Case Details
Date Published:
January 1, 2023Attorneys
Emilio José Rodríguez , Franchesca Marrero ,Categories
Insurance Claims, Personal Injury,
INSURANCE CLAIM DENIALS
Overview
Insurance companies in Florida have a legal obligation to act in good faith when processing and paying out insurance claims. However, some companies may use tactics to deny claims in bad faith, which means they are not fulfilling their legal obligations and may be subject to legal action. Some common tactics used by insurance companies to deny claims in bad faith in Florida include:
Delaying claim processing: Insurance companies may intentionally delay the processing of a claim in an effort to frustrate the policyholder or to avoid paying out the claim.
Making lowball settlement offers: Insurance companies may offer policyholders a settlement that is much lower than the actual value of the claim, hoping that the policyholder will accept the offer rather than pursuing legal action.
Misrepresenting policy language: Insurance companies may misrepresent the language in a policy to try to deny a claim that should be covered.
Refusing to investigate a claim: Insurance companies have a responsibility to thoroughly investigate a claim before making a decision, but some companies may refuse to investigate in an effort to deny the claim.
Using unfair or biased experts: Insurance companies may use experts who are biased or unfairly favorable to the insurance company to evaluate a claim, which can result in an unfair denial of the claim.
If an insurance company is found to have denied a claim in bad faith, the policyholder may be able to pursue legal action to recover damages, including the full amount of the claim, attorney’s fees, and potentially even punitive damages.
The Challenge
Proving that an insurance claim was unfairly denied or denied in bad faith can be challenging for policyholders in Florida. Some of the key challenges include:
Lack of documentation: Insurance companies typically require extensive documentation to support a claim, and policyholders may struggle to provide the necessary documentation to prove their claim was unfairly denied.
Ambiguous policy language: Insurance policies can be complex and difficult to understand, which can make it challenging for policyholders to interpret whether their claim is covered or not.
Burden of proof: Policyholders have the burden of proving that their claim was unfairly denied or denied in bad faith, which can be difficult to do without legal expertise and resources.
Time limits: Insurance policies often have strict deadlines for filing claims and appealing denials, and policyholders who miss these deadlines may forfeit their rights to recover benefits.
Unequal bargaining power: Insurance companies are often large, well-funded corporations with significant resources and legal expertise, which can put individual policyholders at a disadvantage when attempting to negotiate a fair settlement or pursue legal action.
To overcome these challenges, policyholders may need to seek the help of an experienced attorney who can help them gather the necessary documentation, interpret policy language, and navigate the legal process. An attorney can also help level the playing field by advocating for the policyholder’s rights and interests in negotiations and legal proceedings.
Why You Need an Attorney
Hiring an attorney to represent you if your insurance claim was denied in Florida can be beneficial in several ways. Here are a few reasons why you may want to consider hiring an attorney:
Legal expertise: An experienced attorney will have a thorough understanding of Florida insurance law and can provide expert guidance on your legal rights and options.
Level the playing field: Insurance companies often have teams of lawyers and experts working to protect their interests. An attorney can level the playing field by advocating for your rights and interests and working to ensure you receive the full benefits you are entitled to under your policy.
Negotiation and settlement: An attorney can negotiate with the insurance company on your behalf, which can be especially helpful if you are unfamiliar with the negotiation process. Additionally, an attorney can help you evaluate settlement offers to determine whether they are fair and adequate.
Litigation: If your claim cannot be resolved through negotiation, an attorney can represent you in court and present your case before a judge or jury. An attorney can help gather evidence, depose witnesses, and present a strong case on your behalf.
Maximize recovery: Insurance companies may be more likely to take your claim seriously and offer a fair settlement if they know you are represented by an experienced attorney.
In some cases, hiring an attorney may help you recover a higher amount than you would have otherwise been able to on your own. Overall, hiring an attorney to represent you if your insurance claim was denied in Florida can help ensure your legal rights are protected and help you recover the full benefits you are entitled to under your policy.