Solving the Problem of Nonpayment of Valid Healthcare and Homeowner’s Insurance Claims, And Payment of Unsupported Claims
As often claims adjusters evaluate and approve damage claims caused by windstorm and sinkholes, claims denial decisions related to health can more troubling.
Very often those with certain life-threatening health conditions requiring life-saving treatment grappling with daily pain often— are subject to bad-faith claims denials left with no one not even family for support and life preservation.
Whether family or relatives or attorneys retained, you must determine whether the basis of the claim denial could support a bad-faith action against the insurance carrier.
Shining a light on the murkiness of Florida insurance law that is the law today in the US, reading an overview of Florida insurance law will help you become better informed on the rights and duties of an insurance carrier relating to its insureds.
The effect will be to be more assertive in navigating the uncertain and unpredictable route of the insurance claim denial process.
Please spend a moment to learn about the insurance law coverage disputes that arise in big cities such as Orlando, Miami and Fort Lauderdale under insurance law in Florida further below.
What Forms the Bulk of Insurance Lawsuits Brought in Miami, Tampa and Coral Gables, Florida?
According to Florida Office of Insurance Regulation, the problem of insurance disputes is fairly common enough to have government resources devoted to investigating illegal denials of insurance.
Upon bad-faith insurance provider denial there is a process firmly in place to get the insurance company to reverse its initial denial. For this reason, Florida Division of Consumer Services explains that the insured who was denied first:
- Tell the company he or she intends to appeal, unless there is a medical emergency involved; then to
- File a complaint with the Florida Division of Consumer Services
- Ask for an insurance provider review, if necessary.
According Florida law, found in the Florida Insurance Code, it is illegal for an insurance company to do any of the following:
- Knowingly misrepresent pertinent facts or insurance policy premium provisions related to the insurance coverage at issue
- Not acknowledging the insured’s communication promptly when it is reasonable to do so.
- Not implementing reasonable standards for investigating insurance claims, whether life insurance or other forms of insurance.
- Not settling insurance claims in good faith where liability is clear.
- Forcing practically the insured to file a lawsuit by inducing the insured to do so based on a low-ball offer.
- Not keeping records of the insured’s complaints.
- Committing any other act of unfairness.
On the other hand, Orlando carriers are concerned about their right under the doctrine of “duty to defend and indemnify.”
According to the Florida State Bar, Florida does not recognize a “right” of the party sued to defend once a insured has a claim brought against it. Instead, the right exists only to have the insurance company defend or pay for expenses to defend when a lawsuit is filed.
This rule is also known as the “8 corners” rule, which can be explained and utilized effectively with the proper legal counsel knowledgeable about insurance litigation in Florida. Two often muddled concepts are:
- The “duty to defend” and
- The “duty to “indemnify”
A skilled Florida insurance claim lawyer who specializes in insurance disputes with insurance carriers denying reimbursement payment or making bad-faith insurance denials of valid claims, will be able to persuasively argue for a just outcome. With the right insurance lawyer retained, it is more likely that a client can get the just result—whether access to healthcare, recovery of commercial property damages, or reimbursement expenses incurred in defending against potentially frivolous claims.
Factors Making a Solid Case, or Exposing a Spurious Commercial Property, or Healthcare Claim in Tampa, Tallahassee, Florida.
Under Florida law, an insured, also known as a first-party, who believes that he or she is the victim of bad-faith insurance claims denial relating to health care or property insurance, can file a claim with the state of Florida Division of Consumer Services.
Generally, the Florida Division of Consumer Services is responsible for protecting consumers against abuse by insurance companies and scams targeting vulnerable populations and the elderly.
Such programs affect the following practice areas making up Florida insurance law:
- rates, forms, and rules affecting the type of insurance (personal insurance coverages such as auto, residential property, title, and credit insurance), or
- forms and rules for life insurance, car insurance, and health insurance.
On the side of the company or person accused of wrongfully denying a claim, or the first-party (the insured) needing indemnification, a skilled Florida insurance claims attorney would be a reliable resource to use to be advised on these topics at the time of denial of payment or reimbursement. By analyzing all pertinent legal issues and employing all available legal strategies created by the legislature, Supreme Court of the state of Florida, and federal courts, the injured or denied claimant could have a better footing on the protections available for consumers victims of scams or overreaching by large insurance companies.
Helpful Insurance Law Arguments for Resolving Tampa Insurance Law Coverage Disputes In Health Insurance Law
A controversial subject in insurance law recently in the US today has been the effect of the coronavirus on businesses that carry commercial insurance. According to the Sarasota-based law firm Lutz, Bobo & Telfair Trial Lawyers, there are innovative ways to have the insurance carrier reimburse the business to avoid having to dissolve or declare bankruptcy.
