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Jacksonville Insurance Law Blog

What constitutes insurance bad faith?

If you are like most Floridians, you likely have several insurance policies, such as for your car, your home, etc. Naturally you expect your insurance carrier(s) to pay you up to your policy limits if you make a claim. You likewise expect your carrier(s) to defend you if someone sues you and to pay the person if (s)he wins the lawsuit, again up to the limits of your policy.

Unfortunately, however, one or more of your insurance carriers may not pay up and/or properly defend you when the time comes. If this happens, you may be able to sue the company for bad faith.

What do I do if my health insurance claim is denied?

People of all ages in Florida rely on health insurance to give them piece of mind. You know that whether you have a medical emergency or a scheduled appointment, a checkup or a big surgery, your health insurance company will foot the bill.

But, what happens when they do not? What if after filing a claim with your health insurance company, your claim is denied? What then? Try not to panic. Take a deep breath and check out the tips below to see if you might be able to rectify the situation.

Will insurance companies cover older homes?

It is the aftermath of a hurricane. Your Jacksonville home has taken some damage, but since you have property insurance, you are feeling confident that you can repair your house and get on with your life. However, if you own an old home, you might find that your insurance policy is not willing to fully cover your repairs. To understand why these issues may occur, it helps to know whether insurance companies are eager to cover damages inflicted on older houses.

The Insurance Information Institute explains that not all insurance companies are willing to fully insure the replacement building costs of older homes. The problem is that restoring particular features of older homes may be too expensive. Some houses have distinct features like moldings in the walls or ceilings which will cost a lot to recreate if they are damaged or destroyed.

What should I do if involved in an accident?

While making a claim to your insurance company is relatively straightforward, the steps you take after an accident are critical. Your actions will dictate whether your claim is approved or denied, and a denied claim may result in you paying for the accident out of pocket. The Balance offers the following advice on what to do when involved in a car accident.

Call for help

Checking your policy for sinkhole coverage

For Florida property owners, the idea of a sinkhole opening at their location is a nightmare. Unfortunately, it may also be a reasonable fear, based on news reports over the last few years. If you have homeowner’s or property insurance, you may assume you are covered if the unthinkable happens.  At Tyler & Hamilton, P.A, we often assist clients whose insurance claims were denied or were offered insufficient compensation for their loss.

Property Casualty 360° reports that some sinkholes appear with no warning, while others may show signs that they are developing. Those that occur on a distant o part of the property may go unnoticed until they expand to a frequently used area. When water collects underground, with no external drainage, it begins eroding the bedrock. This may happen as a result of many situations, including ruptured sewer lines or seismic activity. Over time, underground spaces and caverns form, making the area above unstable. Sinkholes may also develop in areas where there is drilling or mining. Signs that something may be wrong underground include dying or wilting vegetation in an area where it is green and thriving everywhere else. New ponds, slumping trees and fence posts or cracked foundations may also indicate issues.

What are some examples of insurance bad faith?

While you would expect your insurance company to be there for you after an accident or injury, this isn’t always the case. In fact, some insurance companies in Florida will deny valid claims made by the insured with absolutely no legitimate reason for doing so. HG.org offers the following examples of bad faith insurance practices, which will help you identify any issues when making a claim to your insurance company.

Your insurance company must respond to your claim in a timely manner. Failure to do so is a type of bad faith, and usually entails the company waiting an inordinate amount of time to let the policyholder know whether the claim had been approved. Companies are also obligated to perform a thorough inspection regarding the claim, and if the necessary work is not performed a company may be acting negligently.

What are reasons for car insurance claims denial?

If you have an accident in Florida and make a claim with your insurance provider, you probably expect a quick resolution. After all, you pay your premiums on time and put a lot of trust in your insurance company to keep up its end of the agreement. However, your insurer may deny your claim. There are various reasons this may occur.

According to ValuePenguin, one of the top reasons for a claim denial is that you broke the law when the damage occurred. Your insurer does not have to pay for claims that result from your own negligence.

How much property insurance do I need?

When you choose an insurance policy for your property in Florida, one of the decisions you need to make is how much coverage to buy. This is not always a straightforward thing. You have many considerations to make. It requires understanding what the policy covers and what coverage you actually need.

According to the Insurance Information Institute, you need to think of two different amounts when figuring your property insurance. First, you have to figure out how much you would need to rebuild your home. Second, you have to determine the replacement costs for your possessions.

What are some signs of a bad insurance company?

You expect an insurance provider in Jacksonville to provide with qualified assistance, whether you’re filing a claim or simply asking a question. However, this isn’t always the case. The fact remains that there are some unscrupulous insurance agents out there and getting involved with one can cost you quite a bit of money. That’s why The Balance offers the following advice, which will help you get the coverage you need.

There are no credentials to speak of

What is the best way to avoid an insurance claim denial?

Getting a large hospital bill that you were not expecting can be a financial nightmare. If your health insurance in Florida, denies your claim, it can take a long time to iron things out and get the bill paid. The better option is to avoid a denial in the first place. Consumer Reports explains there are several things you can do to prevent a claim denial from your health insurance company before you ever get treatment.

Above all, you should understand your coverage. Know what doctors you can use and what procedures the policy covers. Be aware of anything that requires preauthorization. These days, preauthorization may even be needed for certain pain medications. Knowing this ahead of time is important to avoid having to pay the bill yourself. Also, understand what to do if you need care due to a work or auto accident. Often your insurer will not cover those claims initially since they may be covered under worker's compensation or an auto insurance policy.

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