Central Florida Personal Injury Lawyer - Denied Insurance Claims

INSURANCE REGULATORS FILE ADMINISTRATIVE COMPLAINT AGAINST ALLSTATE

K.C. Bouchillon — Wed, 20 Feb 2008 08:20:23 GMT

The Florida Office of Insurance Regulation has filed an administrative complaint seeking to suspend Allstate's authority to write policies in Florida. This is the latest salvo in the battle between regulators and Allstate over Allstate's refusal to turn over documents or give straight answers to its request to increase rates as much as 41%.

The regulators previously suspended Allstate's authority after Allstate refused to cooperate in hearings to get to the bottom of why Allstate wants a huge rate increase when other insurers are decreasing or maintaining their rates. An appeals court lifted that ban until it could obtain further information, and that appeal is still pending.

The administrative complaint is a separate legal proceeding, in which the regulators are asking an administrative law judge to enter a separate finding and order suspending Allstate's authority.

In the meantime, Allstate has refused to budge.

Originally posted at InjuryBoard by K.C. Bouchillon

HURRICANE VICTIMS OFTEN SUFFER AT HANDS OF UNETHICAL ADJUSTERS

K.C. Bouchillon — Mon, 11 Feb 2008 09:34:46 GMT

The hurricanes of 2004 devastated tens of thousands of homeowners and their families in central Florida. But for many, the shoddy treatment and lack of professionalism shown by insurance adjusters was worse than the storms themselves. Unfortunately, far too many insurance adjusters forget that Florida law imposes ethical obligations on them when dealing with policy holders with insurance claims.

Our firm has handled hundreds of insurance claims on behalf of homeowners, and we have held insurers and their adjusters accountable for their actions.

So, what are these ethical obligations?

First and foremost, Florida law requires insurance adjusters to put the "fair and honest treatment of the claimant" above the adjuster's (and the insurance company's) own interest, in every instance. In other words, when an adjuster deals with an insurance claim, he is obligated to do what is best for the claimant. Most adjusters fulfill this obligation and truly try to take care of their claimants. On the other hand, many adjusters believe their highest priority is to save the insurance company's money, which results in claims improperly denied, or in payouts that fall far short of the damages suffered by the claimants.

Also, an adjuster is prohibited from approaching investigations and settlements in a manner that is prejudicial to the claimant. In doing so, the adjuster is obligated to make truthful and unbiased reports after a complete investigation. An adjuster must handle claims quickly and diligently, not let them drag out for months or years. (Is your jaw dropping yet?)

Another failing that we have seen in our lawsuits against insurers is that many adjusters fail in their ethical obligation to advise claimants of their rights under their policies. Insurance policies are very complex and tricky, and the average homeowner can't make heads or tails of what's in the policy. The adjusters, on the other hand, know the policies inside and out, and often fail to tell claimants about various benefits and coverages that may be available in some policies, but which aren't obvious to the homeowner (e.g., debris removal, mold remediation, code upgrades). As a result, claimants can end up with far less than they are entitled to.

The bottom line: If you have an insurance claim, the adjuster is supposed to be working for you and maximizing the benefits you recover. If your adjuster is adversarial or discourages you from making certain claims, then something is wrong, and you should consult with an attorney.

Originally posted at InjuryBoard by K.C. Bouchillon

Allstate Withholds Documents, Angers Regulators, Backs Off Rate Hike

K.C. Bouchillon — Fri, 18 Jan 2008 08:15:02 GMT

The State of Florida has suspended Allstate's license after the insurer refused to hand over documents subpoenaed by state insurance regulators. The documents had been requested after Allstate requested rate increases as high as 41%.

The suspension follows a heated hearing earlier this week between Allstate and the regulators. What was supposed to be a two-day hearing before Florida insurance regulators questioning Allstate's baffling request for double-digit premium rate increases ended after just two hours when it became clear that Allstate was withholding documents requested by the regulators.

Angry regulators accused stonewalling and had threatened sanctions, including the suspension of Allstate's licenses to operate four of its Florida companies, in light of Allstate's willful refusal to turn over the requested documents. Regulators grilled Allstate's representatives and lawyers but received mostly evasive, empty answers when trying to ferret out Allstate's relationships with insurance-rating and risk-monitoring companies and insurance trade associations.

Allstate has requested rate hikes as high and 41.9%, but when regulators subpoenaed the documents supporting such an enormous increase, Allstate responded with a 51-page objection, claiming that the requested documents were "irrelevant."

In light of the regulators' reactions, Allstate now says it intends to drop its requested rate increase.

That speaks volumes about what Allstate is trying to hide. It would rather give up tens of millions of dollars (or more) in additional rates, rather than divulge its internal documents.

Allstate's situation highlights what the plaintiffs' bar has warned about for years. Insurance companies are all about profits, and not about customers. After complaining about their supposedly desperate financial situation following the 2004-2006 hurricane seasons, the insurers and their lobbyists convinced a special session of the Florida Legislature to enact new insurance laws designed to give relief to insurers.

