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Articles Posted in Insurance Issues

Recently, the United States Court of Appeals for the Eleventh Circuit issued an opinion addressing issues that commonly occur in insurance coverage disputes between Florida homeowners and insurance companies. In this case, a couple in a neighboring state discovered that a home they recently purchased was infested with brown recluse spiders. After attempting to remedy the infestation, the couple bought a homeowners’ policy from an insurance company. The relevant provisions in the policy indicated that the company would provide coverage against the “direct loss to property,” in cases where there was a physical loss to the home. The policy enumerated exceptions to the coverage, including damages that were the result of “birds, vermin, rodents, or insects.” The insurance company cited that provision in their notice denying the homeowner’s claim.

In response to the denial, the homeowner’s filed a breach of contract lawsuit against the insurance company, alleging that the company was engaging in bad faith. They contended that the spiders presented a deadly risk and infested the entire home, rendering it unsafe for occupancy. They claimed that the insurance policy’s exclusionary provision did not apply because brown recluse spiders are not insects or vermin but rather arachnids.

Under Florida law, insurance companies must engage in good faith practices when reviewing a policyholder’s claim. Insurance companies must acknowledge the receipt of a claim, promptly investigate claims, respond to inquiries, not unnecessarily hinder progress, and offer valid and specific reasons for any denials or delays. In many instances, insurance companies cite specific provisions in the policy to support their decision. However, in some cases, this interpretation may be incorrect.

Florida has one of the highest rates of car accidents involving uninsured or underinsured (UIM) drivers in the country. Car accidents with drivers without appropriate insurance can have long-term medical and financial consequences on a car accident victim, and Florida drivers must protect themselves.

Florida requires that motorists maintain two types of auto insurance, personal injury protection (PIP), and property damage liability (PD). Florida’s designation as a “no-fault” state means that a motorist’s PIP coverage will cover covert medical expenses up to $10,000, without consideration of fault. However, Florida does not require motorists to carry bodily injury coverage; this coverage pays expenses the other party incurs because of an accident. The only time this does not apply is if the responsible driver has been convicted of DUI.

In response to these potentially devastating situations, Florida insurance law requires insurance companies to offer motorists the option to purchase UIM coverage. Thus, although UIM coverage is not mandatory, insurance companies must offer coverage to policyholders. The insurance protects the insured if they are involved in an accident with another motorist who does not have any or enough bodily injury insurance. However, policyholders must understand that UIM coverage is only an option if they carry bodily injury coverage in an amount higher than the UIM coverage. Florida’s minimum bodily injury coverage is $10,000 per person and $20,000 per occurrence.

The COVID-19 pandemic has uprooted the lives of most Americans in Florida and across the United States. Employers, educational institutions, retailers, and almost every other industry has made changes to the way they operate. As a result, Florida drivers are typically only venturing out for mandatory travel or essential supplies. This has led to insurance companies experiencing a decrease in Florida car accident claims and higher profits.

According to an industry news source, in response to the COVID-19 pandemic, the Consumer Federation of America and the Center for Economic Justice, issued a statement advising automobile insurance companies to provide their policyholders with premium relief. The agencies issued this advisory to help individuals who are facing financial difficulties because of an income reduction during this time. Insurance companies are using their discretion to determine whether they will take steps to issue refunds of policyholder’s premiums or provide them with another benefit. The Insurance Information Institute has stated that insurance companies will be returning nearly $10 billion to customers across the United States. However, because this is not a mandatory call to action, insurance companies have the choice as to whether they will reduce insurance rates or return premiums.

There are several different ways that Florida insurance companies are responding to this advisory. The most common actions that insurance companies are taking are reducing premiums, waiving late fees, and issuing discounts. These reductions include, multi-vehicle discounts, multi-vehicle discounts, safe driver discounts, occupation-related discounts, and professional association membership discounts.

Those who have experience dealing with a Florida insurance company, know the process can be a difficult one. Earlier this month, a state appellate court issued a written opinion in an insurance dispute case arising from a fatal Florida car accident. The case illustrates the difficulties that many accident victims face when attempting to recover for their injuries through either a Florida personal injury or a wrongful death lawsuit.

