Florida Insurance Litigation Attorney
The Law Offices of Craig R. Zobel represent policy holders in all aspects of claims and litigation against insurance companies ─ including property, fire, life, hurricane, and other insurance claims. Mr. Zobel has successfully handled cases against insurance companies in the courts of Florida, Texas, Illinois, and Missouri. We can help you untangle your policy’s language and pursue a path that leads to the best possible outcome for you.
Insurance Companies’ Tactics
Consumers carefully purchase insurance policies and often pay into them over decades, with the expectation that they will be able to count on their insurance company in the aftermath of a catastrophic event. What many people don’t realize (until their time of need) is that many insurance companies shrug their responsibilities and contractual obligations to policyholders. Some insurance companies’ sense of responsibility evaporates when the loss is large and their concern shifts to their own bottom line.
Insurers commonly deny, dispute, low-ball or delay claims as a deterrent to those rightly entitled to make claim for the very insurance benefits the insurer contracted to provide. Insurers sometimes try to shift the blame for a problem to something other than the real cause in order to claim an exclusion under the policy. By claiming the loss is not covered under your policy, they seek to evade contractual responsibility to pay for your loss. For example, when a roof collapses in a hurricane due to the weight of water puddling on it, the insurer may claim the roof was not properly maintained, was old, or had wood rot or other pre-existing damages. Sometimes insurers claim the repair is not covered because you were out of compliance with a building code. Some insurers do this to discourage people from pursuing their claims and contractual rights.
Some insurers continue doing this because they know it works; a certain percentage of policyholders will not pursue their rights to contracted benefits because of the time, expense, and expertise required to make the insurance company honor its contract. In the worst of circumstances, after losing everything, many policyholders reach a point where they either give up, or accept much less than what they are entitled to. Unfortunately, some insurance companies knowingly exploit policyholders when they are most vulnerable.
Insurance companies are legally obligated to uphold covered claims. Despite what occurs in practice, the law does not allow them to deny a claim without a reasonable basis. Provided that your insurance policy is current and covers your type of claim, if they do not honor your policy, it may constitute “bad faith.”
Examples of Bad-Faith Tactics
- Low-balling a claim;
- Harassment, threats, and intimidation;
- Unreasonable documentation requests;
- Delaying payment on a claim which would by reasonable standards be considered valid;
- Failing to provide a valid reason for denial of a claim;
- Failure to properly investigate and assess a claim, including using biased adjusters;
- Mailing out wrong forms and then denying a claim because it was made using the wrong form.
- Insisting on multiple unsworn or sworn statements to try to develop inconsistencies upon which to deny the claim.
When a claim for life insurance benefits is made, the insurer obtains all of the decedent’s health records and will often claim fraud as a basis to deny the claim because some marginally or entirely unrelated condition was not clearly disclosed in the initial application for the insurance policy. Sometimes the insurance agent is responsible for creating the problem in filling out the application. Florida unfortunately has a statute that insurance companies sometimes misuse as a basis to deny valid claims when the inconsistency is neither material nor relevant to the loss for which the claim is made.
Bad faith practices engaged in by the insurance company may sometimes be remedied under Florida Statutes governing Insurance claims practices. (see Florida’s Unfair Insurance Trade Practices law here and here). Life insurance is a big business in Florida. In 2011 alone, Floridians paid nearly $42.5 billion in insurance premiums for life and annuity policies. Because of the profit potential, life insurance has been associated with a number of schemes and poor practices, including:
- Misrepresenting the purpose of a life insurance policy as a savings or investment opportunity;
- Churning, or replacing an old policy with a new policy (see Florida state-approved life insurance agent ethics curriculum on this here) under much less favorable terms for the policy-holder;
- Financed premiums (see this excellent overview from life insurance analyst Errold F. Moody, Jr.);
- “Checkbook instead of a check” (see recent coverage on NPR.org)
- Vanishing premiums (see a financial planning association’s take on their drawbacks here);
- Delayed payments and general bad-faith practices (see Consumer’s Digest coverage).
Floridians paid nearly $33.5 billion in property and casualty premiums alone in 2011, and hefty homeowners insurance premiums and assessments for Florida homeowners continue to rise. Due to weather-related risks, Florida property owners must pay a lot for their insurance, and they should have their covered claims honored. Unfortunately, some companies insuring properties in Florida engage in practices designed to minimize the amount paid to insureds for their insured losses.
Fire insurance claims are another type of loss that insurers often look to avoid paying or to minimize the amount it pays. Some insurers try to claim arson on the part of the homeowner or another as a basis to avoid paying the claim. The “arson triangle” is a method insurers sometimes use to deny fire claims- even when the insurance company does not have any direct evidence that the fire was in fact caused by arson.
If you have had a problem with your insurance company fulfilling claims under your homeowners, property, or supplementary policy to cover events such as hurricanes, fires and floods, our firm has the experience to evaluate your claim and will if appropriate vigilantly fight to secure the compensation you deserve under your policy and the law.
The Law Offices of Craig R. Zobel Can Help
Unfortunately, due to the poor practices rampant in the insurance industry, you are unlikely to get an equitable resolution to your insurance claim simply by doing everything you are supposed to. Further, according to a Sun-Sentinel article, complaining to the state about the insurance claims adjusters’ poor practices is also unlikely to yield results. That leaves policy holders with one logical option (and one that the Sun-Sentinel also concluded), which is that “consumers who don’t get resolution [can] file a lawsuit.”
The Law Offices of Craig R. Zobel will work with you to hold the insurance company accountable to the terms of their contract and to secure the maximum potential benefit from your insurance policy. If you have been subjected to denial, delay, low-balling or other bad faith tactics from your insurance company, contact us for a no-cost and confidential initial consultation about your available options. In Florida, damages, interest on unpaid benefits, reasonable legal fees, and punitive damages may potentially be recoverable.
While the Law Offices of Craig R. Zobel, P.A. is often able to resolve insurance claims successfully on the eve of trial, Mr. Zobel has and will take an insurer through trial and appeal if that is appropriate. You may read one of Mr. Zobel’s reported insurance cases by clicking here to, Aetna Casualty and Surety Company v. Garza.
Links to Additional Insurance Resources:
The Florida Department of Financial Services publishes Insurance Insights, an online publication where you can find news, reports, and newsletters.
Florida Office of Insurance Regulation
Includes a wealth of information and resources for consumers, including Industry Reports and Data, press releases specific to Life Insurance, press releases specific to Homeowner’s Insurance, press releases specific to Automobile Insurance, educational resources for Automobile Insurance, educational resources for Homeowner’s Insurance, and educational resources for Life Insurance.
Insurance Industry Groups:
Florida Insurance Council, Insurance News Net, ISO insurance data, NAIC (National Association of Insurance Commissioners & The Center for Insurance Policy and Research), and the Property Casualty Insurers Association of America.
Consumer Federation of America, Insurance Information Institute, Fight Bad-Faith Insurance Companies (FBIC), and the Coalition Against Insurance Fraud.
Insurance Fraud & Scams:
Florida’s Division of Consumer Services publishes an online guide to Fraud & Scams, including unauthorized insurance scams. Insure.com covers dishonest insurance agents here, and The Coalition Against Insurance Fraud also publishes information on how to avoid common insurance scams.
Excellent resources from the American Association for Justice (formerly the Association of Trial Lawyers of America) on insurance industry practices, including a report on “The Ten Worst Insurance Companies in America,” and a report on “Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse and Refuse.”