When you and your insurance company have a good faith dispute over a Florida property damage or personal injury insurance claim, including the threshold issue of coverage as well as disputes over liability or damages, you will benefit by having an attorney dedicated to resolving the dispute so that your claim is paid, including litigating the matter in court if a reasonable settlement cannot be reached.
Coverage Disputes Over First-Party Claims
It is reasonable to expect an insurer to examine any claim to make sure it is covered before paying the claim. Typically an insurance adjuster will investigate the damage and review any accident report, if applicable. A review of the policy may also be appropriate to make sure the type of injury or damage falls within the terms of the policy as a covered claim. However, when these actions are taken solely to find an excuse to avoid paying a valid claim, the insurer may be sued for bad faith and forced to pay monetary damages in addition to the benefits under the policy.
A good faith dispute over coverage may exist based on the facts behind the claim or the terms of the policy, including whether the insured fulfilled its reasonable obligations under the policy, such as keeping up the premiums and providing notice of the claim or a potential claim in a timely manner. Insurance contracts are often highly technical, lengthy, and complicated documents that are difficult to understand or interpret; rarely is an insurance policy written in plain English. Where a good faith dispute exists over coverage, you want an attorney on your team to work with the insurance company to come to an understanding or litigate the matter in court if necessary.
Coverage Disputes Over Third-Party Claims
When a party who is sued has liability insurance, that party’s insurance carrier generally has a duty to settle the claim or defend the party in court. When a dispute arises over whether such a claim is covered under the policy or not, that question may need to be litigated in court. If persuaded at trial, the judge can issue a declaratory judgment ordering the insurance company to defend its insured. In many instances, it is enough just to prove that a potential for coverage exists in order to obtain a declaratory judgment.
Even when coverage is not disputed, there may still be a disagreement over liability or damages. For instance, if your liability insurer agrees to defend you under a reservation of rights, and a judgment is entered against you, the carrier may still dispute their obligation toward you, and further litigation may be necessary to force the insurer to pay the judgment in accordance with the terms of the policy.
In first party claims between insurer and insured, there may be a dispute over the facts in the case. For example, the parties may argue over whether a flooded room is water damage (covered by home insurance) or flood damage (covered only by flood insurance), or they may disagree over the cause of a sinkhole or whether the insured was in some way negligent. Even where the carrier’s liability to pay the claim is not in question, there may be a strong disagreement over the amount of damage and the proper amount to be paid under the claim. Insurance adjusters often assess the damage at a minimal level, and it may take legal intervention from an attorney experienced in the particular type of claim to argue for a more appropriate measure of the damage.
Experienced Florida Insurance Dispute Attorney
If you find yourself at odds with your insurance company over a claim, including questions of liability or damages or even whether your claim is covered at all, call Florida Defense Law, P.A. at 941-706-4472. You can also contact the Firm online to arrange for a free consultation with a knowledgeable attorney experienced in the resolution of insurance disputes.
For answer to common question please see the Insurance Dispute FAQ Page