Disability and Life Insurance Claims Law Blog

Pampers Pacifiers Recalled For Choking Hazard

mindywein@cox.net (Blog Author)54132 — Fri, 29 Apr 2011 08:00:00 EST

The U.S. Consumer Product Safety Commission (CPSC) has issued a recall of approximately 29,000 Pampers Natural Stages Infant Ortho and Bulb Pacifiers. The pacifiers fail to meet federal safety standards and pose a choking hazard for young children.

The pacifiers come in yellow, pink or blue colors and "Stage 1" and "Ortho" or "Bulb" are printed on the package. The recalled pacifiers have an oval-shaped mouth guard and "Pampers" molded on to the handle side of the mouth guard. The product comes two per package and were sold in retail stores nationwide from April 2010 through February 2011 for about $6.

Consumers should immediately take the recalled pacifiers away from infants and contact Key Baby for instructions on returning the product for a full refund or $10 coupon toward the purchase of any Pampers® Natural Stages products. For additional information, contact Key Baby toll-free at (800) 447-1224 anytime, or visit the company's web site at www.key-baby.com

To report a dangerous product or a product-related injury, call CPSC's Hotline at (800) 638-2772 or CPSC's teletypewriter at (800) 638-8270.

Hydroxycut Recall | Liver Damage

mindywein@cox.net (Blog Author)53879 — Tue, 26 Apr 2011 08:00:00 EST

Hydroxycut, a drug used as a weight loss supplement, has been linked to liver damage and other disorders. The drug has been recalled by the FDA as of May 1, 2009. Twenty three serious liver problem reports were known at the time of the recall. The FDA advises everyone to stop using this drug.

The drug is manufactured and sold by Iovate Health Sciences and is very popular in the weight loss and dietary supplement market and is used by individuals seeking to lose weight and by bodybuilders.

Hydroxycut has been linked to causing liver problems, including death due to liver failure. Other symptoms include permanent liver damage, kidney failure, jaundice, nausea, abdominal pain, seizures and cardiovascular disorders.

The FDA recall affects the following products which are marketed as natural supplements under the brand names Iovate or MuscleTech:

Hydroxycut Regular Rapid Release Caplets
Hydroxycut Caffeine-Free Rapid Release Caplets
Hydroxycut Hardcore Liquid Capsules
Hydroxycut Max Liquid Capsules
Hydroxycut Regular Drink Packets
Hydroxycut Caffeine-Free Drink Packets
Hydroxycut Hardcore Drink Packets (Ignition Stix)
Hydroxycut Max Drink Packets
Hydroxycut Liquid Shots
Hydroxycut Hardcore RTDs (Ready-to-Drink)
Hydroxycut Max Aqua Shed
Hydroxycut 24
Hydroxycut Carb Control
Hydroxycut Natural

Chantix Medication | Suicide

mindywein@cox.net (Blog Author)53880 — Tue, 26 Apr 2011 08:00:00 EST

Chantix, a smoking cessation medication, is under scrutiny by the FDA due to an increased risk of suicides and other disorders. The "quit smoking" drug has been under investigation by the FDA since November 2007 after it received reports of 37 Chantix suicides and 400 reports of suicidal behavior that may be linked to the drug. This is especially true with individuals that have serious preexisting psychiatric illness.

Chantix is sold by Pfizer and helps smokers permanently stop smoking. Approved by the FDA during 2006, the drug gained popularity by helping people "kick the habit." Problems associated with the drug include:

Suicide
Attempted Suicide
Abnormal behavior which resulted in serious physical injury

Severe injury or death due to an accident or fall caused by seizures, black-outs or other sudden problems.

The 2011 Hurricane Season Forecast | Hurricane Insurance Claim Lawyer | Miami, FL

mindywein@cox.net (Blog Author)53497 — Wed, 20 Apr 2011 08:00:00 EST

The 2011 Hurricane season begins June 1^st and again this year is predicted to produce above average hurricane activity in the Atlantic basin. Experts from the Colorado State University forecast team predict that there is a 72% probability that at least one major hurricane will make landfall along the U.S. coastline during 2011, whereas the historical probability of this event is 48%. In addition, the hurricane forecast team predicts that 2011 will see a 175% increase of the average hurricane season, a clear indication that a busy hurricane season awaits.

Now is the time to begin preparing for hurricane season. This includes reviewing insurance policies to ensure coverage, obtaining additional insurance coverage if necessary, taking pictures of insured property, stocking up on canned foods and water, removing debris from your property and trimming tree limbs. Having a hurricane plan in place also reduces stress in the event a possible hurricane landfall is imminent. It's never too early to plan ahead, so start today.

Topamax | Cleft Lip | Cleft Palate | Miami Personal Injury Lawyer

mindywein@cox.net (Blog Author)53340 — Mon, 18 Apr 2011 08:00:00 EST

This month the U.S. Food and Drug Administration announced that pregnant women who took Topamax are at risk of developing birth defects in their unborn children, including cleft lip and palate. It has been reported that the incidences of cleft lip and cleft palate are 21 times the normal rate of those birth defects.

In March, the FDA issued a warning letter and placed Topamax in Pregnancy Category D, meaning that pregnant women who take the drug are at high risk for developing serious birth defects.

The warning letter wasn't the drug's first brush with controversy. Last year, Ortho McNeil's parent company, Johnson & Johnson, plead guilty to a misdemeanor under the Food, Drug and Cosmetic Act and paid a $6.14 million criminal fine for promoting the off-label use of the drug for non-approved uses such as weight loss, alcohol dependence, eating disorders and mood and anxiety disorders. In addition, another subsidiary of the company agreed to pay more than $75 million in a False Claims Act suit alleging it illegally promoted Topamax and caused false claims to be submitted to the government for unapproved uses.

Injured parties are likely to face arguments from the manufacturer that the oral clefts at issue were the result of congenital birth defects and had nothing to do with the mother's use of the drug. Other issues to overcome include ruling out environmental factors such as toxic exposure or malnutrition during pregnancy, which can also cause oral clefts.

Generic versions of Topamax have been available since 2006.

Yamaha Rhino ATV Crush Injuries Due to Rollover | Miami Personal Injury Lawyer

mindywein@cox.net (Blog Author)53137 — Thu, 14 Apr 2011 08:00:00 EST

First introduced in 2003, the Yamaha Rhino ATV has been connected to countless injuries and deaths of riders, including children. After more than 46 deaths, there was a recall of over 120,000 Yamaha Rhino ATVs on March 31, 2009. The Rhino's main design criticism stems from its narrow wheelbase, small tires, high center of gravity, and lack of doors which all combine to make it be highly susceptible to rollovers which result in crushing injuries and death. Weighing over 1000 lbs, the crush injury to a leg can be catastrophic. The leg injuries can result in an amputation or a long and painful recovery process. If the leg is not amputated, leg impairment and disfigurement is very likely. Unfortunately, children suffer severe injuries or death when a Yamaha Rhino tips over, even when the child in strapped into the passenger seat.

Denture Cream | Neurological Disease | Miami Personal Injury Lawyer

mindywein@cox.net (Blog Author)53138 — Thu, 14 Apr 2011 08:00:00 EST

Dentures are worn by approximately 35 million people in the U.S. A recent study reported in the journal Neurology reported that several patients who used denture cream in large quantities had symptoms of neurological side effects. All of the patients tested showed high levels of zinc. Manufacturers of these products are not required to list zinc as an ingredient in their denture cream product labels.

Denture adhesive products such as Poligrip and Fixodent and others contain the mineral zinc. It is now known that denture cream zinc absorbed in excess by your body can lead to zinc poisoning and can create unexplained weakness, numbness, loss of sensation, copper deficiency and neurological disease. Zinc blood tests can quickly determine if you have excess zinc in your body. Unfortunately, for some it may be too late to reverse nerve damage or any neurological impact.

Lawn Tractor and Riding Mower Rollovers | Miami Personal Injury Lawyer

mindywein@cox.net (Blog Author)52355 — Fri, 01 Apr 2011 08:00:00 EST

According to a 2009 U.S. Consumer Products Safety Commission report, more than 247,000 people are injured while mowing their lawns. Unfortunately many die or suffer permanent catastrophic injuries. Most of these deaths or injuries could have been prevented if the lawn tractor or mower had a Roll-Over Protective Structure (ROPS) installed. ROPS consist of frame bars that provide a safety zone to the operator in the event of a rollover. Seatbelts are also necessary in order to restrain the operator and keep the operator in the safety zone.

Despite the fact that manufactures of lawn tractors and riding mowers have known the vital importance of ROPS in preventing needless deaths and injuries to its operators, most manufactures will not sell tractors and mowers with preinstalled ROPS. A purchaser of this equipment must retrofit their tractors and mowers on their own either at the time of purchase or at a later time.

Fentanyl Pain Patch Can Cause Death or Overdose

mindywein@cox.net (Blog Author)41863 — Mon, 01 Nov 2010 08:00:00 EST

Fentanyl pain patches prescribed by doctors for moderate to severe chronic pain can cause serious, life-threatening complications. In 2004 and again in 2008, the FDA recalled several lots of defective patches due to leaking problems. Over 1,000 patients die every year due to accidental fentanyl overdoses.

Duragesic, Sandoz, and others known as fentanyl transdermal systems, are potent schedule II opioid pain medicines that are 100 times stronger than morphine with effects similar to heroin. The fentanyl is supposed to be released in controlled doses into the patient's bloodstream by absorption through the skin. These patches have been recalled due to a flaw in the patch that causes the fentanyl to leak, leading to direct contact with skin. Direct contact with the fentanyl can lead to an overdose and even death. Other symptoms include loss of consciousness and difficulty breathing.

