_leader.jpgRecently, a NASA satellite broke up and fell to Earth. It ended up landing in a remote location in the South Pacific.

The question many were asking prior to it landing was whether or not one’s home or car would be covered if stricken by the NASA satellite.

The odds of a person getting struck by satellite debris has been calculated by NASA at 1 in 3,200. But the odds of you actually getting hit by a satellite is less than 1 in 10 trillion.

Still, if you are unfortunate enough to be in the satellite’s path, will your insurance cover the damage? If you have home insurance, the answer is likely to be “yes.”

As with every insurance policy, the first thing one must do is to actually read the policy to determine the scope of coverage. In most home owner policies, “falling objects” is a covered peril. Therefore, the falling satellite is likely covered.

On the other hand, your car may or may not be covered. It all depends on whether or not you carry comprehensive coverage.

Comprehensive coverage (sometimes called “comprehensive car insurance” or “other than collision”) typically pays for damages on covered costs that aren’t caused by a collision. For instance, it covers damages stemming from storms and natural disasters like tornadoes, hurricanes, and earthquakes, as well as Vandalism and theft, broken/shattered windows and windshield, animal damage, and falling objects – like a satellite. So if you have purchased comprehensive coverage, and your car is struck by a satellite, then odds are in your favor that you will have coverage for that loss.

Health insurance will also cover you for any injuries you sustained from being hit by a satellite. Should you happen to die after being struck by a satellite, and you have life insurance, then your designated beneficiaries should get paid as well.

Insurance coverage is purchased to cover unexpected expenses associated with rare situations like being struck by a satellite.

But even if you have purchased the correct insurance coverage, it is not uncommon for an insurance company to deny your claim. In such instances, our firm is prepared to assist you with your insurance claim.
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If you are facing a dispute over an insurance claim in Florida, contact Alvarez & Barbara, LLP toll free at 866-518-2913 for a free and confidential consultation to discuss your rights.

This Year is Proving to be one of the Costliest Years Ever for Weather Disasters

tornadoDM3030a_800x533.jpgThe National Weather Service estimates that weather disasters have cost more than $35 billion this year, based on insurance estimates.

This year has seen some very harsh weather. The year has seen intense floods, drought and tornadoes. In May, a twister killed 160 people in Joplin, Mo. and in April a devastating tornado ripped through Alabama. Texas has been hard hit by a heat wave that will cost the state in excess of five billion dollars in crop and livestock loss.

Nationwide, the number of natural disasters has tripled in the last two decades, according to insurance firm Munich Reinsurance America. Thunderstorm losses since 1980 have become five times more severe, on average. There were $20 billion in such losses by midyear in 2011, doubling the average of the past three years.

In sum, 2011 will go down in history as one of the costliest years in recent years as a result of natural disasters.

Closer to home, we are still in the middle of hurricane season. While South Florida has not been struck by a hurricane in five years, history suggests that it is only a matter of time before another hurricane does strike us. If a hurricane does strike South Florida, it is likely to cause extensive damage to the region.

As such, it is imperative to be prepared. This blog has many useful links to learn more about what you can do to prepare in advance of a hurricane’s arrival, and how to deal with a hurricane’s aftermath.

Adjusters Hired By Insurance Companies are Seldom Disciplined

david_goliath_1.jpgWhenever a small business or individual files an insurance claim, it often turns into a battle between the claimant’s adjuster and the insurance company’s adjuster. In many ways, it’s a fight between David and Goliath due to the difference in resources available to each side. As a result, you would think that our government would do a better job of leveling the playing field. However, whenever David does something wrong he is often punished by state officials. On the other hand, when Goliath mishandles a claim, the chances of a crack down are very slim.

Here is a very telling fact that shows the amount of power insurance companies have in Florida: when there’s a complaint against an insurance company’s adjuster there’s a less than 16 percent chance the adjuster will be disciplined; however, whenever there’s a complaint against a public adjuster, representing a home owner, or business owner, there’s a 75 percent chance the state will discipline that person.

On both sides there are certainly adjusters that need to be investigated and disciplined. By and large, most adjusters approach their jobs with honesty and complete professionalism. Nevertheless, that doesn’t mean you shouldn’t be prepared to file a complaint against an insurer’s adjuster for mishandling a claim.

During the claims process make sure to request and keep all documents related to the claim. Also, keep a journal noting phone calls and the dates and people you spoke to. Make sure to check the licenses for any adjuster, contractors or roofers helping with your claim. This can be done at www.myfloridacfo.com. Lastly, if you feel that your claim is being mishandled, don’t hesitate to immediately contact the Department of Financial Services.

The insurance claim process is often daunting and time-consuming. At Alvarez & Barbara, LLP, we have the resources and expertise to properly help you with your insurance claim especially if your claim is being mishandled by your insurance company, or the adjuster hired by your insurance company.
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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.

About the AuthorGabriel de las Salas is an attorney with the law firm of Alvarez & Barbara, LLP. His practice is focused on general civil and commercial litigation, including personal injury, insurance claims and real estate disputes. Mr. de las Salas received his B.A., cum laude, from the University of Florida, and his J.D., from Stetson University College of Law.

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