Palm Beach County Lawyer Answers Questions About Insurance Disputes

Q:  If the insurance company denies my life insurance or property damage claim, what do I do?

A: If your claim is denied, you may wish to seek the services of an attorney who is familiar with insurance law.  You should ask the attorney to evaluate your claim (at no cost) and advise you as to whether your claim is viable.  Since the denial of an insurance claim involves important legal consequences, the best thing to do is seek legal counsel. We will evaluate your claim at no cost and with no obligation.   

Q: After I submitted my claim for life insurance proceeds, the insurance company stated that it was going to review the medical records of the insured.  Can the insurance company do that?

A:  Florida law allows the insurance company to review the medical records of the insured if the insured died less than 2 years after the policy was issued.  This initial 2 year period is referred to as the “contestability period”.  This means the insurance company can evaluate whether the insured made any misrepresentations on the application for insurance.  If the insurance company determines that a misrepresentation on the application occurred, it can deny payment.  However, insurance companies will often wrongly deny payment by asserting that a misrepresentation was made.  That’s why it’s important to seek counsel’s advice.

Q: The insurance company sent me a premium refund check instead of my life insurance benefit.  Should I cash the check?  What should I do?

A: If the life insurance company sends a premium refund check to you, cashing the check could have legal consequences to your claim.  Ideally, you should not cash the check until you have spoken to an attorney who can further evaluate the matter and advise if the cashing of the check will detrimentally impact your claim. 

Q: Should I file a complaint with the Florida insurance department?

A: If you feel that the insurance company has acted improperly with regard to your claim, you can file a complaint with the Florida Department of Financial Services (“FDFS”).  FDFS can then investigate the insurance company to determine if it has engaged in any wrongdoing or violated any statutory requirements.  Under Florida law, the insurance company has 20 days to respond to the department. However, the insurance department does not have the ability to award damages for your claim.  You would need to retain a private attorney to pursue a claim for damages.  To file a complaint with FDFS, you would need to contact the Division of Consumer Services at 877-693-5236.

Q:  I heard that I can go to mediation for my residential property damage claim.  Is that true?

A: The Florida Department of Financial Services offers a non-binding mediation program for residential property damage claims.  The mediation is coordinated through the department, which appoints a neutral mediator to help resolve your damage claim.  Once you file a request for mediation, the insurance company has 21 days to resolve the dispute.  If you and the insurance company cannot resolve the claim, the dispute will go to a mediation conference.  You can be represented by an attorney but it is not required.  Mediation is not binding, which means that neither you nor the insurance company is obligated to accept a settlement.  The insurance company pays the cost of the mediation.  To request mediation, you can go to the FDFS website or call 877-693-5236.

Q: I sustained damages to my condominium unit.  How should I proceed?

A: When an owner of a condominium unit sustains damages, it’s important to understand that your unit is subject to two separate coverages.  The unit owner typically has insurance covering his or her individual unit.  This personal insurance coverage usually applies to furniture, wall and ceiling coverings, appliances, electrical fixtures, water heaters, curtains, drapes, blinds, and countertops.  If any of these items are damaged, the unit owner should file a claim with his or her personal insurance carrier.  Any damages sustained to the structural portions of the unit, like the ceiling, walls, and permanent fixtures, are the general responsibility of the association and usually fall within the association’s master policy.

Ultimately, if you suffered damages to your unit, you should take inventory of what was damaged and notify both your individual insurer and your condominium association.       

Q:  If I use your services to file a life insurance or property damage claim, what will be your attorney’s fee?

A: We work on a contingency fee basis for all insurance claims.  This means that we do not recover our attorney’s fee unless there is an actual monetary recovery.  Our fee is based upon a percentage of the recovery.  All fee agreements are in writing as prescribed by law.  We do not enter into verbal agreements with our clients.  If you’d like to get further information about our fees, please contact us.    

Q:  Can you review my claim without any obligation?

A: Yes, we can review your insurance claim at no cost.  There will be no obligation for you to retain our legal services.  We reserve the right to decline any claims that we feel have no legal merit.   

Q: Do you handle claims in any part of Florida?

A:  Yes.  Whether you are in Miami, Fort Lauderdale, West Palm, Orlando, Tampa, Fort Myers, Naples, Ocala, Jacksonville, Tallahassee, or Pensacola, our firm can service clients with an insurance claim in all parts of the state.  As long as your claim is governed by Florida law, we can assist you.

Q:  I want to file a life insurance or property damage claim against my insurance company.  What information does your firm need from me?

A: For life insurance claims, we would need to review the denial letter, application (if available), copy of the policy (if available), and any other correspondence you received from the insurance company.   For property damage claims, we would need to review the denial letter, policy (if available), and any estimates of damages, damage reports, and/or public adjuster’s estimates relating to your claim.  If a public adjuster is working with you, we would need to know that as well.