Close Menu

When you purchase an insurance policy and pay your premiums on time, you expect to receive the benefits of that insurance policy. Theoretically, you are buying the peace of mind that certain unforeseeable losses will be covered. However, the culture within insurance companies is profit-driven. When claims are paid, they reduce profits. As a result, many legitimate claims are wrongfully denied when policyholders most need the help of their insurers. Sometimes insurance adjustors make low-ball offers for substantially less than what policyholders need, hoping the policyholder will settle for that sum and walk away. If you are making an insurance claim after an accident, you can enlist the insurance claim lawyers at Payer & Associates to make sure that you are being treated fairly. Insurers also have attorneys, and it is common for these attorneys to search for ways to pay less to policyholders, or even deny your claim.

The Process of Pursuing an Insurance Claim

The language of the insurance policy governs the benefits that are offered to policyholders. Usually, there is a set of exclusions. These are conditions that, if they exist, will not be covered. For example, there may be a “named driver exclusion” in an automobile insurance policy. This is an endorsement that states that a particular individual who has access to your car will not be covered by the insurance carrier if he or she is driving and gets into an accident. Usually, the exclusion is attached to the policy because the underwriter knows that there is a problematic driver in the policyholder’s house, such as a person with a drunk driving conviction or a teenager who has already gotten into numerous accidents. Both the individual and the car owner who allowed him or her to drive can still be held personally liable for damages in the event of an accident, and their own assets may be used to satisfy a judgment.

Insurers often phrase their denial letters so that policyholders are convinced the denial is appropriate, even though it is not. Insurers tend to construe the language of the policy in their own favor. But courts may interpret the policy language differently, and an attorney who has experience dealing with insurers, judges, and juries can evaluate whether it is worth litigating an insurance claim that has been denied.

All insurers owe a fiduciary duty to their policyholders. If an insurer fails to act reasonably in fulfilling this fiduciary duty, it may be subject to a bad faith claim. Historically, first-party insurance policies were only subject to the remedies available under contract law. Now, under Florida Statutes section 624.155, a policyholder may bring a first-party bad faith cause of action.

An insurance company acts in bad faith if it fails to settle a claim when, looking at all of the circumstances, it should have done so if it had acted honestly and fairly towards the insured, and with regard for the insured’s interest. Whether a particular insurer has acted in good faith requires the court to look at the extent of the carrier’s efforts to give an insured the protection required under the insurance policy.

Contact an Experienced Miami Insurance Claim Lawyer

If you have had an insurance claim denied are involved in a car accident or another harmful event, you can consult the aggressive attorneys at Payer & Associates for guidance on your legal options. Our insurance lawyers have over 40 years of combined experience and represent people through the Greater Miami area, including in Miami Gardens and Hialeah. We also can assist accident victims in the area around Sunrise. Call us or contact us online for your free confidential consultation with one of our attorneys. We are available for home and hospital visits upon request and are available to meet with you 24 hours a day 7 days a week.

Share This Page:
Facebook Twitter LinkedIn