There are multiple types of Fentanyl Pain Patches that can be defective:

Duragesic (fentanyl transdermal system):

Manufactured by Ortho-McNeil-Janssen Pharmaceuticals, Inc., a subsidiary of Johnson & Johnson (generic patches sold by Sandoz, Inc. also affected)
Recalled on February 12, 2008 because of manufacturing defects
Recall affects 32 million 25 microgram-per-hour patches

Fentanyl Transdermal System:

Manufactured by Watson Pharmaceuticals, Inc.
Recalled on August 8, 2008 because of leaking fentanyl gel
Recall affects 75 microgram-per-hour patches from lot number 92461850, with expiration dates of August 31, 2009

Actavis Fentanyl Transdermal System:

Sold by Actavis, Inc., and manufactured by Corium International Inc. (pouches containing the recalled patches may include a Abrika Pharmaceuticals Inc. label)
Recalled on February 17, 2008 because of a fold-over defect that could cause leaking fentanyl gel. Recall was expanded on March 1, 2008.
Expanded recall affects all Actavis Fentanyl Pain Patches (25, 50, 75 and 100 microgram-per-hour) with expiration dates from May 2009 to December 2009

Other Generic Manufacturers:

Generic Fentanyl Pain Patches are manufactured by numerous companies, which may have defective products. Mylan Laboratories is one generic manufacturer. Mylan patches are different from the usual pain patches because they are not reservoir based, but instead use a mesh matrix. Experts agree that the mesh matrix is much safer than the reservoirs, which are prone to leaking toxic amounts of the opiate drug. Right now, there have been reports of about 28 deaths possibly related to the Mylan matrix patches. Further investigation will reveal whether the products were defective.

Fentanyl Pain Patch lawsuits are continuing to be filed around the country. There are at least 60 cases against Johnson & Johnson for their Duragesic patch. Plaintiffs have won every one of the first four Fentanyl Pain Patch cases to go to trial, with combined verdicts exceeding $36 million.

J.P. Gonzalez-Sirgo, P.A. is currently investigating Avandia drug cases.

blog@www.jpgonzalez-sirgo.com (Blog Author)29735 — Sun, 09 May 2010 08:00:00 EST

The Law Firm of J.P. Gonzalez-Sirgo, P.A. is currently investigating Avandia drug cases that have caused significant injuries, including heart attacks and heart-related death. Do not stop use of Avandia unless advised by your physician.

Avandia is manufactured by GlaxoSmithKline (GSK) and is used to treat Type 2 diabetes. The drug was released in 1999 and has been used by over 10 million patients in the U.S.

In the May 21, 2007 issue of the New England Journal of Medicine, a report was published that suggested that Avandia may significantly increase the risk of heart attack, stroke and death. The risk was even more significant for those patients that already suffered from prior heart disease or where at risk for a heart attack. Please go here to read the report. Shortly thereafter, the U.S. Food and Drug Administration (FDA) advised Avandia users to consult with their doctor about alternative treatment. In addition, the FDA required the Avandia drug maker to include a "black box warning," the most serious type of drug warning label indicating that the drug can cause life threatening side effects. Please click here to read the advisory alerts issued by the FDA.

On February 22, 2010, the FDA issued this press release where they announced that it was reviewing a recent study to evaluate the cardiovascular safety of Avandia. They will report their findings to an advisory committee at a July 2010 meeting.

In addition, on February 20, 2010, U.S. Senators, Max Baucus and Chuck Grassley released a committee report based on a two year investigation into Avandia. In their letter to the FDA, the Senators state, "The totality of evidence suggests that GSK was aware of the possible cardiac risks associated with Avandia years before such evidence became public.... Based on this knowledge, GSK had a duty to sufficiently warn patients and the FDA of its concerns in a timely manner. Instead, GSK executives intimidated independent physicians, focused on strategies to minimize findings that Avandia may increase cardiovascular risk, and sought ways to downplay findings that the rival drug ACTOS (pioglitazone) might reduce cardiovascular risk." Please go here to view the Senator's press release.

If you were prescribed Avandia and thereafter suffered one or more of the following conditions, you may have a viable claim:

Angina
Congestive Heart Failure
Heart Attack
Liver Toxicity
Severe Allergic Reaction
Stroke
Bone Fractures

If your loved one died as a result of taking Avandia, the family may also be entitled to bring suit for their loss.

If you or your loved one have suffered severe injuries after taking Avandia, please contact the Law Firm of J.P. Gonzalez-Sirgo, P.A. for a free consultation.

What You Should Know About Traumatic Brain Injury (TBI)

blog@www.jpgonzalez-sirgo.com (Blog Author)29218 — Tue, 30 Mar 2010 08:00:00 EST

A traumatic brain injury can lead to a permanent disability and change life, as you know it. This type of head trauma is often deadly. Unfortunately, traumatic brain injuries are more common than you probably realize.

Did you know that an estimated 1.7 million people suffer from traumatic brain injuries each year? Of those, 52,000 people are likely to die and 275,000 people will require hospitalization. What is even more alarming is that these TBI cases contribute to nearly 30.5 percent of all injury-related deaths in the United States.

What about costs associated with traumatic brain injury cases? It is estimated that traumatic brain injuries cost about $60 billion dollars in direct medical costs, as well as indirect costs, such as lost productivity.

A TBI can be in the form of a mild concussion or a more serious head injury, resulting in brain damage. Regardless of whether you suffered a TBI from a slip and fall accident or a severe car accident, you could be left with serious complications to deal with. A traumatic brain injury can have lasting affects on your family life and can affect your ability to work.

If you or someone you know has suffered a traumatic brain injury, you should contact one of our experienced Miami injury attorneys at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

What Should You Do When Filing a Florida Fire Claim?

blog@www.jpgonzalez-sirgo.com (Blog Author)28927 — Thu, 25 Mar 2010 08:00:00 EST

Imagine driving around the corner to see your house engulfed in flames. All of your personal items and family mementos can be lost in mere minutes. You could be left wondering where to start, as your family attempts to recover from the devastating loss.

The first thing you need to do after a Florida house fire is contact your insurance company and notify them of the fire immediately. When negotiating with your insurance company, you should keep a record of all conversations. Maintain a journal of the person you spoke with, when you spoke to them, and what was said.

Your insurance company may ask you to give a recorded statement. Know your rights before you do so. Also, be aware that your insurance company may ask you to sign a release or waiver. You should not have to sign such a form to settle a claim.

Do the best job you can in documenting all of your losses. Spend time with family and friends to recall all the items that were lost in the fire.

Lastly, keep in mind that the insurance company is not on your side. You should seek legal advice to help you obtain a fair settlement for your claim.

If you are filling a Florida fire claim and are having trouble, you should contact an experienced Miami insurance attorney at our office at (305) 461-1095 or (866) 71-CLAIM.

$20.4 Million Verdict for Condo Association Sends Loud Message

blog@www.jpgonzalez-sirgo.com (Blog Author)27644 — Wed, 03 Mar 2010 08:00:00 EST

A recent victory for insurers across Florida and especially condominium associations was announced on February 17, 2009 in a Miami Dade County courtroom. QBE Insurance, one of the largest condo insurers in Florida, was handed a jury verdict to the tune of $20.4 million, which does not include attorney fees, interest and other costs which can easily add millions more to the judgment.

The case started when Hurricane Wilma blew through Miami Dade County during the 2005 hurricane season and damaged Buckley Towers in North Miami Beach. The condominium association filed their insurance claim and received a denial letter from QBE Insurance. Among other things, the denial letter stated the property losses existed before hurricane Wilma, poor property maintenance and normal wear and tear. Even fraud was later used as an excuse for denying their valid claim. Because of the hurricane damages sustained, Buckley Towers was in the process of being condemned by the county's building department due to dangerous living conditions.

The message being sent to insurance companies is that policyholders are not going put up with their "Delay, Deny, and Don't Pay Tactics." Thanks for insurance bad faith laws in the State of Florida, insurance companies will be paying dearly for aggressively implementing their dirty tactics on legitimate claims.

Ten Worst Insurance Companies in the U.S.

blog@www.jpgonzalez-sirgo.com (Blog Author)27645 — Wed, 03 Mar 2010 08:00:00 EST

Recently the American Association of Justice released a list of the top 10 worst insurance companies in the United States.

Topping the list is Allstate. While Allstate's t.v. commercials say "Your in Good Hands with Allstate" the grim reality is that instead you are in a "Boxing Ring" with Allstate when it comes to paying your insurance claims.

The whole list includes:

1. Allstate;
2. Unum (for denying claims contrary to doctors' evaluations);
3. AIG (for engaging in "massive corporate fraud and claims abuses");
4. State Farm (for denying and delaying Katrina claims);
5. Conseco (for hardball tactics with long term health care claims);
6. WellPoint (for routinely canceling policies of pregnant women and the chronically ill);
7. Farmers Insurance Group (for rewarding adjusters who meet low claims payment goals);
8. UnitedHealth (for compromising patient health by denying or delaying physician reimbursement);
9. Torchmark (for preying on low income Southern residents and discriminating against minorities on burial policies); and
10. Liberty Mutual (for hiring a consultant to train adjusters to adopt aggressive practices).

It should come as no surprise that ATLA is an association representing lawyers on the plaintiffs' side of the legal profession.

Read Health Insurance Policy to Understand What is Covered

blog@www.jpgonzalez-sirgo.com (Blog Author)27647 — Wed, 03 Mar 2010 08:00:00 EST

Most people never imagine needing a prosthetic device and therefore never read the fine print on their health insurance policy. But as Good Morning America recently aired, health insurance companies usually balk at paying for expensive prosthetics. In this story, Susan Bailey, wife and mother of two boys who lost her legs right above her knees due to an E. coli infection that spread to her legs. While she lay in a two week coma, her husband approved the amputation in order to save her life.

After the ordeal, she went home with a pair of "cheap" prosthetics, the only ones her insurer would approve. After falling around the house and yard just to complete everyday mundane chores, she learned of a prosthetics manufacturer that developed the "C-leg" made specifically for people like Susan with leg amputations right above the knee level. The cost for this model is around $100,000 per pair and her insurer denied her claim and appeals.

Eventually, Ms. Bailey obtained her C-leg prosthetics after her state's insurance regulator overturned her insurer's decision.

The point here is that people think that they will automatically be covered for a prosthetic device and that is not true. Also, according to the Amputee Coalition of America, insurance companies routinely deny the more expensive prosthetic models, even the less expensive models that can cost around $12,000.

Consumers should read the fine print on their policies and know what is covered and what is not covered.

