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Insurance Claims

Maintaining a sound insurance policy to protect you when disaster strikes is a prudent decision. As long as you pay your premiums, you should expect your insurance policy to cover damages if an incident occurs. UnfortunatelyInsurance companies are notorious for denying insurance claims or paying lower amounts to maximize profits.

If your insurance company attempts to avoid their contractual responsibility, you can seek legal compensation. The state of Florida has laws that protect policyholders from abuse by insurance companies, and a Kissimmee insurance claim lawyer can help you file an insurance claim dispute.

Florida's Insurance Claim Laws and Regulations

The Florida Statutes have an insurance bad faith law. According to the insurance code Section 624.155, you can bring a civil suit against an insurance company when the insurer acts in bad faith.

Section 626.9541 maintains that insurance companies should not use deceptive methods or engage in unfair competition to coerce customers. If the insurance company misrepresents the benefits, conditions, or terms of the insurance policy or knowingly charges extra premiums without providing benefits, you are eligible for an insurance claim.

Section 626.9541 also explains acts of bad faith by insurance companies. These include:

  • Denying your claim without any investigation
  • Failing to implement or adopt normal standards of an investigation
  • Failing to act immediately on a claim or delay claim processing
  • Making false representations about the insurance coverage
  • Making a material misrepresentation to deny a claim
  • Misrepresenting the terms of the policy
  • Failing to provide reasons for rejecting a policyholder's insurance claim
  • Failing to pay the undisputed amount within 90 days

As a policyholder, you also have the right to cancel your insurance coverage. If you cancel the policy, the insurance company may retain part of your premium. However, the insurance company cannot cancel a policy after it is in effect for 90 days unless:

  • The policyholder made a material misrepresentation in their policy application
  • The risk of the policyholder changes
  • The policyholder refuses to make premium payments
  • The policyholder fails to honor the underwriting requirements

Section 626.9705 represents life or disability insurance claims. A life or disability insurance company cannot refuse to cover, renew or sell a policy, create premium rates for a policyholder or establish any discriminatory charges on a person to prevent them from accessing coverage. Section 626.9707 also holds that an insurer cannot refuse to sell or fulfill a claim or introduce premium rates because the policyholder has sickle cell traits.

Other sections that establish the foundation for insurance claims are 626.9551 regarding coercion of policyholders and 626.7283 that covers policy cancelation and return of policy money.

What are my rights as an insurance policyholder in Kissimmee?

If you are a policyholder in Kissimmee, Florida, according to Section 626.9641, you have a right to:

  • competitive pricing and fair marketing methods that help you choose the best option among comparable insurance policies.
  • obtain comprehensive coverage. For example, in Florida, residential insurance policies must provide coverage against hurricane damage in some coastal regions. If a policyholder wishes to decline coverage, they have to document this exclusion in writing. If there is no written exclusion, the insurance company should offer a payout if damages to property occur.
  • advertising that balances the benefits and limitations of an insurance policy.
  • be served by a competent and honest insurance agent.
  • a readable insurance policy. If your coverage has several deductibles, your insurance policy should clearly explain the deductibles and the amounts.
  • get coverage from a financially stable insurance company.

Insurance companies are required to act in good faith. This regulation ensures that policyholders have adequate protection in exchange for reasonable premiums.

Can the insurance company deny my claim?

There are multiple reasons why an insurance company may attempt to deny your claim including:

  • If a policyholder fails to pay the premiums on time, leading to a policy lapse.
  • If a policy has a material misrepresentation, like a false statement in the policy application. The mistake is material if it breaches the policy and renders the contract between you and the insurance company null and void.
  • If the damage is beyond your policy coverage. Exclusions might be included in the policy, but insurance companies often attempt to deny coverage to avoid a payout.

Some insurance companies may also ignore or delay your claim in an attempt to minimize or refuse a payout. As you wait for their response and grow desperate for a settlement, the insurance company may offer you a lower amount than the value of your claim.

How do I determine if I need an insurance claim lawyer?

If your insurance company denies your rightful claim or delays your payout to minimize the settlement, consider consulting an insurance dispute attorney. Filing an insurance claim against your insurance company is a civil action that seeks compensation for the company's act of bad faith.

You may need a Kissimmee insurance claim lawyer if:

  • A life insurance policy isn't paying out a deceased family member's benefit.
  • An insurance company refuses to give you a policy for reasons that are in bad faith.
  • Your insurance company refuses to release a payout after an accident.
  • Your insurance company refuses to cover an incident included in your coverage.
  • You have a case where disputes are likely to arise. This may include claims with extensive damage or if an insurance adjuster attempts to minimize your losses after the first inspection.

How can a lawyer help me with an insurance claim?

Insurance companies send insurance adjusters to investigate and determine a fair amount for your claim when an incident happens. They will often take photographs and ask questions as evidence for your payout.

It's best to have an insurance claim lawyer available during the inspection to protect you when you answer questions or provide requested information. Insurance adjusters can use minor details to reject your claim. Having an attorney present helps you protect your interests.

Moreover, your insurance company may deny your claim or refuse to pay a fair amount of money for your case. In some situations, policyholders accept a low amount from the insurance company. An insurance claim lawyer can file a lawsuit and help you fight for the correct value of your claim.

Will my insurance pay for a lawyer?

Insurance claim lawyers work on a contingency basis, meaning the attorney only gets paid once the insurance claim pays you. You don't have to shy away from hiring an insurance claim lawyer for financial reasons.

How can a lawyer help me maximize my insurance claim?

An insurance claim lawyer will work hard to ensure you get a fair settlement by:

  • Gathering evidence: your attorney will gather the necessary evidence for your insurance claim while you focus on recovering from the disaster.
  • Contesting the offer: your lawyer can contest a low payout from an insurance company.
  • Building the case: your insurance claim attorney will establish the damages that occurred and the amount of compensation due.
  • Filing your case on time: it's crucial to file your case on time to expedite the payments and help you recover. If you have a medical insurance case, filing your claim in a timely manner pushes the insurance company to settle, helping you pay your medical bills.
  • Countering the insurance company's defenses: the insurance company will prepare their defense to dismiss your arguments. An insurance claim attorney will provide evidence against the insurance company's arguments to help you win your entitled compensation.

The Ward Law Group, PL fights for the rights of policyholders in Kissimmee, Florida. Our insurance claim attorneys have years of experience in all matters of insurance, including:

  • Automobile insurance claims
  • Disability insurance disputes
  • Fire damage claims
  • Health insurance claims
  • Homeowner insurance claims
  • Hurricane and windstorm claims
  • Insurance agent or insurance broker negligence
  • Liability insurance claims
  • Life insurance claims
  • Professional liability insurance disputes
  • Uninsured motorist coverage

If you have a claim against your insurance company, contact us for a free case review.