ERISA Claimants Must Exhaust Their Administrative Remedies

Fri Oct 19th, 2018 on     Insurance Claims,    

If you have had your insurance benefits claim denied or otherwise mishandled by your insurance company, then you’re entitled to challenge the adverse determination made by your insurer under Florida (and federal) law.  It’s important to note, however, that the procedures and limitations applicable to your case will be somewhat different than the “standard” if your insurance benefits policy is ERISA-governed. The Employment Retirement Income Security Act (ERISA) is a federal regulatory scheme that establishes […]

How Ambiguous Insurance Provisions Are Resolved

Fri Oct 12th, 2018 on     Insurance Claims,    

Whether you’re a policyholder in a health, disability, or property insurance plan, it’s possible that you will encounter — or have already encountered — some blowback when it comes time to submit a claim for benefits.  Insurers are fundamentally incentivized to deny, undervalue, or otherwise mishandle claims so that they can minimize their own costs.  This is particularly true in situations where an important coverage-related provision of the contract is ambiguous and therefore open to […]

Reasons to Avoid the Internal Appeals Process

Fri Oct 5th, 2018 on     Insurance Claims,    

If you have had your insurance benefits claim — disability, health, property, etc. — denied or otherwise subject to an adverse determination, then you are entitled by law to challenge the insurer’s determination.  Generally speaking, your plan will determine many of the protections and limitations relevant to your benefits claim (and any subsequent challenge). Policies that are ERISA-governed, for example, require that the claimant first exhaust their administrative remedies — by going through an internal […]

Employers Cannot Punish Employees for Exercising ERISA Rights

Fri Sep 14th, 2018 on     Insurance Claims,    

Though Florida employers are well aware of the standard discrimination and retaliation prohibitions that restrict their ability to discharge and otherwise punish employees for their actions — such as reporting discrimination in the workplace — there continues to be something of a blind spot when it comes to the exercise of ERISA-related rights. Those who exercise their ERISA-related rights may therefore find themselves subject to unexpected retaliatory action, despite the fact that it is prohibited […]

Common Liability Insurance Exclusions

Fri Jun 22nd, 2018 on     Insurance Law,    

Most businesses in Florida and elsewhere purchase some form of commercial general liability (CGL) insurance coverage so as to avoid the potentially disruptive effect of a personal injury lawsuit brought against the business. For example, a small retail business with few assets may only have enough funds to cover costs — if a customer slips-and-falls on the premises, and thus severely injures themselves, then the ensuing lawsuit could seriously disrupt (and even bankrupt) the business. […]

Florida’s PIP requirement under attack in Tallahassee

Mon Apr 3rd, 2017 on     Insurance Law,    

As we’ve documented on this blog, the state’s infamous personal injury protection or no-fault requirement, which mandates that all Florida drivers must carry a minimum of $10,000 worth of medical coverage to cover injuries regardless of liability, has long been the subject of scorn, with detractors calling it an unnecessary system that facilitates fraud and results in higher auto insurance premiums.

As we’ve also discussed on our blog, the PIP requirement has nevertheless managed to hold on for nearly 40 years now despite a cavalcade of bills being introduced over the years calling for its elimination. Recent reports suggest, however, that the end of PIP is perhaps now closer to becoming a reality than ever before.

Are animal sanctuaries required to carry liability insurance?

Mon Mar 27th, 2017 on     Insurance Law,    

There are certain attractions here in Florida that hold universal appeal, meaning chances are good that you’ll go out of the way to pay them a visit regardless of whether you’re a resident, a tourist or even a snowbird. While this, of course, includes the major theme parks, spring training complexes and miles of sandy beaches, it also means historic sites, nature preserves and even animal sanctuaries.

Indeed, our state’s perpetually sunny skies and temperate conditions make it a prime location for animal sanctuaries hosting all manner of mammals, reptiles, fish, insects and birds.

Insurance to emerge as key topic during 2017 legislative session

Thu Mar 16th, 2017 on     Insurance Law,    

It may seem hard to believe, but tomorrow marks the start of the 2017 legislative session, meaning lawmakers in both chambers — the Florida Senate and the Florida House of Representatives — will be convening in Tallahassee for what promises to be an entertaining two months.

While they will be addressing such traditional issues as education, health care and, of course, the budget, they will also be tackling some other topics that don’t often receive the attention they perhaps deserve or that are entirely novel, including medical marijuana, gambling and, of course, insurance.

Florida homeowners insurers facing downgrade

Mon Feb 20th, 2017 on     Insurance Law,    

Many Florida homeowners have mortgages that are backed by either the Federal National Mortgage Association or Federal Home Loan Mortgage Corporation. In most of these cases, the homeowners have property insurance that has been issued by a Florida-based company. On Feb. 14, an Ohio company that rates insurance companies around the country based on their financial stability indicated that it will likely be downgrading the ratings of at least 10 of those Florida insurers. This move could create significant problems for affected homeowners.

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