How an Attorney Can Help with Your Denied Claim

What materials the policyholder needs to review at the outset and what investigation and/or discovery needs to be undertaken depends on what type of claim is being made by the policyholder, i.e., whether it is a claim for first-party property coverage or a claim for third-party liability coverage under the auto insurance policy. If the claim is for breach of duty to defend, what information you will need to review to determine the insurer’s likelihood of successfully defending the claim will depend on the jurisdiction. Some states, usually referred to as “four-corner states” compare the allegation of the complaint to the policy in order to determine whether the insurer breached its duty to defend. Some jurisdictions state that the duty to defend is determined by comparing the allegation of the complaint, plus any other information known by the insurance company, to the terms of the insurance policy. In these jurisdictions, the attorney representing the insurer will need the complaint in the underlying action, as well as the company’s investigation materials at the time it made its decision to deny a defense, and the policy in order to determine whether the insurer breached its duty to defend. Finally, there are some jurisdictions which affirmatively require an insurance company to pursue an investigation into a claim before it makes a decision to deny a defense. In these states, if the carrier failed to undertake the necessary investigation when it made its decision to deny a defense, the attorney representing the carrier may need to pursue some discovery into the facts of the underlying claim in order to analyze whether the insurance company’s denial was proper. Note, however, that some jurisdictions hold that the failure to originally pursue the necessary investigation bars the insurer from undertaking the investigation at a later date. That is why it is important that your attorney request a certified copy of the auto insurance policy. Most auto insurance policies have explicit requirements in the conditions section of the policy regarding when notice of the claim must be given and what must be included in said notice.

Assuming that your insurance company denies your claim, the attorney’s at Suarez and Montero can investigate to fully understand the basis of the denial. Understanding the denial provides an attorney with an opportunity to respond. For example, if the insurance company denies the claim on the grounds that it disputes whether the insured owed the vehicle in question, the policyholder’s attorney should respond by forwarding documentation demonstrating the existence and ownership of the vehicle, e.g., pictures, registration, loan documents etc. to the insurance company. If the insurance company denies the claim on the grounds that the claim is not covered under the policy, or the accident is not covered by the policy, our attorneys can determine whether the insurance company has interpreted the policy correctly and/or whether there are other provisions which might afford coverage. Additionally, our attorneys should examine the case law interpreting the policy provisions relied on by the insurance company to determine whether there may be exceptions that would apply. When the insurance company claims that your claim is not covered by the policy it is especially important for an attorney to determine the actual facts surrounding the accident and claim. Additional investigation, including the use of experts, may be necessary to determine a covered cause of an accident. Occasionally an auto insurance company will deny coverage on the ground of misrepresentation in the application and attempt to rescind coverage. In these cases, your attorney can obtain a copy of the application (if you don’t already have a copy) and review it with you. It is possible that you didn’t even complete the application, the agent did. You may be able to claim that if the wrong box was checked on the application, it was due to the agent’s mistake, not your misrepresentation as an insured. Alternatively, or additionally, you may defend on the ground the alleged misrepresentation did not materially increase the risk, and that had the application been completed correctly, the company would have accepted the risk. Whether the insurance company would have accepted the risk may be determined by interrogatory, request for admission, or by deposition of the underwriters. In the event the company claims it would not have accepted the risk, the policyholder’s attorney may be able to disprove this claim by establishing other instances under similar facts where the company did accept the risk. Again, this information may be obtained through interrogatory, request for documents, or by deposition.

Contact an Experienced Personal Injury Attorney Today!

Driving can be dangerous in Miami. If another driver tries to run you off the road or intentionally crashes into you, it can result in a horrific car crash. When you’re involved in a car accident or another crash caused by negligent driving, talk to a car accident attorney about your options going forward. There is no replacement for quality legal advice after being involved in a car accident. The car accident attorneys at Suarez and Montero would love to have an opportunity to explain the law in Florida to assist you in presenting a strong claim against the at fault party. Every firm is distinctive and auto accident victims have needs that are also distinct. needs are different. The Florida auto accident attorneys at Suarez & Montero encourage you to reach out so that we can explain more about the different ways that our law firm and attorneys can provide legal help and guidance after an auto accident. Make an appointment with us at one of our many locations. Remember, we work on a contingency basis so you will owe us nothing If we are unable to obtain successful results for your case. The attorneys at Suarez & Montero can meet with you to discuss further. always available to talk with you and answer your questions. Our skillful attorneys are genuinely committed to our clients. We will fight to make sure that you get the maximum amount of compensation owed to you. Let us help you get the medical care you need and fight to make sure you are compensated for your injuries! Our attorneys are ready to provide proven legal representation in pursuing your claim and stand ready to protect your rights. We are available 24/7 to give you a free, no risk case consultation.

We serve clients throughout Florida including those in the following areas:

Miami-Dade: Aventura, Coral Gables, Doral, Fontainebleau, Hialeah, Homestead, Kendall, Miami, Miami Beach, Miami Lakes, North Miami, Tamiami, and Westchester.

Broward: Fort Lauderdale, Hallandale Beach, Hollywood, Pembroke Pines, and Weston; and Palm Beach County including Boca Raton, Lake Worth, and West Palm Beach.

The Law Offices of Suarez & Montero Car Accident Attorneys represents accident victims injured in various types of accidents including:

• Distracted Driving Accident Lawyers

•Drunk Driving Accidents

• T-Bone Car Accidents

• Road Rage Car Accidents

• Head-on Collisions

• Rollover Accidents

• Rear-end Car Accidents

• Left Turn Accidents

• Failure to Yield Car Accidents

• Sideswipe Accidents

• Merging Accidents

• Lane Change Accidents

• Construction Zone Car Accidents

• Truck Accidents

• Semi-Truck Accidents

• Bicycle Accidents

• Train Accidents

• Pedestrian Accidents

• Boating Accidents