Practicing in all areas of Insurance Dispute Laws
Life is great, but then, unfortunately, something goes wrong, for no reason, and life becomes difficult for good people. Someone becomes negligent and a preventable accident happens that is the cause of some other party. A loved one is neglected in a nursing home and is injured. A simple surgery ends in death. An inattentive driver changes a life forever. A work place accident hospitalizes the family breadwinner. The list goes on and on, and insurance companies quite often want to reject claims or settle them at an unacceptable amount.
Sometimes the question isn’t whether an injured person deserves fair compensation – it’s whether there is insurance in force to pay the claim. Insurance “coverage” disputes can be complicated, and the law in this area is always changing.
Recent Court decisions have forced insurers to pay claims which they formerly denied. Those decisions have opened the door to thousands of people who otherwise would have gone without fair compensation due to a lack of adequate insurance coverage.
Insurance company representatives are skilled at evaluating claims, and do not hesitate to deny insurance coverage where they can. A lay person, with no insurance experience or legal knowledge, stands little chance of persuading an insurer to cover a claim once it has been denied.
For more information, please visit our Frequently Asked Questions for Insurance Disputes or you can contact us and one of our professional legal staff members will get back to you as soon as possible.
Gallese Law Firm has handled many insurance coverage disputes, including the presentation of complex coverage arguments to Court. To discuss your insurance dispute with Gallese Law Firm please call our Stuart Florida office at 772-220-2088 or contact us by e-mail firstname.lastname@example.org. There will be no charge for the initial consultation.
Claims and loss handling is the materialized utility of insurance; it is the actual “product” paid for. Claims may be filed by insureds directly with the insurer or through brokers or agents. The insurer may require that the claim be filed on its own proprietary forms, or may accept claims on a standard industry form, such as those produced by ACORD.
Insurance company claims departments employ a large number of claims adjusters supported by a staff of records management and data entry clerks. Incoming claims are classified based on severity and are assigned to adjusters whose settlement authority varies with their knowledge and experience. The adjuster undertakes an investigation of each claim, usually in close cooperation with the insured, determines if coverage is available under the terms of the insurance contract, and if so, the reasonable monetary value of the claim, and authorizes payment.
The policyholder may hire their own public adjuster to negotiate the settlement with the insurance company on their behalf. For policies that are complicated, where claims may be complex, the insured may take out a separate insurance policy add on, called loss recovery insurance, which covers the cost of a public adjuster in the case of a claim.
Adjusting liability insurance claims is particularly difficult because there is a third party involved, the plaintiff, who is under no contractual obligation to cooperate with the insurer and may in fact regard the insurer as a deep pocket. The adjuster must obtain legal counsel for the insured (either inside “house” counsel or outside “panel” counsel), monitor litigation that may take years to complete, and appear in person or over the telephone with settlement authority at a mandatory settlement conference when requested by the judge.