What You Need to Know When You File a Claim with Your Auto Insurance Company

At the outset of handling an auto insurance claim, the attorney will need to obtain 1) a certified copy of the insurance policy; 2) the policyholder’s written proof of loss; and 3) the insurance company’s file regarding the claim, including any and all investigation materials. The insurance policy should provide the framework for the initial analysis and help determine whether there is coverage. In order for a property claim to be covered under an auto insurance policy, the claim must be covered by the insurance policy and there must be no applicable exclusions in the policy, and the conditions must have been complied with by the policyholder.

Who is Considered a Named Insured?

Most coverage applies to many parties besides those listed as the Named Insured. By definitions within the policy other parties, such as corporate officers, employees, family members, or parties added to the coverage by endorsement or by Certificate of Insurance (in compliance with contractual requirements as discussed in the Introduction), may apply. The following steps will help identify whether a party is an “insured.” First, identify the party or parties involved in the loss. If any or all of those parties are not specifically named in the Declarations as Insureds, check to see if there are any Endorsements or other policy language which would add such parties specifically as insureds. Next, if there is no such endorsement, check the wording of the insuring agreements, definitions, or conditions to see if coverage is in any way extended to such a party or entity. Some policies include a “Persons Insured” subsection. Next, check the exclusions to see if such parties are excluded. Additionally, check with your broker or agent to see if any Certificates of Insurance have been issued which would add such parties to the policy as insureds. If no coverage for any party involved in the loss is found, determine if that party has other insurance which would apply to the loss, and whether such coverage would apply to any other party who is insured under the policy.

When Did the Policy Go into Effect?

An insurance policy takes effect when the insurance company receives an application and it is accepted. Generally, the effective date or inception date of an insurance policy is the date stated upon the declarations page. The effective date is not the date the supplemental application is returned but rather the date accepted by the insurer. The duration of an insurance policy, when fixed by clear and unambiguous language, will not be altered because of some incident bearing upon the effectiveness of the policy, such as countersigning or a premium payment that is untimely. Also, it is well settled in Florida that the statute in effect at the time an insurance contract is executed governs any issues arising under that contract. It is also important to note that the addition of another person on a policy of insurance as an insured is not the reissuance of the entire policy and, therefore, a statute enacted between the issuance of the original policy and the endorsement adding the person is inapplicable to the policy.

The rights and obligations of the parties under an insurance policy are governed by contract law as they arise out of an insurance contract. Hence, the lex loci contractus rule determines the rights and risks of the parties to an automobile insurance policy regarding coverage. The rule is applicable even where the insured stands in a tort relationship to the uninsured motorist because an action by the insured against the insurer arises out of an insurance contract between the parties. Further, Florida courts in applying choice of law principles will tend to look at statute of limitations choices as any other choice of law issue. If an action to recover uninsured motorist benefits could be determined by the fortuity of the location of the accident, it would substantially restrict the power to enter into stable contracts in our migratory, transitory society. For example, where the cause of action arises from a California insurance contract, even though the automobile accident occurred in Florida, Florida’s borrowing statute is applicable in determining the statute of limitations. It is necessary under that statute to look to California in order to determine the applicable limitation.

Have the Policy Conditions Been Complied with?  The insurance practitioner should be sure to check whether the breach of any policy condition would be grounds to deny coverage. An auto insurance policy often contains specific condition requiring your claim to be submitted within a certain number of days. A failure to submit certain documents related to your claim within the requisite time may bar a claim. Thus, it is important to have an attorney check the policy, state statute, and with the carrier regarding whether the time limits have been complied with. The conditions section of an auto insurance policy frequently contains a provision regarding misrepresentation and/or fraud. If the claim being made lacks credibility and/or the insurer is being asked to pay a claim which it did not believe was part of the risk, an insurer’s attorney will want to consider whether there are grounds to defend denial of the claim on the grounds of misrepresentation in the claim. If the insurer’s attorney believes there has been a misrepresentation in the application, e.g., the insured failed to disclose three prior claims, he or she will want to first review the application to determine if there was a misrepresentation. Generally, if the misrepresentation was made with the intent to deceive, or materially increased the risk, there are grounds to void coverage.

Contact an Experienced Personal Injury Attorney Today!

If you or a loved one were involved in a car accident or any type of accident due to the negligence of another, 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

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