Insurance Claims

When you are injured in an accident or suffer property damage, you may sustain a serious financial blow. In most cases, a claim needs to be made to an insurance company that covers the loss at issue. For instance, after a car accident, you first need to make a claim under your own Personal Injury Protection (PIP) insurance coverage before suing the other party. In that litigation, the other party probably will be defended and indemnified by an insurance company. Insurance companies owe their insureds the coverage specified under the policy, but sometimes they issue improper denials or engage in bad-faith conduct. The Pensacola insurance lawyers at Cardoso Law, PLLC can fight for your rights.

Florida laws cover insurance policies. The type of claim will determine how quickly an insurer needs to settle a claim that is made. Insurance policies upon which a claim may be made include car, boat, homeowner, commercial property, hurricane, storm, mold, fire, and theft. Generally, an insurer needs to investigate the claim and either pay or deny the claim within a reasonable time frame. With a PIP claim, an insurer has 30 days to either pay or deny.

Under section 627.70131, an insurer should, within 14 calendar days, review and acknowledge that it received a communication about your claim, unless it makes payment during that time period or unless the failure to acknowledge is caused by factors that go beyond the insurer’s control.

Often, insurance policies have a deductible. This is the amount that you need to pay before the insurer honors the claim. In some cases, insurers promptly investigate and pay claims. In other cases, it is possible to reach a settlement with an insurer. If the claimant and the insurer agree in writing to settle a claim, the insurer is supposed to pay the claimant according to the settlement terms within 20 days of reaching the settlement. However, the payment may be conditioned upon the execution of a mutually agreeable release. Additionally, there are situations in which a claim cannot be settled because the insurance company acts in bad faith. You should promptly consult an insurance attorney in Pensacola if you suspect bad faith.

Implied in every insurance contract is a duty of good faith and fair dealing. Florida insurers are supposed to adhere to this duty in their conduct toward an insured. Unfortunately, not all insurers abide by this duty. It may be possible for a policyholder to sue to recover what is owed when an insurer displays bad faith. Bad-faith conduct includes denying claims without investigation, ignoring claims or other communications, misrepresenting the coverage provided by an insured’s policy, denying a claim without a reasonable basis, failing to provide a basis for denying a claim, or failing to promptly inform an insured that more information is required to adjust the claim.

There are two types of insurance bad faith claims: first-party and third-party bad faith. In both cases, the insurer has a contractual obligation to pay benefits but does not. First-party claims can be brought by the insured against their own insurance company with the assistance of a Pensacola insurance attorney. In Florida, there is a cause of action for first-party bad faith when the insurer fails to try to settle a claim when it could and should have, had it acted fairly and honestly toward the insured, with due regard for the insured’s interests.

Unlike first-party insurance, third-party insurance covers the policyholder regarding their liability if they are sued by another person for injuries or damage sustained as a result of a policyholder’s actions. Third-party insurance policies compensate a policyholder for any damages owed, but they also create a contractual duty to provide a legal defense for the insured policyholder during litigation.

When you buy insurance, you likely work hard to pay your premiums to make sure that you can obtain financial support in case you suffer losses. Insurance companies may put profits ahead of people, including their own policyholders. It can be vital to have someone on your side to advocate for you in your insurance claim. At Cardoso Law, PLLC, we represent people throughout Escambia and Santa Rosa Counties. Call us at (850) 466-2073 or use our online form to set up a consultation with an insurance lawyer in the Pensacola area.