In exchange, the insurers were supposed to pass on the savings to consumers through significantly lower homeowners' premiums. Instead, most insurers lowered their rates very little or not at all, and some, including Allstate, have asked for more money. As a result of the insurers' broken promises, Florida Gov. Charlie Crist is exploring a class action lawsuit against insurers to force them to abide by the law.

For more information on this subject, please refer to the section on Car and Motorcycle Accidents.

Originally posted at InjuryBoard by K.C. Bouchillon

Florida Property Insurers Face Possible Class Action over Broken Promises

K.C. Bouchillon — Tue, 08 Jan 2008 19:00:07 GMT

Florida Gov. Charlie Crist is investigating a possible class action suit against property insurers for failing to lower rates and pass on savings to insurers after receiving historic concessions from the Florida Legislature.

In the face of massive lobbying by insurance companies begging for relief from several years of disasters and allegedly declining profits, the Florida Legislature in January 2007 overhauled the state's insurance statutes in an effort to relieve the pressure on insurance companies. The trade-off was to be lower insurance rates for Florida property owners, who desperately needed such cuts after devasting losses in 2004 and 2005.

Instead, many insurers, including some of the largest -- such as Allstate and Nationwide -- either reduced their rates minimally or asked for rate INCREASES.

''I'm increasingly concerned they are potentially violating the new law,'' Crist told The Miami Herald.

``Common sense would dictate to you that if they are not passing on the savings to the customer, they are violating the law that says they must pass on the savings to the customer.''

As reported in the Herald, the core of the dispute is the January 2007 law, which provided billions in additional cheap reinsurance to private insurers in return for a requirement that they pass on the savings to consumers.

Many companies have lowered their rates but ''those that have not should be accountable,'' Crist said. He said he believes companies may have tried to skirt the law by minimizing their risks and maximizing their profits illegally.

Allstate has had the temerity to ask for rate ranging from 27.4 percent to 43.4 percent. At the same time, Allstate has dropped at least 350,000 Florida policyholders in the past four years.

''There are consequences to violating the law if we can show that they have -- and I believe that they have,'' Crist said.

Originally posted at InjuryBoard by K.C. Bouchillon

Florida Legislature Reauthorizes PIP Statute, With a Twist

K.C. Bouchillon — Sat, 20 Oct 2007 15:48:15 GMT

The Florida Legislature has reauthorized the Florida Personal Injury Protection ("PIP") statute, which will become effective on January 1, 2008.

One particular provision of the new PIP statute dealing with reimbursement of a claimant's attorney's fees is particularly interesting. In some cases, there may be no attorney's fees awarded at all. When a claimant files suit against his or her insurance company for unpaid or unreimbursed PIP benefits, the new provision would potentially bar an award of attorney's fees if the court determines that the claim "should have been brought in a prior civil action" but wasn't.

What does this mean? Well, another provision of the same statute says that "all claims related to the same health care provider for the same injured person shall be brought in one action," ordinarily. In other words, it appears that the Florida legislature has determined that one of the times that a claim "should have been brought in a prior civil action" is when the claimant had made a prior claim against "the same health care provider for the same injured person."

This could create a pitfall for a claimant. For example, if a claimant sues his insurer for failure to pay the claimant's health care provider for treatment, a later suit, based on a later refusal to reimburse, could result in the claimant not recovering his attorney's fees in the second lawsuit. This would seem to require that the claimant complete his treatment with the health care provider to make sure he sues only once for all of the denials of the insurer to pay benefits for treatment by that provider.

What else may qualify as "a claim that should have been brought in a prior civil action" has yet to be determined by a court.

For more information on this subject, please refer to the section on Car and Motorcycle Accidents.

Originally posted at InjuryBoard by K.C. Bouchillon

Holocaust Survivors Seek Insurance Money

Christina Cole — Sun, 22 Apr 2007 21:41:23 GMT

A path is being made in Washington to give the "forgotten survivors" of the holocaust the right to sue insurance companies in federal court. Red tape has prohibited thousands of holocaust survivors from getting insurance claim money that could help them to live the rest of their days and years in dignity.

A South Florida congresswoman is sponsoring a bill that could help to cut the red tape before it's too late.

After over 20 years, there are an estimated 97% of holocaust era insurance claims that are still currently in limbo.

"It is an outrage that these individuals should be victimized again, either by huge insurance companies or by institutions that hoard restitution funds that rightfully deserve to be used by the living survivors among us," said Florida Congresswoman Ileana Ros Lehtinen on Monday.

Ros Lehtinen is leading a bipartisan effort to right an old wrong while there is still time. She's introducing a bill to allow survivors to sue insurance companies in federal court.

"All they're asking is for justice that has been long denied them," said Ros Lehtinen.

Originally posted at InjuryBoard by Christina Cole