According to the court’s opinion, a driver caused a fatal accident while using his step-father’s vehicle. At the time of the accident, the driver had his step-father’s permission to use the vehicle. There were several insurance policies in effect at the time of the accident. Specifically, the driver had three policies with three different insurance companies, one of which was with Geico. In addition, the driver’s step-father had a policy with Allstate.

Allstate paid out $250,000 to the plaintiffs, which was the policy maximum. Pursuant to that agreement, the $250,000 was not an agreement to release the driver of all liability, but would offset any other recovery obtained by the plaintiffs.

Many individuals in Florida have purchased some sort of insurance policy, whether it be car insurance, homeowner’s insurance, or another form of insurance. Insurance can protect an individual when accidents occur, but, unfortunately, sometimes insurance companies can be difficult to work with, or may refuse to cover a claim even when they are supposed to. Insurance disputes are common because insurance companies pour significant resources into legal teams to limit their liability. One form of insurance dispute occurs when the parties disagree on the amount of loss suffered by the insured. Depending on the policy, there are different ways to solve this type of dispute; one common way is through an appraisal.

For example, take a recent Florida appellate case. According to the court’s written opinion, the plaintiff had a homeowner’s insurance policy from State Farm, the defendant. The policy stated that when the two parties could not agree on the amount of loss suffered by the plaintiff, both parties would choose a qualified, disinterested appraiser who would then set the amount. In September of 2017, the plaintiff submitted a claim under the policy, and State Farm issued her a payment for her loss. However, the plaintiff disputed the amount of the loss, and notified State Farm that she was going to use a public adjuster as her appraiser. State Farm objected to this, because the plaintiff and the adjuster had an agreement that the adjuster would assist her and then receive a ten percent contingency fee. Because the adjuster received a portion of the final amount, State Farm argued that he could not be truly disinterested as the terms of the policy stated he must be.

The court ultimately agreed with State Farm. Under Florida law, when interpreting the terms of a contract, courts interpret plain and unambiguous language in accordance with its plain meaning. If a term has an ordinary meaning that it is usually assigned, then the court will give it that meaning in a contract, unless the parties specifically define it otherwise. The court found that the term disinterested could not apply to an adjuster who had a direct financial interest in the outcome; the higher the appraised value, the higher his commission. As such, the plaintiff was unable to retain the adjuster as her appraiser, and instead had to find an independent, disinterested appraiser who did not have a financial stake in the final outcome.

Florida motorists must purchase automobile insurance that provides at least $10,000 in personal injury protection (PIP) and $10,000 in property damage. PIP coverage is a no-fault coverage that provides compensation to motorists and qualified family members for certain accident-related medical expenses. Florida is a no-fault state, and insurance companies cover their policyholders in an accident. However, the law does not require motorists to purchase insurance to protect themselves when they are negligent. When someone is involved in an accident with a driver that does not have adequate protection, the victim may face significant challenges recovering for their losses.

To avoid potential significant financial burdens, motorists should purchase uninsured/underinsured motorist (UIM) protection. Unlike several other states, Florida automobile insurance laws do not require motorists to purchase uninsured/underinsured motorist (UIM) protection; however, this coverage provides drivers, their passengers, and household family members, with additional financial security.

UIM protection is useful in cases where motorists are involved in an accident with an at-fault driver with inadequate insurance coverage. Further, this coverage protects policyholders in hit-and-run accidents, unknown vehicle collisions, or if the policyholder or their family members suffer injuries as a pedestrian or cyclist.

Car accidents can leave injured motorists, passengers, and pedestrians with substantial property damage, physical injuries, and psychological trauma. After seeking medical attention, one of the first steps a Florida car accident victim should take is to file a claim with the at-fault driver’s insurance company. Many Floridians assume that insurance companies operate swiftly and fairly; however, this is often far from the truth.

In most instances, car accident victims will attempt to recover damages from the at-fault party or their insurance company. This requires filling out lengthy forms, providing detailed information, and explicitly requesting appropriate compensation. Insurance companies rarely agree to the amount the victim claims and will either counteroffer, deny, or even delay deciding the clam. If an insurance company is engaging in unlawful practices or countering an inadequate amount, injury victims should contact an attorney to file a complaint

To initiate a lawsuit against an insurance company, potential plaintiffs should file a complaint in court. Attorneys can assist the plaintiff in including all relevant and pertinent details, including a demand for damages. During pre-trial pleadings, both parties will have the opportunity to file motions to support their claims. If the case survives pre-trial proceedings, the parties will then engage in discovery and then trial.

