Unfortunately, denials and disputes are all too common when insurance adjusters are trained first and foremost to protect their own bottom line.
An insurance company that acts in bad faith and denies or undervalues your claim can be held accountable with the help of a Florida insurance dispute lawyer. Get in touch with our skilled attorneys for help with getting the coverage you are entitled to.
Why Do Insurance Disputes Arise?
An insurance dispute is a disagreement between a policyholder and their insurance company. Insurance disputes in Florida may arise when:
- Benefits are rejected outright
- Payments are made to the policyholder at a lower rate than expected
- Benefits are unreasonably delayed
- The insurance company claims the policyholder made material misrepresentations or omissions related to the terms of the policy
While a policy being rescinded is not the same as a claim denial, it does mean the policyholder or their family are no longer eligible for benefits. For instance, if a smoker registers for life insurance while claiming to be a non-smoker and subsequently passes away, the insurance adjuster may have grounds to rescind their family’s claim during the contestability period after the death.
Types of Insurance Claim Disputes We Handle
Our experienced Florida insurance dispute lawyers can assist with strategic negotiation and swift legal action in the following types of insurance disputes:
- PIP claims
- Rescission claims
- Life insurance
- Property insurance (general property, commercial property, costs to repair and replace assets that are owned and operated as part of a business)
- Homeowners insurance
- Business interruption
- Bad faith insurance
Can You Sue an Insurance Company Directly in Florida?
Under Florida law, you have the right to pursue a civil claim against an insurance company that has acted in bad faith with your claim. A Florida insurance claim dispute lawyer can help you build your case and follow through on what you may be owed.
Examples of actionable insurance claim denials in Florida include:
- Refusing to pay a legitimate claim
- Denying claims without investigation
- Unnecessary delays in launching an investigation
- Late or delayed payments
- Purposeful undervaluation of your claim
- Failing to communicate in a timely manner, including failing to notify a claimant of additional paperwork required for a claim
- Breach of duty
What Are Three Ways in which an Insurer Can be Liable for Bad Faith?
According to Florida Statutes 624.155, an insurance company can be held liable for “bad faith” in three instances:
- When an insurer does not attempt in good faith to settle claims when it could have done so by acting fairly and honestly toward the insured party and with due regard for their interests;
- When an insurer issues payments to insureds or beneficiaries without providing a statement setting forth the coverage under which payments are being made;
- When an insurer delays or fails to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
How to Dispute an Insurance Claim Denial
Insurance companies have a legal obligation under Florida law to consider their responsibilities to their claimants when acting in their own best interest. If you suspect your claim denial stems from an effort to protect the insurance company’s own bottom line, you may have a valid bad faith insurance dispute.
The first step is to file for an internal appeal of your insurance company’s decision. This process is time sensitive and may include a request for documentation of the reasons for the denial, your insurer’s relevant criteria, and any other paperwork and details involving the claim.
How to File a Complaint against an Insurance Company in Florida
To file a complaint against an insurance company in Florida, the policyholder must give notice to both the insurance company as well as the state Department of Financial Services. If your claim is resolved to your satisfaction within the 60 day window, you no longer need to consider legal action against an insurance company. However, if your benefits have been reduced or are still denied, you may be able to file a civil lawsuit in the state of Florida with the help of an insurance dispute lawyer.
To file a complaint, you will need documentation of your claim, which might include photos, videos, assessments from medical experts or contractors (depending on the nature of your insurance dispute claim), and more. You may also need your initial policy agreement, evidence of your payments, and other documentation as needed to show your own compliance with the terms of the insurance policy. An insurance dispute lawyer in Florida can help you assemble all of the evidence needed to build and strengthen your case.
Benefits of Hiring a Lawyer for a Florida Insurance Dispute
Besides helping you assemble and file all of the necessary paperwork, a lawyer for insurance disputes knows all the ways adjusters try to negotiate down claim amounts and evade payments. Bear in mind that the insurance company has hired and trained industry professionals to protect their own interests. Our experts will be by your side to do the same.
Our Florida insurance dispute attorneys have context for what amounts are standard in similar settlements and can gather evidence and expert testimony in support of your rights as a claimant. Our attorneys can reject lowball offers, negotiate for the highest possible settlement, and represent you in court in the event of persistent bad faith denials. In addition to the payments owed to you by insurance, it may also be possible to win punitive damages in a successful insurance dispute.
Florida Insurance Dispute Lawyer: FAQs
Our attorneys are frequently asked the following questions about insurance disputes in Florida:
What is it called when an insurance company refuses to pay a claim?
When an insurance company refuses to pay a claim, it is called a denial. Refusing to pay a claim unfairly is illegal, known as a “bad faith” denial.
What is the first party bad faith statute in Florida?
First party insurance policies include health insurance and coverage in the event of certain natural disasters, such as fires, floods, or tornadoes. The first party bad faith statute in Florida includes insurers who deny first party insurance payments for illegitimate reasons, or who fail to process, investigate, and communicate with policyholders about their claims.
How do I fight my insurance company?
Insurance disputes are complicated and involve strict timelines, immense paperwork and filing requirements, and in-depth insight into the fine print of insurance policy guidelines and covered exceptions. With the help of an insurance claim dispute lawyer, you can build a strong case that illustrates why your denial was made in bad faith, and why you should receive the appropriate payments. An attorney can also help advocate for punitive damages to discourage other insurance companies from trying to take advantage of their constituents.
What percentage of insurance appeals are successful?
Data shows that policyholders are wary to appeal insurance denials, with only about one in 500 cases continuing onto an appeal. However, insurance appeals are powerful tools, especially when handled by an experienced insurance dispute lawyer. More than 50 percent of insurance appeals are successful when they involve denial of coverage or reimbursements.
Who regulates insurance companies in Florida?
The Florida Department of Financial Services (FDFS) regulates insurance fraud. The FDFS Insurance Consumer Helpline is available for clarifying consumer rights and addressing difficulties settling insurance claims.
Get in Touch with a Florida Insurance Dispute Attorney
The dedicated attorneys at Chiappetta Trial Lawyers are available to help you understand your options when you receive an insurance denial. An experienced Florida insurance dispute lawyer can help you assemble all the necessary paperwork, examine your policy, and make sure you do not miss out on benefits you are entitled to. Contact us today for a complimentary consultation.
