Florida Insurance Law Blog : Florida Insurance Lawyer & Attorney : Mark Nation Law Firm : Orlando, Longwood, Gainesville

My client's home is insured by State Farm Florida.  On July 1, 2010, there was a significant wind event in east Orange County, Florida.  My client submitted the claim to his homeowners insurer.  The homeowners insurer hired an engineering firm to inspect the house.  The engineers hired by the insurance company wrote a report that there was no wind damage on the roof, and that any problems with the roof were due to the fact that the roof was over 20 years old.  

However, prior to the July 1 storm the roof was not leaking and was otherwise functioning fine.  The roof has substantial wind damage.  (Such damage is relatively easy to see.  For an article I wrote on how to determine if a roof has wind damage click here http://www.floridainsuranceblog.com/articles/insurance-coverage-homeowners/roof-claims/  The article also has a video showing a roof inspection, and how to prove wind damage to a shingle roof.)

In many homeowners claims, an insurance company will hire engineering firms to write them a report.  Often those reports are quite favorable to the insurance company.  If this happens to you DO NOT get discouraged.  The fact that an engineering firm says that there is no wind damage, or no sinkhole damage, etc is not the end of the inquiry, IT IS JUST THE BEGINNING.  Essentially, every insurance case I've ever won started with a denial letter. 

My deal with people is simple:  Never evaluate an insurance denial on your own.  I will look at any insurance denial for free.  If the insurer is correct I will let you know, and if they are wrong I will let you know that also. 

In this case, because of the refusal to pay for the wind damage, I filed a lawsuit today for breach of the insurance policy. 

As with most of my insurance claims, if I win this case the insurance company will have to pay my fees and costs, and if I lose, I'll work for free. 

• Email This
• Print
• Comments
• Trackbacks
• Share Link

My clients were injured in a motor vehicle accident.  Before the accident, they wisely took out substantial automobile insurance to protect them, including coverages for bodily injury liability, uninsured motorists coverage, personal injury protection, and medical payments. 

As a result of the accident, they incurred medical expenses.  These medical expenses were properly submitted to their car insurer, 21st Century, under their PIP and Med Pay coverages.  The auto insurer paid 80% of the medical charges under PIP, but refused to use the Medical Payments coverage to pay the remaining 20%.  (PIP in Florida pays the first 80% of medical charges, typically up to a limit of $10,000.  Med Pay is intended to pay any amounts not paid by PIP). 

The insurance company says that, based on its insurance policy, it doesn't have to pay anything under the Medical Payments coverage until the PIP is totally exhausted.  In reality, the insurance policy states that the Medical Payments coverage is "excess" over the PIP.  This means that the insurer is required to pay any amounts that are in excess of the 80% paid by PIP. 

Today, I filed a declaratory judgment action against 21st Century insurance to have a judge determine if my interpretation is correct, or if the insurer's interpretation is correct. 

As with most of my insurance cases, if I win, the insurance company will be required to pay my fees and costs, and if I lose, I'll work for free. 

• Email This
• Print
• Comments
• Trackbacks
• Share Link

My client's home was damaged by fire in 2010.  At the time of the fire she was insured with Citizens Property for her homeowners insurance.  Citizens sent out an estimator who initially estimated the damages for approximately $40,000.  My client's contractor estimated that the damage was approximately $130,000.  Citizens later sent an additional check for another $40,000. 

My client hired me today to help her with the claim.  Today, I filed a lawsuit against Citizens for breach of the insurance policy for failing to properly pay for the fire damages. 

My client has been out of her house for nearly a year now, and there is no way she could afford to hire me by the hour.  So, my deal with her is simple.  As with most of my insurance cases, if I am successful Citizens will be required to pay my fees and costs, and if I lose, I'll work for free. 

• Email This
• Print
• Comments
• Trackbacks
• Share Link