Be careful with" In Network" vs. "Out of Network" Medical Providers

blog@www.jpgonzalez-sirgo.com (Blog Author)27648 — Wed, 03 Mar 2010 08:00:00 EST

The Miami Herald recently examined a growing problem within our health care system: Patients receiving additional medical bills after they visited a network provider. Why? Because the physician who treated them was an out of network provider. If the provider is an out of network provider, the insurance company will be a minimum amount and the insurer will be responsible for any difference. This issue is getting worse because insurance companies are requiring their customers to pay higher deductibles, co-payments and other penalties for going out of network.

Patients are getting punished with higher medical bills even when they do visit an in network provider but then receive services from an out of network provider. This is not an easy issue to maneuver around when presented with an emergency situation. What layperson is going to slow down or stop emergency medical procedures and begin to ask doctors and providers if they are in their respective health insurance coverage network?

Many doctors and medical providers say that they are prohibited by Federal law from discussing financial issues because such talk may discourage patients from appropriate and necessary emergency medical procedures.

I believe that this is just another way for health insurance companies and HMO's to shift more health costs to consumers and it's something we all need to be aware of because it will only get worse.

Hurricane Preparation

blog@www.jpgonzalez-sirgo.com (Blog Author)27650 — Wed, 03 Mar 2010 08:00:00 EST

It's never too early to begin preparing for hurricane season. Below is some useful advice:

BEFORE A HURRICANE:

Create a family plan, including options where you may stay during a storm.
Locate and review homeowner's insurance policy or renter's insurance policy. If you're a business owner, do the same.
Inquire where nearest hurricane shelter is located.
Keep trees and shrubs trimmed and safely store all loose yard items.

WHEN A HURRICANE WATCH IS ISSUED:

Fuel all cars.
Purchase extra fuel and safely store in approved containers.
If you own a home generator, purchase necessary fuel. Read owner's manual and follow all safety guidelines.
It is advised that you get cash, since after a hurricane many banks are closed; ATM machines are broken or simply run out of cash.
Stock up on supplies, including food, water, personal hygiene, equipment, and other supplies. Ensure you purchase battery operated items, such as a radio, TV, flashlight, etc.
Anchor yard items that are too heavy to move or bring into your garage or home.
If you own a boat or other watercraft, ensure that it is secured and anchored.
Ensure you shutter or board your windows.
Since you may lose electricity to your home for many days, it is recommended that you adjust the temperature in your refrigerator and freezer to its coldest temperature.
Secure your valuables and important documents in waterproof containers.

DURING A HURRICANE:

If you decide to ride out the storm in your home, stay indoors and away from windows. Try to stay in a small interior room, closet or hallway.
Keep all interiors doors closed.

AFTER A HURRICANE

Stay away from downed power lines. Call FPL immediately.
Use charcoal and gas grills only outside.
Operate any home generator only outside your home due to the risk of carbon monoxide poisoning or death if operated inside your home.
Do not call 911 except for life-threatening situations.
Avoid driving due to flood like conditions and dangerous debris.
Treat any intersection as a "Four Way Stop Sign."

Hurricane Season 2009 Officially Started June 1.

blog@www.jpgonzalez-sirgo.com (Blog Author)27652 — Wed, 03 Mar 2010 08:00:00 EST

Hurricane Season 2009 Officially Started June 1.

June 1 officially signaled the beginning of the 2009 Atlantic hurricane season. Hurricane season runs from June through November. According to hurricane forecasters, this year promises to be a normal to below average hurricane season, with 9-14 named tropical storms, including 4-7 hurricanes with 1-3 likely to be a Category 3 or higher hurricane. Last year there were 5 major hurricanes.

It's never too early to begin preparing for hurricane season. Below is some useful advice:

BEFORE A HURRICANE:

Create a family plan, including options where you may stay during a storm.
Locate and review homeowner's insurance policy or renter's insurance policy. If you're a business owner, do the same.
Inquire where nearest hurricane shelter is located.
Keep trees and shrubs trimmed and safely store all loose yard items.

WHEN A HURRICANE WATCH IS ISSUED:

Fuel all cars.
Purchase extra fuel and safely store in approved containers.
If you own a home generator, purchase necessary fuel. Read owner's manual and follow all safety guidelines.
It is advised that you get cash, since after a hurricane many banks are closed; ATM machines are broken or simply run out of cash.
Stock up on supplies, including food, water, personal hygiene, equipment, and other supplies. Ensure you purchase battery operated items, such as a radio, TV, flashlight, etc.
Anchor yard items that are too heavy to move or bring into your garage or home.
If you own a boat or other watercraft, ensure that it is secured and anchored.
Ensure you shutter or board your windows.
Since you may lose electricity to your home for many days, it is recommended that you adjust the temperature in your refrigerator and freezer to its coldest temperature.
Secure your valuables and important documents in waterproof containers.

DURING A HURRICANE:

If you decide to ride out the storm in your home, stay indoors and away from windows. Try to stay in a small interior room, closet or hallway.
Keep all interiors doors closed.

AFTER A HURRICANE

Stay away from downed power lines. Call FPL immediately.
Use charcoal and gas grills only outside.
Operate any home generator only outside your home due to the risk of carbon monoxide poisoning or death if operated inside your home.
Do not call 911 except for life-threatening situations.
Avoid driving due to flood like conditions and dangerous debris.
Treat any intersection as a "Four Way Stop Sign."

With Storm Season Underway, Lightning Strikes Are Abundant.

blog@www.jpgonzalez-sirgo.com (Blog Author)27655 — Wed, 03 Mar 2010 08:00:00 EST

With hurricane season officially here as of June 1, everyone is keeping their eyes and ears open for any signs of hurricane activity over the Atlantic Ocean. But Floridians need to be aware that Florida is considered the lightening capitol of the nation. Every year in Florida, an average of nine people die as a direct result of getting struck by lightning. In addition, hundreds if not thousands of homes, businesses, condominiums and other properties get struck by lightning resulting in serious property damages. Damages could include fire, smoke, roof, electrical and many other damages that may result in substantial losses.

It is important that you heed any warnings issued from the National Weather Service and take all necessary steps to protect life and property.

In the unfortunate event your home, business or condominium suffers property damages due to a lightning strike, you should contact your insurance company immediately.

Attempting on your own to obtain a fair settlement from your insurance company is not always easy. If you find yourself in this situation, seek professional assistance.

Unlicensed Practice of Public Adjusting

blog@www.jpgonzalez-sirgo.com (Blog Author)27656 — Wed, 03 Mar 2010 08:00:00 EST

With hurricane season already underway, it is important to remind everyone that the unlicensed practice of adjusting insurance claims is a third degree felony as provided by
Section 626.8738, Florida Statutes.

Contractors that attempt to help victims of hurricane disasters and other catastrophes by offering assistance with their insurance claim maybe illegally engaging in the practice of public adjusting.

If a contractor or anyone is acting as a public adjuster in any manner by negotiating or effecting the settlement of an insurance claim on behalf of an insured and you are performing any of these services for money, commission or anything of value without being licensed as a public adjuster (Section 626.854, Florida Statutes), you could be subject to arrest.

If you are a contractor and then become licensed as a Public Adjuster, you cannot enter into a contract to do both the public adjusting and construction work on the same property as per Florida Statute 626.8795, Public adjusters; prohibition of conflict of interest:

"A public adjuster may not participate, directly or indirectly, in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the licensee; may not engage in any other activities that may be reasonably construed as a conflict of interest, including soliciting or accepting any remuneration from, of any kind or nature, directly or indirectly; and may not have a financial interest in any salvage, repair, or any other business entity that obtains business in connection with any claim that the public adjuster has a contract or an agreement to adjust."

The definition of a public adjuster, as explained in Section 626.854, Florida Statutes, is any person, except an attorney, who, for money or any other thing of value (which would include securing a contract for repairs):

Prepares, completes or files an insurance claim form for an insured.
Aids in any manner on behalf of an insured in negotiating for or effecting the settlement of a claim.
Advertises or solicits for employment as an adjuster of such claims.

If you or anyone you know is acting or posing as a public adjuster, please take a moment to carefully explain the consequences of such behavior.

If you should have any questions about what activities constitute acting as a public adjuster, please contact the Florida Department of Financial Services at 850-413-3136.

Has your Roof Tile, Floor Tile, Carpet or Cabinets Been Damaged?

blog@www.jpgonzalez-sirgo.com (Blog Author)27657 — Wed, 03 Mar 2010 08:00:00 EST

If due to a covered loss as outlined in your homeowner's insurance policy, you need to repair or replace a certain amount of roof tiles, floor tiles, a portion of your carpet or a portion of your kitchen cabinets, you may be entitled to a complete replacement of the entire material. If you are unable to match the damaged items with the same quality, color, or size of material, your insurance company may have to replace the damaged materials in all adjoining areas. For example, this means that if a portion of your roof tile is damaged in a wind storm, and that roof tile is discontinued and you are unable to locate the same quality, color or size for the roof tile, the insurance company may have to pay to have all of your roof tiles replaced. The same is true for other covered materials, such as your floor tile, carpet, cabinets, etc.

The theory behind this claim settlement practice is that no homeowner should be left with patched carpeting or mismatching roof or floor tiles that leads to a devalued property.

Unfortunately, some insurance companies attempt to pay only for the damaged portion or affected area of the covered item leaving homeowners with mismatches and devalued property values. Read your policy. If the damaged material cannot be replaced or repaired in a manner that maintains a consistent appearance for your property, then you may be entitled to a complete replacement of the damaged material, including those parts that were not damaged.

Florida Insurance Companies Offering Homeowner's Insurance Policies in Miami Dade County

blog@www.jpgonzalez-sirgo.com (Blog Author)27660 — Wed, 03 Mar 2010 08:00:00 EST

To assist our South Florida residents, we have compiled a list of property insurance companies selling homeowner's insurance policies. This is especially useful in light of State Farm's recent announcement to drop all of their homeowners and property insurance policies in the near future.