Recently, Florida’s Supreme Court ruled that insurance companies must comply with Florida Statutes section 627.727, which covers uninsured motorist (UM) coverage minimums. The ruling comes after an insurance company appealed a lower court’s ruling in favor of the plaintiff in a dispute over coverage after a Florida motorcycle accident.

Before his death, a man purchased home insurance coverage that included a collector vehicle. The policy included a UM provision that limited benefits to accidents involving the collector vehicle. After the man’s death, his family tried to recover for damages through the UM provision in his home insurance policy. The defendant insurance company denied coverage, citing the UM limitation. The plaintiffs filed a lawsuit against the Florida insurance company, arguing that Florida Statutes section 627.727 prohibits the insurance company from placing restrictions on UM coverage. On appeal, the defendant argued that section 627.727 does not apply to specialty insurance policies, such as the collector vehicle at issue.

Florida Statutes section 627.727 governs “motor vehicle insurance, uninsured and underinsured vehicle coverage, and insolvent insurer protection.” Typically, the statute provides coverage to the policyholder, their spouse, and resident relatives. This coverage applies when a person suffers bodily injury by a negligent motorist, whether they are driving or a passenger in their vehicle, driving or riding in someone else’s car, or suffer injuries as a pedestrian. There are several exceptions to this statute, but there are no exclusions related to a collector or antique vehicle.

Insurance companies play a vital role in most Florida car accident cases and are expected to abide by the terms of their policies faithfully. However, in many instances, insurance companies wrongfully deny claims, and Florida personal injury victims end up in lengthy and costly disputes. These disputes can take longstanding financial, physical, and emotional tolls on Florida car accident victims. Florida has several statutes and remedies in place to hold insurance companies liable for delaying or wrongfully denying claims. Floridians who are at a standstill with an insurance company should retain an experienced attorney to help them get their rightfully due damages.

Florida motorists typically purchase automobile coverage with the expectation that the company will provide them with financial protection if they are involved in an accident. Insurance companies must deal with their policyholders in “good faith” and with “fair dealing.” These terms mean that the insurance company must treat their policyholders fairly and carefully when determining the validity of a claim, and settle claims against the insured within the agreed-upon coverage limit. Insurance companies act in bad faith when they refuse to pay or settle a claim without a reasonable basis, fail to promptly and adequately investigate or defend a claim without justification, implement deceptive practices to avoid paying a claim, or refuse to offer the full value of a claim.

There are generally two types of Florida bad faith insurance claims, first-party and third-party claims. First-party insurance claims occur when a Florida motorist’s insurance company fails to address and pay a claim adequately. This typically occurs when a Florida driver evokes their policy’s underinsured or uninsured coverage.

Florida motorists should engage in a comprehensive and thorough review of their available insurance policies to ensure that they have adequate protection in the event they are involved in an accident. One area of coverage that deserves close scrutiny is the terms of the insurance company’s uninsured and underinsured motorist (UIM) coverage. UIM coverage protects Florida drivers that suffer injuries because of a negligent driver who does not have adequate vehicle insurance. A shocking 25 percent of Florida drivers do not have insurance, and this can have disastrous consequences for injury victims.

Florida’s no-fault insurance rules require that insurance companies protect their own policyholders in minor accidents, so long as the drivers purchase personal injury protection. However, issues arise when a driver sustains serious injuries in a Florida collision. In these instances, Florida drivers must file a claim with the at-fault driver’s insurance company. Filing a complaint with the negligent driver’s insurance company often raises challenges because Florida law does not require drivers to purchase insurance coverage that protects them from liability if they injure someone else.

Appropriate UIM coverage can provide a motorist with extra protection in case the other party is under or uninsured. However, policyholders often face difficulty evoking this policy because insurance companies are reluctant to pay out substantial amounts. Insurance companies will sometimes wrongfully delay claims, or assert specific provisions to avoid paying out claims.

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