Another Example of the Pitfalls Associated with Handling an Insurance Dispute without Legal Advice

When you file a homeowners insurance claim in Florida because your residence is damaged by wind, fire or some other peril covered by your policy, you probably assume that your insurance carrier will uphold the policy obligations set forth in your policy.  However, insurers face an inherent conflict of interest because they maximize profits by denying claims, deferring payments and settling for less than the full value of claims.  When an insurance company elects not to fulfill its contractual duties, policyholders often are forced to resort to litigation to obtain the benefits to which they are entitled under their policy.

If you become embroiled in a dispute with your insurance company, prompt legal advice from a knowledgeable Florida insurance claims lawyer can protect your legal rights.  There are many pitfalls of litigation that can easily derail your claim if you try to deal directly with your insurance carrier.  Insurance companies have a team of attorneys, adjusters and investigators all working diligently to avoid or minimize liability for claims.  The best strategy for balancing the playing field is to retain an insurance attorney to guide you through potential legal complications that can undermine your claim.

The recent appellate court case out of the 2nd District of Florida, Diaz, et al v. Tower Hill Prime Insurance Co. provides an example of the potential missteps that an insurance lawyer can help you avoid.  The policyholders in Diaz owned an insurance policy that covered sinkhole damage.  The policyholders noticed damage to their property and submitted a claim with their insurer.  The insurer inspected the property, but the carrier denied the claim based on the position that the damage was not caused by a sinkhole. 

The insureds subsequently hired their own experts to investigate the loss which yielded a report indicating that the damage was caused by sinkhole activity.  Following completion of the report, the policyholders filed a lawsuit for breach of contract.  When the insurance company moved for neutral evaluation, the policyholders disclosed their expert report to the insurance company.  The carrier moved for summary judgment based on an alleged breach of the policy by the insured for failing to disclose the report earlier.  The insured contended that the non-disclosure constituted concealment of a material fact in violation of the policyholders’ duty to cooperate with the insurer during the claims process.

The trial court granted the motion for summary judgment which authorized the insurance company to deny the claim.  On appeal, the 2nd District Court indicated that it had rendered a recent decision under similar facts that reached the opposite conclusion.  The court noted that the language of the policy provision relied on by the insurer was identical in both cases.  Based on the court’s prior ruling in Herrera v. Tower Hill Preferred Insurance Co., the court reversed the trial court’s grant of summary judgment and remanded the case for further proceedings.

Although this decision does not necessarily mean that the policyholders will prevail on remand, this case demonstrates how a detail as subtle as the timing of the release of an expert report can impact an insurance claim.  The trial court in this case did not even require that the insurer demonstrate that the delay in providing the report prejudiced the insurance company.  These is just one of a multitude of stumbling blocks that can trip up a policyholder who is not represented by an experienced Miami insurance attorney.

If you have questions about Miami-Dade homeowners insurance claims, you are welcome to contact our experienced Miami homeowners insurance attorneys.  My law firm represents policyholders in claims disputes in Miami and throughout Florida.  The Law Firm of J.P. Gonzalez-Sirgo, P.A. offers free consultations and case evaluations.  No Recovery, No Lawyer Fees.  Call 305-461-1095 or Toll Free 1-866-71-CLAIM.

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