Property Insurance Companies Selling Policies in Miami Dade, Broward, Monroe and Palm Beach Counties:

Allstate Floridian Insurance Company
American Strategic Insurance Corp.
American Traditions Insurance Company
ASI Assurance Corp
Citizens Property Insurance Corporation
First Floridian Auto and Home Insurance Company
Florida Farm Bureau Casualty Insurance Company
Florida Peninsula Insurance Company
Homewise Preferred Insurance Company
Liberty Mutual Fire Insurance Company
Olympus Insurance Company
People's Trust Insurance Company
Royal Palm Insurance Company
Security First Insurance Company
Southern Fidelity Insurance Company
Southern Oak Insurance Company
St. Johns Insurance Company, Inc.
Tower Hill Preferred Insurance Company
Tower Hill Prime Insurance Company
Tower Hill Select Insurance Company
United Property & Casualty Insurance Company, Inc.
Universal Insurance Company of North America
Universal Property & Casualty Insurance Company

If you are in the market for homeowner's property insurance coverage, make sure to shop around and obtain a few quotes before deciding which company to go with.

Safeguard Important Documents in Preparation for Hurricane Season.

blog@www.jpgonzalez-sirgo.com (Blog Author)27661 — Wed, 03 Mar 2010 08:00:00 EST

In what forecasters predict will be an average hurricane season this year, with approximately 9-14 named tropical storms, it is important to take necessary steps to safeguard all documents that may be important in the event of a catastrophic wind storm or hurricane, especially if you must file an insurance claim.

Documents you may consider safeguarding include:

Insurance Policies,
Birth Certificates,
Marriage Certificates,
Social Security Cards,
Passports,
Bank Account Statements,
Credit Card Accounts Numbers, Contact Numbers, PIN Numbers, etc.,
Copies of Driver's License and other Identification Cards,
Prescriptions and Medications,
Tax Returns,
List of Other Account Numbers, Contact Numbers, etc.

Offsite safeguarding is the best option. Renting a safe deposit box at a bank is great, but make sure you have the key with you in the event you must evacuate your home. You may also not have access to your bank's safe deposit box for sometime following the loss of power. Electronic storage is also an option and it basically entails scanning all documents into PDF format files and storing them into an email account for future retrieval. You can also scan all important documents into a CD and have a friend or family member that lives away from you (preferably in another state) hold it for you.

As an alternative, you may also consider organizing all important documents into one small plastic container that you can easily grab and go in case of an emergency.

Business Interruption Insurance Can Protect a Restaurant from Death in case of a Kitchen Fire!

blog@www.jpgonzalez-sirgo.com (Blog Author)27277 — Wed, 24 Feb 2010 08:00:00 EST

Own a restaurant? Then you should own business interruption insurance coverage in case your business suffers a serious kitchen fire. Business Interruption insurance covers your restaurant's loss income in the event a fire destroys your restaurant and you are forced to shut down pending repairs. The policy also protects you against other covered events. Read and understand what is and what is not covered. Can you afford not to be covered? Can you afford to be without income for months on end? The answer is no. Over 80% of small businesses that shut down because of a disaster never re-open again due to financial issues.

Unfortunately, many insurance companies choose to play hard ball with business owners by delaying payments or even flat out denying them.

Should you find yourself with a difficult business interruption insurance claim, you should contact an experienced Miami business interruption insurance claim lawyer at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

What You Can Do To Protect You Florida Home in a Fire

blog@www.jpgonzalez-sirgo.com (Blog Author)27171 — Tue, 23 Feb 2010 08:00:00 EST

Imagine pulling up to your Florida home only to discover that it is on fire. You have spent a life time accumulating valuables and personal mementos only to see them engulfed in flames. Unfortunately, this reality happens all too much to fellow Floridians.

The good news is that there are several things that you can do to help protect your home from destruction in a fire. Some of those recommendations include making sure that your roof is fire-resistant. If your roof catches on fire, then it may be all over rather quickly.

Other tips include making sure all smoke detectors are operational. You should test them monthly.

Also, you should consider making sure you have fire extinguishers throughout the entire house. Make sure that everyone in the house knows how to operate them.

One of the most important things you can do is to ensure that you have the right fire insurance coverage. You need to immediately file a Florida fire insurance claim in the event of a fire.

Unfortunately, many insurance companies try to take advantage of their customers by delaying payments or sometimes even denying claims

If you or someone you know has a home that has suffered fire damage, you should contact an experienced Miami fire insurance attorney at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

Reduce Your Risk of Property Damage From a Florida Hurricane

blog@www.jpgonzalez-sirgo.com (Blog Author)26929 — Thu, 18 Feb 2010 08:00:00 EST

Most Floridians are aware of the fact that they might be affected by a hurricane. That is the risk that we all take by living in our great state.

Although the hurricane season doesn't officially begin until June 1^st, it is never too early to start preparing your property for an active hurricane season.

We have compiled several tips that you and your family can follow to help avoid property damage in a Florida hurricane. These tips include ensuring all smoke detectors work properly, keeping a survival kit on hand, storing plenty of water, unplugging all electronics, storing valuables and electronic devices in high places and placing towels near all windows and doors.

For a complete description of these tips, please read our article Six Tips to Avoid Property Damage in a Florida Hurricane.

Hopefully, you have purchased hurricane insurance. Unfortunately, many insurance companies will delay payments or even deny claims. If you are a victim of your insurance company then you need to obtain legal advice.

If you own a home that has been damaged in a hurricane and you are considering filing an insurance claim, you should contact an experienced Miami hurricane insurance attorney at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

Filing a Disability Claim for Hepatitis C

blog@www.jpgonzalez-sirgo.com (Blog Author)25908 — Fri, 29 Jan 2010 08:00:00 EST

Have you ever wondered what you would do if you contracted a serious illness such as hepatitis C? If not, you should consider the fact that you may already have this serious condition and not even know it. Many victims don't show any symptoms of having the infection.

So, what is hepatitis C? It is a viral infection that attacks the liver and results in inflammation. It may not sound serious, but the end result can be permanent damage to your liver.

What is even more frightening is how easy it is to contract. For example, you could get the virus by sharing needles, sexual contact and even through giving birth. Also, if you had a blood transfusion or an organ transplant before 1992, you could be at risk of contracting hepatitis C.

It is important that you know the symptoms that include fever, nausea, muscle pain, fatigue and tenderness in the liver. Do those symptoms sound familiar? They resemble flu-like symptoms. Imagine thinking that you have the flu only to discover that you actually have hepatitis C.

If you think you have this condition, you need to seek medical attention immediately. You may be eligible to file a disability claim for having hepatitis C.

If you or someone you know has been diagnosed with hepatitis C, you should contact an experienced Miami disability insurance lawyer at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

Hypertension Sufferers May Qualify for Disability Insurance Benefits

blog@www.jpgonzalez-sirgo.com (Blog Author)25909 — Fri, 29 Jan 2010 08:00:00 EST

Although high blood pressure, also known as hypertension, can usually be managed effectively with medication, when you do experience the symptoms of this condition, it can be debilitating. If you have high blood pressure, you know how difficult it can be to function normally when you are dizzy, have a headache or possible nosebleed.

These symptoms of high blood pressure aren't the only complications associated with this disorder. Hypertension has been linked to heart attack and stroke. Blood pressure goes up as your heart pumps more blood and your arteries become restricted. Without proper treatment, hypertension can result in artery damage, heart failure, aneurysm and kidney complications.

If you are suffering from high blood pressure, you could be entitled to disability insurance benefits. When a medical condition keeps you from working and earning the income you need to pay your bills and take care of your family, these disability benefits can be the answer you are looking for.

For more information on filing a high blood pressure disability insurance claim, contact an experienced Miami disability lawyer at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

Be sure to read the article, High Blood Pressure Disability Insurance Claim, to learn more about this topic.

Press Release - Attorney J.P. Gonzalez-Sirgo Named To Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum

blog@www.jpgonzalez-sirgo.com (Blog Author)24062 — Mon, 28 Dec 2009 08:00:00 EST

We are pleased to announce that the Million Dollar Advocates Forum, www.MillionDollarAdvocates.com, has accepted attorney J P Gonzalez-Sirgo to be certified as a life member of both the Million Dollar Advocates Forum and the Multi-Million Dollar Advocates Forum. Please go here to read the entire Press Release.

The Million Dollar Advocates Forum is recognized as one of the most prestigious groups of trial lawyers in the United States. Membership is limited to attorneys who have won million and multi-million dollar verdicts, awards and settlements. The organization was founded in 1993 and there are approximately 3000 members located throughout the country. Fewer than 1% of U.S. lawyers are members. Forum membership acknowledges excellence in advocacy, and provides members with a national network of experienced colleagues for professional referral and information exchange in major cases. Members of the Million Dollar Advocates Forum must have acted as principal counsel in at least one case in which their client has received a verdict, award or settlement in the amount of one million dollars or more.

Members of the Multi-Million Dollar Advocates Forum must be Life Members of the Million Dollar Advocates Forum and must have acted as principal counsel in at least one case which has resulted in a multi-million dollar verdict, award or settlement. Mr. Gonzalez-Sirgo has been approved for membership in both the Million Dollar Advocates Forum and the Multi-Million Dollar Advocates Forum.

Please go here in our Library section to get addition information of this announcement.

Can I File a Disability Insurance Claim for Osteoarthritis?

blog@www.jpgonzalez-sirgo.com (Blog Author)23890 — Wed, 23 Dec 2009 08:00:00 EST

Are you suffering from osteoarthritis? If so, you are not alone. Osteoarthritis is the most common form of arthritis. This condition tends to be very painful and even disabling for those who suffer from it.

Even though you may have been diagnosed with osteoarthritis, you might not know exactly what this disorder entails. Osteoarthritis is a degenerative joint disease where the cartilage in the joints starts to wear down, causing excruciating pain in some patients. What's even more concerning about osteoarthritis is the fact that it can affect just about any joint in the body. However, it is more commonly found in the hands, hips, neck, knees and lower back.

Anyone can develop osteoarthritis. It does appear to be more common, though, in older adults, women, people with bone deformities, individuals who are obese and people suffering from other diseases.

For symptoms of osteoarthritis, read the article titled, Osteoarthritis Disability Insurance Claims.

Osteoarthritis can be a life-altering condition, affecting your ability to do normal household chores, as well as impairing your ability to perform your duties at work. It may even lead to a possible loss of wages.