Typically, government programs are a safety net for small businesses to rely upon. However, the concept of “interruption insurance” is another option you may consider pursuing so long as an effective legal argument can be made on your behalf to demonstrate that it applies.
Examples of such interruption include:
- A loss of income and other damages suffered as a result of a disaster.
- A natural disaster, commonly understood.
- Disaster other than natural disasters such as “forced shut-downs” due to a non-natural disaster.
There are strong incentives to attempt to pursue these claim with the right Florida insurance lawyer experienced in these kinds of cases to recover the following:
- Profits
- Fixed costs
- Overhead insurance coverage
- Temporary costs
- commission and training,
- other general “business-related expenses,”
- and/or lost streams of revenue.
Admittedly, each factor can or may not be appliable in your insurance law case, as the policyholder under a given property insurance plan. An experienced Florida insurance lawyer will have the know-how to determine the best route to take to bolster a case for an bad-faith insurance denial of a property damage claim or the more novel “business interruption” claim.
Legal Advice: Why Do Tampa Policyholders Need Access To A Florida Insurance Lawyer?
As many Florida lawyers have valuable legal advice and legal services to offer at high prices, there are some concerns likely how much an insurance lawyer is worth as a personal advocate for a policyholder. Based on insurance law nuances in Florida, evaluating an insured’s policies, their meaning and predicting how the terms may be interpreted in your particular situation—are undoubtedly priceless in terms of notwithstanding the incredibly high average rate of Florida lawyers and law practices, who can charge between reportedly $199 to $420 per hour, per Clio.com’s 2021 statistics.
Based on the skill and years of experience of the Florida insurance lawyer handling the organization or other involved party’s case, a client can recover greater amounts if the lawyer stays up to date with the everchanging landscape of Florida insurance bad-faith insurance litigation.
Without the insured having a valued and trusted in-house or outside counsel as its disposal, you may end up needlessly being exposed to risk and liability for actions that you aren’t even responsible for. The ramifications are that many companies will face similar situations of having to close down affecting the local and national economy in ways that cannot be completely ascertained.
Why Should I Hire a Skilled Florida Insurance Law Firm for My Healthcare Claim Denial?
Given the fast-changing world of health care and businesses with frequent reports of injury cases resulting in property loss, car accidents and wrongful death, having a distinguished Florida insurance lawyer is a must.
Whereas many Florida law firms may be generally knowledgeable about how to represent a business entity, a particularly skilled and incredibly talented and experienced insurance attorney will be intimately familiar with the most recent decisions in employment law, ready and willing to use whatever tools in his or her arsenal to prosecute or defend the case.
Many top-rated law firms have a proven track-record specialize in these cases, including Fort Lauderdale-based insurance law firm David Low & Associates, P.A., among others in Orlando, Miami and Fort Lauderdale and surrounding areas, offer an initial free consultation and/or evaluation to help strategize your best course of action during a time of stress and uncertainty about the future.
For such a Florida law firm competent in insurance law, a specialist will ask you, the client, questions to maximize the value of your case or minimize liability in exploring your legal options—whether handling claims of relatively inexperienced property owners, a large corporation with real estate, or greater assets to protect, or a patient denied necessary treatment by a doctor or hospital. Such representation often necessitates employing novel legal arguments and arguments for fundamentally changing the law to benefit you, the client.
In any case, you should be prepared to create a narrative of facts detailing everything that you remembered before, during and after the incident leading up to the dispute, including keeping meticulous records of expenses made during the insurance litigation, or in the case of the responsible merchant, the costs to defend.
As a policyholder involved in the insurance dispute, it is also imperative to share any business malpractice or personal insurance company policy maintained and investigate other potential actors responsible for the wrongful act causing personal injuries. Also important is it that your attorney test the strength and validity of any insurance claim made.
Forming an Attorney-Client Relationship: Call an Orlando Insurance Claims Attorney Today to Discuss Your Case and Odds of Victory for the Company!
Whether you are the insured without a safety net under an insurance policy or a carrier seeking to minimize liability for those questionable medical malpractice insurance claims, having the right attorney on your side can navigate the vast and ever-changing landscape of Florida insurance law and ever evolving case precedent. The attorney-client relationship forms upon consultation when you consider hiring the attorney in Orlando or other surrounding areas.
Once formed, this relationship helps prepare the client to bring a winning case to receive compensation where there is clearly established liability and avoid liability for insurance claims that have no support in fact or law and are mere conjecture and conspiracy.
Whether you are looking for an Orlando, Miami or Fort Lauderdale-based insurance claims lawyer, Lawsuit.org will help you pinpoint one in the right practice area by offering a free consultation to obtain the just results that an insured or insurance company needs.