If you have developed osteoarthritis, you may qualify for disability insurance benefits. You should contact an experienced Miami disability lawyer at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents people who have had their valid long term disability benefits denied, delayed or terminated irrespective if the policy was purchased individually or issued through an employer group policy. We can also assist with the initial application process, during the administrative appeals process, termination, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out.

Filing an Insurance Claim for Sleep Apnea

blog@www.jpgonzalez-sirgo.com (Blog Author)23532 — Wed, 16 Dec 2009 08:00:00 EST

Though we may have heard of sleep apnea, many of us do not know what it is. Sleep apnea is a common sleeping disorder that is easily characterized as one or more pauses in breathing or shallow breaths while a person is sleeping. The problem with sleep apnea is that most people don't realize that they are suffering from it until a family member or bed partner notices the warning signs.

So, what causes sleep apnea? It is generally a result of a blocked or narrowed airway. If you believe that you have this sleep disorder, you need to familiarize yourself with the symptoms, which include loud snoring, pauses in snoring, choking or gasping for air while asleep, morning headaches and memory problems, to name a few.

Fortunately, sleep apnea can be treated. You should seek advice from your physician if you exhibit any of the sleep apnea symptoms.

Sleep apnea can have many negative impacts on your life. It can affect your ability to perform at work, leading to an eventual loss of wages. You may be eligible to file a disability insurance claim.

If you are suffering from sleep apnea and have filed or considered filing a disability insurance claim, you should contact an experienced Miami insurance claim attorney at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

For more information on this subject, read the article, Sleep Apnea Disability Insurance Claim.

For more information contact a Miami disability lawyer at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM.

You May Qualify for Disability Benefits If You Suffer From Bell's Palsy

blog@www.jpgonzalez-sirgo.com (Blog Author)22366 — Tue, 24 Nov 2009 08:00:00 EST

Do you or someone you know suffer from Bell’s Palsy? The truth of the matter is that many Americans suffer from this surprisingly common condition, which is sometimes mistaken for stroke.

Bell’s Palsy is a condition that causes paralysis, numbness or weakness in the facial muscles. It generally is confined to one side of the face and can cause inconveniences, such as facial drooping and the inability to open the eye. This condition can also lead to difficulties with taste and the production of tears.

Bell’s Palsy symptoms can come on rapidly. A person may go to sleep one night feeling great and wake up the next morning feeling the frightening symptoms of Bell’s Palsy.

If you are concerned that you have Bell’s Palsy, you should watch out for a variety of symptoms, which include excessive tearing, dry eye, loss of taste, drooling, pain in or behind the ear, facial numbness and a sudden sensitivity to sound.

Though, Bell’s Palsy generally heals within weeks, it may require medical attention. In some cases, the effects of Bell’s Palsy are permanent.

Read our article, Bell’s Palsy Disability Insurance Claim, for more information about this shocking condition.

If you are suffering from Bell’s Palsy, you may be eligible to file a disability insurance claim. The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective of whether the policy was purchased individually or issued through an employer group policy. The firm is available to assist individuals with the initial application process, during the administrative appeals process, handling denials of claims or termination of benefits, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out. Please contact our office to discuss your case in more detail.

You May Qualify for Disability Benefits if You Suffer from Crohn's Disease

blog@www.jpgonzalez-sirgo.com (Blog Author)21855 — Mon, 16 Nov 2009 08:00:00 EST

Perhaps you or someone you know has been diagnosed with Crohn's disease. As you can imagine, it can be an overwhelming experience. Did you know that Crohn's disease affects an estimated 400,000 to 600,000 people in North America? In many cases, the disease is not diagnosed immediately. However, it can significantly impact your daily activities and cause immense pain. Crohn's disease is defined as a type of inflammatory bowel disease that affects the gastrointestinal tract. Symptoms include abdominal pain and cramping, fever, fatigue, joint pain and kidney stones, to name a few. There are many other symptoms associated with Crohn's disease. It is important to note that the inflammation associated with this disease is not limited to the intestines, as it can cause problems anywhere from the mouth to the end of the rectum. Crohn's disease often has a huge impact on daily life, including job performance. Victims who suffer from Crohn's disease may be eligible to file a disability insurance claim to help with medical costs and compensation for lost income. If you are suffering from Crohn's disease and have filed or are considering filing a disability insurance claim, you should contact an experienced Miami insurance claims lawyer at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or (866) 71-CLAIM. You should also read the article, Crohn's Disease Disability Insurance Claim, for more information about this disease.

Insured's Cost of Hiring an Inexperienced Long Term Disability Insurance Attorney

blog@www.jpgonzalez-sirgo.com (Blog Author)21324 — Fri, 06 Nov 2009 08:00:00 EST

In a recent posting under this website's Frequently Asked Questions (FAQ) section, the following question was asked: What are the trademarks of the right long term disability insurance lawyer? In response to this question, I went on to describe certain characteristics I would look for in an attorney before representing me in a long term disability insurance claim. You can go here to review this question and answer.

Recently, on November 3^rd, 2009, the United States Court of Appeals for the Fifth Circuit on appeal from the Southern District of Texas agreed with the lower court and affirmed its decision that the insured failed to exhaust administrative remedies prior to bringing suit.

In a nutshell, the insured had coverage under a long term disability benefits policy issued by Hartford Life Insurance Company which was governed by the Employee Retirement Income Security Act (ERISA). After having received benefits for a period of time, the insurer notified the insured that benefits would be terminated since the insured was cleared to return to work. The policy allowed the insured to appeal within 180 days. The insured hired an attorney who wrote a letter stating that insured ‘intended" to appeal the termination of benefits and requested various documents in hopes of supplementing the record. The insurer did not consider this letter a formal appeal and treated it as such.

Some three and half years later, the same attorney submitted a formal appeal package including medical records and a vocational expert's reports, etc. Since this appeal arrived way past the 180 days appealable period, the insurer rejected the appeal. The insured filed suit and shortly thereafter summary judgment was ruled in favor of insurer. The insured then appealed the decision and the court ruled in favor of the insurer. To read the entire decision, please go here.

It appears from these facts that the attorney representing the insured was not very familiar with ERISA law and how it pertains to long term disability plans. This potentially cost the insured thousands of dollars of lost long term disability insurance benefits. The hiring of an experienced long term disability insurance lawyer is very important.

The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective of whether the policy was purchased individually or issued through an employer group policy. The firm is available to assist individuals with the initial application process, during the administrative appeals process, handling denials of claims or termination of benefits, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out. Please contact our office to discuss your case in more detail.

Don't Be a Victim of "Sneaky" Disability Insurance Tactics

blog@www.jpgonzalez-sirgo.com (Blog Author)20640 — Tue, 27 Oct 2009 08:00:00 EST

If you are receiving disability benefits a private investigator may be following you. Insurance companies have been known to employ "sneaky" tactics to deny disability coverage. One of these tactics includes hiring a private investigator.

The investigator will try to catch you in the act of doing something that doesn't coincide with your disability. This person may park outside your home with a video camera ready to film you participating in an activity that the insurer can use as proof that you are not really disabled. The private investigator might even follow you to the store, your kid's soccer games and other events.

Some insurers will follow up the surveillance with a personal interview. An insurance representative might come to your house in hopes that you will try to play up your disability. He or she will then show you the video footage or pictures. At this point, you could end up saying something that you shouldn't.

It is unfortunate that insurance companies use these tactics, because people who are disabled do not want to be that way and often "overdo it" by trying to participate in the activities they once enjoyed. If you have been the victim of insurance company tactics and have been denied disability benefits, contact a Miami insurance claim lawyer at the law firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or toll free at (866)-71-CLAIM.

Have a Complaint Against Your Life Insurance Company?

blog@www.jpgonzalez-sirgo.com (Blog Author)20470 — Fri, 23 Oct 2009 08:00:00 EST

If you have a complaint against your life insurance company due to a denial of a life insurance claim or other bad faith insurance practices, you have several options at your disposal.

One option includes contacting your State Insurance Commissioner's office and filing a complaint. In Florida, you can go here to file a complaint. You will be asked to fill out a complaint form. They will then contact your insurer and ask for a response. When they receive a response, they will then contact you and advice you of their decision. It is important to note that the State Insurance Department powers are limited in many ways.

Another option to consider is to hire an experienced life insurance attorney. Not all attorneys are well versed in this practice area, so make sure to do your share of due diligence before hiring an attorney. The attorney you hire should be experienced in handling:

Life Insurance Claim Denials or Delays
Life Insurance Beneficiary Disputes
Life Insurance Application Misrepresentation Issues
Life Insurance Contestability Period Issues
Life Insurance Company Complaints to Interplead Life Insurance Policy Proceeds
Other Life Insurance Claim Issues such as:
o No Names Beneficiary or Incomplete Beneficiary Information
o Insurer Not Responding to Claim
o Cause of Death not Covered
o Lapsed Life Insurance Policy
o Accidental Life Insurance Claim Issues

Are you the Beneficiary on a Lost Life Insurance Policy?

blog@www.jpgonzalez-sirgo.com (Blog Author)20480 — Fri, 23 Oct 2009 08:00:00 EST

Life insurance company statistics reveal that 80% of all life insurance policies issued are never paid. The main reasons include the owner's failure to pay premiums and issuance of term life policies which end without a death payment. Another reason is that beneficiaries never claim the death benefits because of forgotten or lost life insurance policies.

Life insurance policyholders buy life insurance to provide financial protection to loved ones in the event of their death. Unfortunately, some policyholders never inform their loved ones or beneficiaries of the life insurance policies existence. This seems to occur because policyholders do not want to cause arguments between loved ones over beneficiary rights. Other times, the policyholder dies and even though someone may have known of a life insurance policy's existence, no one seems to know where the policy is located or which insurance company issued it. In addition, life insurance companies will usually not know if the policyholder died and therefore will not contact the policies beneficiaries to voluntarily tender the policy's death benefits. Because of this, millions of dollars in life insurance proceeds go unclaimed every year.

If you believe that you may be the beneficiary of a lost or forgotten life insurance policy, there are steps you can take to attempt to locate the policy. Doing it on your own will be extremely difficult since over the last few decades, there have been thousands of life insurance companies. In addition, many of these companies have either merged, demutualized, changed names or gone into receivership. When attempting to locate a lost life insurance policy, some old fashion investigative work might come in handy. You can try contacting the policyholder's past attorneys, accountants, insurance agents, or other trusted professionals throughout the last few decades to see if they have any knowledge of the existence of any life insurance policies. You can also look through cancelled checks to look for any insurance premium payments that might relate to a life insurance policy. Try doing the same for old credit card statements in the event policy premiums were paid via credit card. Try contacting old employers to see if the policyholder owned any group life insurance policies.

You can also hire a policy finder service that will make limited efforts in locating a missing policy for you. You can also hire a more expensive and personalized service which owns proprietary databases to locate missing policies. Missing life insurance policy services can be easily found on the internet.

Sometimes, the life insurance company discovers that the policyholder has indeed passed. When this occurs, the insurer will attempt to locate the policy's beneficiaries. If the insurer is unsuccessful, the life insurance policy is turned over to the state where it becomes unclaimed property. States maintain databases listing the names and addresses of beneficiaries of lost life insurance policies. In Florida, you can go here to check if you are the beneficiary to an unclaimed life insurance policy. As of the date of this blog, the Florida Bureau of Unclaimed Property holds unclaimed property valued at more than $1 billion.

On a national level, you can go to the National Association of Unclaimed Property Administrators or MissingMoney.com and conduct a search for missing money, including life insurance policies.

Whichever search option you choose could prove the difference between not collecting anything, to possibly collecting the full death benefits, or the policy's cash value or even stock from a demutualized insurer.

Lapsed Life Insurance Policy?

blog@www.jpgonzalez-sirgo.com (Blog Author)20371 — Wed, 21 Oct 2009 08:00:00 EST

If you are the owner or beneficiary of a life insurance policy, it is important that you understand how the policy works in the event premium payments are not paid or if the policy lapsed. Understanding the exact policy type is important to figuring out the options available.

Assuming you are beyond the contestability period of the policy, below are certain options that may be available.

If the policy type is a term life insurance policy, the option available is very simple. Simply stated, if the owner of the policy dies during the term life of the policy and the policy did not lapse, the beneficiary should have no problems collecting the policy benefits. If the policy lapsed due to non-payment of policy premiums, the policy most likely is not in force and any claims will be denied.

If the policy type is a whole life, permanent life or other similar policy, the policy will most likely have a cash surrender value. If the owner of the policy dies and the policy never lapsed, the beneficiary should have no problems collecting the life insurance benefits. However, if the policy lapsed due to non-payment of policy premiums, the policy may still be in full force and effect. This is true because life insurance companies will automatically convert a whole life or similar life insurance policy into an extended term policy or reduced paid up policy.

Unlike term life insurance policies, with whole life or similar life policies if premiums are not paid, the insurance company will start drawing against any cash surrender value to continue paying the premiums in order to prevent the policy from lapsing and becoming worthless. Other times, the life insurance company will keep the policy in force, but at a lower death benefit. Regardless of the method chosen by the life insurance company, once the cash surrender value is depleted and premiums are no longer paid, the policy will lapse and become worthless. If the owner of the policy should die during this period, the beneficiary may have death benefits payable. In between the time the owner failed to make premium payments and the insurer applying the cash surrender value to the policy in order to continue the premium payments, the life insurance company will attempt to contact the owner and beneficiary of the policy to communicate this fact and attempt to prevent the policy from lapsing.

If the reason premium payments stopped was because the owner died, the beneficiary should have no issues collecting the benefits, even decades later.

Should You Handle the Long-Term Disability Claim Yourself?

blog@www.jpgonzalez-sirgo.com (Blog Author)20253 — Mon, 19 Oct 2009 08:00:00 EST

Many individuals are not able to pay their bills once they become disabled. Long-term disability insurance is designed to provide benefits to people who are disabled and can no longer work. Applying for these benefits can be overwhelming and many valid disability claims are denied. Knowing this information may lead you to ask - should I handle my long-term disability claim myself or hire a Miami insurance claim lawyer?

Disability benefits should be able to provide you with the necessary income to support yourself and your family. Since long-term disability benefits are so vital, it is often advisable to work with an experienced Florida insurance lawyer who can walk you through the entire process to help improve your chances of being approved.

Claims are sometimes denied and you do have the right to appeal. An attorney will be able to help you with the appeal and ensure that the right evidence is presented that will back up your claim.

An insurance lawyer in Miami can provide much needed assistance if your benefits have been delayed or terminated. Insurance companies are known for using tactics to deny or stop benefits, but a knowledgeable disability insurance lawyer will be able to step in on your behalf to make certain that you receive the compensation in which you are entitled.

Contact J.P. Gonzalez-Sirgo at 305-461-1095 or 866-71-CLAIM, for more information regarding your long-term disability claim.

Tips for Fiing a Life Insurance Claim

blog@www.jpgonzalez-sirgo.com (Blog Author)19952 — Tue, 13 Oct 2009 08:00:00 EST

Life insurance can provide family and loved ones with some financial security in the event the policyholder dies. Filing a life insurance claim can be difficult considering you are still mourning the death of your loved one. Filing a life insurance claim as early as possible will help alleviate some of the financial burden the deceased wanted his beneficiaries to avoid when he/she decided to purchase the policy. This is especially true in cases where the deceased was the primary bread winner.

Below are tips to help a life insurance beneficiary file a life insurance claim, and hopefully make the process a little easier.

1. Locate the life insurance policy.
2. Contact the life insurance agent that sold the policy. Inform the agent about the death and try to engage his/her assistance.
3. Contact the insurance company and file the claim. Be prepared to answer questions about the policy.
4. After contact, wait for necessary paperwork to arrive. Fill out the paperwork. Accurately answer all questions. Call insurance company if you don't understand a question.
5. Obtain a copy of the death certificate.
6. Mail the insurance company all the completed paperwork along with the death certificate. Send the package certified mail, return receipt requested.
7. The insurance company may contact you for further questioning or clarification. Answer all questions to the best of your ability.
8. Follow-up with the insurance company to obtain status of the claim process.
9. Contact an experienced life insurance lawyer if your claim is delayed or denied.

Following the above tips will help beneficiaries cope with the additional responsibility of filing a life insurance claim at a difficult time.

Can a Doctor Hired by a Disability Insurance Company Truly Be Independent?

blog@www.jpgonzalez-sirgo.com (Blog Author)19768 — Fri, 09 Oct 2009 08:00:00 EST

When a policyholder files a disability insurance claim, the disability insurance company has the right to request that you undergo an independent medical exam or IME. In addition, the disability insurance company has the right to review your medical records, pay their own doctor to review your medical records, decide which medical tests to use in evaluating your claim, and hand pick which test results to take into consideration when evaluating your claim. Furthermore, the same insurance company serves as the "administrative board" in claims that are challenged or appealed by policyholders. This is especially true in ERISA type claims. Go here to learn more on ERISA claims.

Well, recently the United States Supreme Court handed down a decision that will begin shifting the balance a little more in the policyholder's direction regarding claims filed under ERISA. In the case, Met Life v. Glenn, the Supreme Court was faced with the following question(s): Can the same insurance company that pays a claim, also be the same entity that decides if payments be made or not? Can this structure or set-up provide a fair review of a claim?

For the first time, the court decided that there is a conflict of interest that exists when reviewing the legitimacy of the claim determination.

This decision was followed by a federal court decision that stated that the independent medical exam or IME is not independent after all.

If a doctor is hired and paid by an insurance company to prepare an "impartial review" of the insured's medical records how can this be a true impartial analysis of the medical records when the doctor is literally on the insurance company's payroll.

Due to the U.S. Supreme Court's ruling, it will be interesting to see how other lower level courts decide on similar issues. Stay tuned.

Disability Insurance Claim Filing Tips

blog@www.jpgonzalez-sirgo.com (Blog Author)19734 — Thu, 08 Oct 2009 08:00:00 EST

Long-term disability insurance should be part of everyone's financial planning. It protects you and your family in the event you are unable to work due to an illness, injury or other medical condition. To the surprise of disability insurance policyholders, the claim's process can be riddled with complexities that exist to stymie claims and benefit payments. Below are a few tips to consider when filing a long term disability insurance claim:

Read your disability insurance policy: Once you have located your policy, read it carefully. Disability policies written many years ago are different that those offered today. Is your policy an "own occupation" vs. "gainful (any) occupation policy." Go here to learn more about this topic.
Speak with your medical doctor: Advice your doctor that you will be filing for disability. Inform your doctor to clearly note in your medical records the diagnoses, but more importantly, to clearly note how this disabling condition restrains you from performing your occupation's work duties or any other occupational duties.
Consult with an experienced disability insurance lawyer: Not all lawyers are well versed in the disability insurance law world, especially employer based policies which are covered under the Employer Retirement Income Security Act of 1974 (ERISA). Go here to learn more on selecting the right disability insurance attorney for you.
Govern yourself accordingly: Insurance companies may which to investigate you and your activities. Field investigations may be conducted, including unannounced home visits, speaking with your neighbors, videotaping you, and even running your name through internet search engines to see what comes up. Recently, Facebook and other internet social web pages are proving to be beneficial to insurance companies as they seek to prove that you are not disabled after all by printing pictures and other information directly from your personal internet web pages.

According To Data, Recession Has Not Impacted Disability Claims

blog@www.jpgonzalez-sirgo.com (Blog Author)19610 — Tue, 06 Oct 2009 08:00:00 EST

According to the Council for Disability Awareness (CDA), surprisingly the recession has not increased disability insurance claim filings. It is important to note that CDA member firms represent over 75% of the commercial disability insurance marketplace, creating a solid base for gauging disability insurance claim trends. Based on CDA's 2008 survey of member firms, there were 573,500 disabled individuals receiving long term disability insurance payments. This was only a 1.5% increase over 2007's results. In addition, 156,000 new disabled individuals were approved for long term disability benefits during 2008, while 147,745 stopped receiving long term disability benefits for one reason or another. In total, CDA member firms paid out $7.9 billion in long term disability insurance payments during 2008. Obviously it is difficult to ascertain the exact reasons why the recession has not increased long term disability claims. Historically, past recessions have proven disability claims increase. However, it is believed that one reason claims are flat during the current economic downturn is that employees are ever more fearful that if they go on disability leave, their jobs will not be around when they are able to return to work.

Interesting Long Term Disability Insurance Statistics

blog@www.jpgonzalez-sirgo.com (Blog Author)19611 — Tue, 06 Oct 2009 08:00:00 EST

According to the Council for Disability Awareness (CDA), a non-profit organization whose goal is to inform and educate the public about disability trends and the economic impact it creates. CDA member firms represent over 75% of the commercial disability insurance marketplace. Based on its annual long term disability claims review, the 2008 survey exposed some interesting statistics.

CDA member firms reported that 95% of disability claims were not work related, the incidence and duration of individuals filing and staying on long term disability is flat or declining, new cancer, nervous system related and cardiovascular/circulatory, AIDS and musculoskeletal/connective tissue disorders are all declining or trending down. During 2007 and 2008, the primary causes of long term disability insurance claims included musculoskeletal/connective tissue disorders, cancer and cardiovascular/circulatory problems. Currently, musculoskeletal/connective tissue disorders account for 22.8% of all new claims filed, followed by cancer (13.7%), injuries & accidents (10%), maternity-related (8.7%), cardiovascular/circulatory (8.5%), mental disorder/psychiatric (6.4%), nervous system-related (5.8%). Other claims made up 24.1% of all new claims filed.

The "Effective Date" of a Life Insurance Policy

blog@www.jpgonzalez-sirgo.com (Blog Author)18732 — Mon, 21 Sep 2009 08:00:00 EST

The "effective date" of your life insurance policy is the official and legal start date of your policy. This is a very important date since benefits can be triggered while an application is in process. In addition, this date also affects the contestability clause and the suicide clause of the policy.

Since a life insurance policy is a contract, the "offer and acceptance" rule applies. With life insurance, offer and acceptance means that both parties have agreed to be bound by the terms and conditions of the contract. During the application process, the offer is started when the applicant mails the application and initial premium to the insurance company. The life insurance company accepts the offer when formal notice is sent to the applicant accepting the applicant's life insurance policy and premium. It is important to note that without the initial premium attached to the application there exist no offer. If no premium is initially sent to the insurer, acceptance occurs when the applicant sends the required premium after receiving notification of application approval from insurer. The effective date is set when the insurer receives the initial premium.

It is recommended that an applicant mail the initial premium along with the application since one's health can deteriorate during the underwriting process and before the policy is issued. If your health changes or the applicant dies during underwriting, the effective date will prove to be very important. The effective date can also be established by the date the policy is actually delivered or received by the applicant. This can include a manual delivery or via email receipt since so many policies are actually purchased online.

While choosing a life insurance carrier, understanding how the insurer establishes the effective date is important especially if faced with health issues or even death during the underwriting process.

Michael Jackson's $17.5 Million Dollar Policy Quickly Settled for $3 Million

blog@www.jpgonzalez-sirgo.com (Blog Author)18733 — Mon, 21 Sep 2009 08:00:00 EST

Michael Jackson's $17.5 Million Dollar Policy Quickly Settled for $3 Million

According to entertainment news website HollyScoop.com, in a rush to cash in on "something" from Michael Jackson's $17.5 million dollar insurance policy, a quick $3 million dollar settlement was reached with Lloyds of London. The insurer provided coverage in the event losses were sustained due to cancellations of any of the 50 planned concerts. However, the policy did not cover any losses due to illegal or illicit taking of drugs. Due to the fact that rumors have been circulating that Michael may have died due to a massive drug overdose, the representatives of Michael's estate decided it would be best to settle for something rather than nothing in case the LA County Coroner's office ruled that indeed Michael's death was caused by a drug overdose.

Now that we all know that Michael's death was the result of lethal levels of "acute propofol," the estate representative's decision to quickly settle the life claim proved correct.

September is National Life Insurance Awareness Month

blog@www.jpgonzalez-sirgo.com (Blog Author)18586 — Fri, 18 Sep 2009 08:00:00 EST

Every September, the nonprofit Life and Health Insurance Foundation for Education (LIFE) holds an industry wide effort to promote the importance of life insurance. Nearly 70 million adult Americans have no life insurance. In addition, those with life insurance do not have the recommended coverage amount.

Life Insurance Awareness Month is a good time to review your current life insurance policy or life insurance needs with your insurance professional. During these tough economic times, Americans are looking for ways to cut expenses, including eliminating their life insurance policy. Instead of eliminating your life insurance policy, a better alternative would be to look for ways to reduce your monthly premiums. You may be able to reduce your premiums if you are healthier, have lost weight, significantly improved your health or stopped smoking. If your life circumstances have changed such as your family no longer relies on your financial support or you paid off your mortgage, you might consider decreasing your life insurance coverage. If you currently have no life insurance policy, you should consult with your life insurance agent now since life insurance rates are at historic rates. Currently, basic term life insurance is 50% less than 10 years ago.

Unum Loses on Long Term Disability Case

blog@www.jpgonzalez-sirgo.com (Blog Author)18394 — Tue, 15 Sep 2009 08:00:00 EST

Last month, a federal judge ruled in favor of an individual in a lawsuit filed against First Unum Life Insurance Company. In doing so, the claimant was granted long term disability insurance benefits retroactively beginning in 1995. In addition, it was discovered that Unum operated under a conflict of interest by not only acting as the claim benefits payer, but also the claims administrator. The claimant in this case was insured through a disability policy purchased by his employer and later under a conversion policy. Initially, Unum denied coverage citing that the policy had terminated and the conversion policy did not apply because the allowable time for filing a claim had expired. Unum unsuccessfully argued this point and in addition argued that the claimant should not be entitled to benefits because the claimant had tried to return to work during this time period. However, the attorneys for the claimant successfully argued that the attempted effort to return to work was involuntary due to his financial situation. The court agreed.

Lack of Ownership Proof Disallows Life Insurance Recovery

blog@www.jpgonzalez-sirgo.com (Blog Author)18395 — Tue, 15 Sep 2009 08:00:00 EST

Business entities, including small businesses, frequently purchase life insurance on key employees and owners. Recently, a court case in Michigan proved how important it is for businesses to keep track of their policies and ownership documentation in order. Unlike individually owned policies, business owned policies are affected through business ownership and shareholder changes, business dissolution, and other factors. In the Michigan case, during the 1970's a small business purchased a life insurance policy for its owner from MetLife Inc. The business was dissolved in 1975. In 2000, Metlife converted from a mutual insurer owned by its policyholders to a publicly traded company. This meant the policyholders were entitled to cash. In this case, it meant nearly $200,000. Since Metlife could not locate the business, the money was given to the State of Michigan. The widow of the small business, now 80 years old, discovered the money was being held by the State of Michigan and filed a claim. Her claim was denied because she could not provide adequate proof that she was indeed the owner of the policy and that the business had been dissolved. The claim was denied despite the widow showing documentation about the family's ownership and status as corporate officers of the dissolved corporation. A Michigan Court of Appeals agreed with the state. However, the court did leave a reason for hope by stating that historic shareholders may be allowed to recover the proceeds. The widow's attorney will continue to fight this case.

This case is a good example of why businesses that are beneficiaries of life insurance policies must keep good control over their life policies. As the case above shows, a business that is dissolved may encounter problems when attempting to claim life insurance proceeds on a key employee or owner.

Life Insurance Rescission

blog@www.jpgonzalez-sirgo.com (Blog Author)18237 — Fri, 11 Sep 2009 08:00:00 EST

Your insurer has rescinded your life insurance policy? Insurance policy rescission is basically a cancellation of your policy and restoring the insured and insurer to their original positions before the policy took effect. Most life insurance policies have a two (2) year window to rescind a policy if the insurer believes the insured misrepresented material information on the application during the underwriting process. Material information is defined to include information that would have affected the life insurance company's decision had they known about it before issuing you the policy. Material information can include prior health and medical information or prior criminal convictions.

Unfortunately, sometimes policyholders die during the two year rescission window and when the beneficiary files the life claim, the insurer investigates deeper only to discover that material information was not disclosed during the underwriting process. At this point, the insurer can rescind the policy leaving the beneficiaries empty handed.

If the policyholder dies and the two year rescission window has expired, the insurer may still choose to undergo an investigative process to determine if material information was not disclosed that would have otherwise cause them not to issue the insured a policy. Even though they legally can't rescind the policy, the insurer can nonetheless choose to breach their contract and simply not pay or delay the payment of the life insurance proceeds. This would require the beneficiary to hire an experienced life insurance lawyer to demand payment or file suit.

The best approach here is to simply take your time properly filling out your life insurance application and revealing any and all material information as requested in the application. Not doing so can cause your beneficiary the misfortune of receiving a rescission notification instead of a much needed check which was your intent when you decided to purchase life insurance......to help your loved ones in the event of your untimely death.

Need To Sell Your Life Insurance Policy?

blog@www.jpgonzalez-sirgo.com (Blog Author)18238 — Fri, 11 Sep 2009 08:00:00 EST

You don't have to die before receiving some cash on your policy. During these trying economic times, continuing to pay premiums on life insurance policies can be difficult. Because of this, some life insurance policy owners are considering selling their policies in the open market in exchange for some much needed cash.

At the forefront of the buying is Wallstreet with their ever resourceful securitization tactic, but only this time it's with life insurance policies. They are essentially buying bundles of life insurance policies, packaging, securitizing and re-selling them to investors worldwide.

Reasons for wanting to sell your life insurance policy include:

Premiums are unaffordable,
Threat of policy cancellation is imminent,
Need cash and have nothing else to sell,
Cash is needed for medical treatment not covered by your health insurance,
Cash is needed to fund long term health care needs,
Other reasons.

Some issues you should be aware of if you sell your policy include:

Your policy will be owned by a stranger who will probably re-sell your policy making it nearly impossible to find out who the owner is,
You may be contacted numerous times until your death by different owners of your policy inquiring about the status of your health,
Since the policy will remain in full force and effect, it may become difficult to purchase new life insurance in the future,
Income implications, especially if you are on government paid programs such as food stamps, Medicaid, housing vouchers and other programs that may cause you to become ineligible,
Tax implications since the funds you obtain will be considered taxable income.

Before accepting the first offer you receive on your life insurance policy, try and obtain at least three (3) bona-fide quotes from reputable companies.

The Law Firm of J.P. Gonzalez-Sirgo, P.A. has the experience, knowledge and skill required to handle your life insurance claim throughout the entire State of Florida. If your life insurance claim has been denied, rejected, delayed or underpaid, we can help. The firm is also available to represent you during the sale of your life insurance policy.

Number One Insured Complaint – Insurer Claim Payments.

blog@www.jpgonzalez-sirgo.com (Blog Author)18239 — Fri, 11 Sep 2009 08:00:00 EST

According to the National Association of Insurance Commissioners (NAIC), the number one complaint logged by state insurance regulators is policyholder's dissatisfaction with their insurance companies' handling of their claim payments. This includes claims delays, claim denials and low ball settlement offers. Disability insurance ranked highest in the type of insurance category, while life insurance ranked in the lowest insurance type category.

Because of this, it's important for those searching to buy any insurance, especially long term disability insurance, to check out the insurance company's complaint record with their state insurance regulator's office. This is especially true if the company you are considering is small or lacks in the reputation arena. In Florida, you can go here to check the complaint history of the insurance company you are considering.

In addition, it is important for policyholders to have a mechanism to file complaints against their insurance company. Filing a complaint against your insurer may result in your state's insurance regulator applying additional pressure to the insurance company regarding your claim. In Florida, if you find yourself in the unfortunate situation where you must file a complaint against your insurer, you can go here.

Dealing with the Case Manager Assigned to your Disability Insurance Claim

blog@www.jpgonzalez-sirgo.com (Blog Author)16801 — Wed, 12 Aug 2009 08:00:00 EST

When you file a long term disability insurance claim, your disability insurance company will assign a "case manager" to your disability claim. The case manger will act as your point of contact for the disability insurance company. Initially, the case manager will be friendly, helpful and seem very nice. Don't be fooled. Case managers are trained to extract information from claimants that will later be used against you when denying your claim. When filing alone, claimants have the tendency to get comfortable with their case manager. The reality is that case managers are trained to find reasons to deny your disability claim, not help you get your disability claim approved. Remember, disability insurance companies are interested in protecting and increasing their profits, not paying out monthly disability insurance benefits.

The best approach to use against case managers is to think carefully before answering their questions. Case managers are trained to carefully question claimants on the merits of their disability application. If you are contacted by the case manager on the spur of the moment and are not prepared to answer questions, be courteous and ask the case manager to contact you at a more appropriate time. Alternatively, you may obtain his or her direct line so you may contact the case manager at a later time when you are better prepared to answer questions.

By following this advice, you will be better positioned to deal with your case manager and avoid hampering your disability claim.

Human Resource Managers Need To Better Understand Group Long Term Disability Plans

blog@www.jpgonzalez-sirgo.com (Blog Author)16803 — Wed, 12 Aug 2009 08:00:00 EST

Human resource managers need to do a better job of selecting a group long term disability insurance plan for their employees. A disability insurance policy can save an employee from financial ruin. Because of the importance of such a policy, human resource managers need to pay special attention to the fine print of the plan, particularly, the policy's definition of disability. The "own occupation" versus "any occupation" definition can determine your employees' ability to collect disability benefits.

Under the "own occupation" definition, an employee may become eligible for disability benefits if the employee becomes unable to perform the specific duties of his or her job at the time of the disability. Under the "any occupation" definition, an employee would have to be unable to perform the material duties of any occupation for which he or she is qualified to perform based on past experience and training. As you can see, this can mean the difference between receiving disability benefits or not. If an employee has an "any occupation" policy, the employee will have to prove that not only can he or she not perform the specific duties of their job at the time of disability, but is also unable to perform the material duties of any occupation that he or she may be reasonably suited for based on experience and training. Obviously, under this policy type the potential for denial of your employees disability claim is greater. The ability of an insurance company to dispute a claim if an employee is able to work in some other job based on experience or training increases compared to the "own occupation' policy.

Some other plan areas to dissect include coverage length and definition of employee compensation for disability benefits calculation purposes.

By making sure you understand the group long term benefits plan you are proposing to your employees you can avoid minimizing disputes and unfulfilled expectations when one of your employees files a disability claim.

Local, State and Federal Employees and their Long Term Disability Claim

blog@www.jpgonzalez-sirgo.com (Blog Author)11881 — Tue, 12 May 2009 08:00:00 EST

City, county, state and federal employees are government employees. Government employees are considered public employees. Public employees enjoy many benefits, including participation in a government sponsored retirement pension plan, but there is one other great benefit you may not be aware of. Your long term disability insurance claim is exempt from the Employee Retirement Income Security Act (ERISA) which governs employee benefit plans. ERISA is an arcane federal law which is complicated and ambiguous and affords less protection to employees than Congress intended when it passed the act in 1974. Under ERISA, the deck is stacked against the employee when filing for long term disability insurance benefits. Therefore, as a public employee your long term disability insurance claim is considered non-ERISA.

As a non-ERISA claim, your claim is treated similarly to that of an individual who went out into the open market and purchased a private long term disability insurance policy. This is important because your legal rights are affected for the better since you are afforded more favorable consumer protection laws. If you should become disabled due to sickness or injury and are unable to perform the material and substantial duties of your occupation, you can file for long term disability benefits. If your claim is denied, you are entitled to bring suit for breach of contract in state court, have a jury trial, bring new and additional evidence into trial, recover attorney's fees, and sue for bad faith and punitive damages.

In essence, the difference between having your claim handled under non-ERISA vs. ERISA provisions can mean the difference between having your long term disability insurance benefits granted or denied. As a public employee in the local, state or federal government, you have this added benefit.

The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective if the policy was purchased individually or issued through an employer group policy. The firm is available to assist individuals with the initial application process, during the administrative appeals process, termination, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out. Please contact our office to discuss your case in more detail.

Representing Professionals with their Denied or Terminated Long Term Disability Claim

blog@www.jpgonzalez-sirgo.com (Blog Author)11882 — Tue, 12 May 2009 08:00:00 EST

Statistics show that nearly 70% of long term disability claims are denied. Studies also show that an individual not represented by an experienced disability attorney is six (6) times more likely to be denied long term disability benefits. The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents professionals in various occupations that have had their long term disability insurance claim benefits denied or abruptly terminated. Common reasons for denial and termination of benefits include, but are not limited to:

Any occupation clause,
Own occupation clause,
Fraud,
Residual disability,
Zero disability,
Disability has abated,
Pre-existing condition,
Many other reasons.

Professionals we can assist include:

Physicians
Dentists
Nurses
Chiropractors
Surgeons
Accountants
Pharmacists
Optometrists
Engineers
Architects
Contractors
Real Estate Developers
Lawyers
Corporate Executives
Business Managers
Banking and Financial Executives
Business Owners
Professors
Teachers
Other Professionals

Total Disability vs. Residual Disability

blog@www.jpgonzalez-sirgo.com (Blog Author)11883 — Tue, 12 May 2009 08:00:00 EST

Total disability is defined in your disability insurance policy. This definition can vary from policy to policy. Three commonly used definitions include own-occupation, modified own-occupation and gainful occupation.

Own-occupation is the most flexible definition of total disability for the insured. If the insured is unable to perform the material and substantial duties of his or her occupation at the time you become disabled, the disability insurance company will pay the claim even if you are working in some other capacity or employment that is not similar to your occupation.

Modified own-occupation is also referred to as income replacement insurance and is the most widely used definition of total disability in policies today. Under this definition, a disability insurance company will pay your claim if you are unable to perform the material and substantial duties of your occupation and you are not working in any other occupation.

Gainful occupation is the most restrictive definition and the most commonly used by employer group long term disability policies. Under this definition, a disability insurance company will pay your claim if you are unable to perform the material and substantial duties of your occupation, or any occupation for which you are deemed reasonably qualified by education, training or experience.

Residual disability is defined in your disability insurance policy. Residual disability is also referred to as partial disability. This definition can vary from policy to policy. Two commonly used definitions include loss of income and loss of time/duties.

Loss of income is when you have suffered a residual disability and can still perform the material and substantial duties of your occupation, but you have suffered a loss of income of at least 20%. The disability insurance company will stop paying your claim when your loss of income is less than 20%.

Loss of time and duties is when you have suffered a residual disability and can still perform the material and substantial duties of your occupation, but you have suffered a loss of time and duties. The disability insurance company will stop paying your claim when you are back to working full-time.

It is important to know and understand how total disability and residual disability are defined in your policy. Before deciding to purchase a long term disability policy, ask how total and residual disability is defined.

When Other Attorneys Tell You "Sorry, Can't Help"

blog@www.jpgonzalez-sirgo.com (Blog Author)11884 — Tue, 12 May 2009 08:00:00 EST

It is not uncommon for an individual whose long term disability benefits have been wrongfully denied, terminated or delayed to attempt to personally resolve the matter on their own. But, when these efforts are exhausted, some simply choose to "give up." Exactly what disability insurance companies want! The remainder may choose to protect their rights and seek legal representation. Exactly what disability insurance companies do not want! But what happens if after calling a few attorneys and explaining your situation, you are told "sorry, can't help." My advice - do not give up.

Disability insurance law is not an area of law many attorneys practice. In addition, disability insurance law is not an area of law an inexperienced attorney can all of a sudden learn overnight. This is due to the fact many long term disability policies were issued through an employer group plan and such policies are governed through ERISA (Employer Retirement Income Security Act), a complicated federal law enacted in 1974. Individual policies are governed by state law, including insurance bad faith laws, which can further complicate matters. Therefore, it is not uncommon for an individual who needs legal representation with their long term disability insurance claim to find attorneys unable or unwilling to help. If you are in a situation whereby other attorneys have told you "sorry, can't help" please do not give up.

Statistics Show That 70% of Long Term Disability Claims Are Denied

blog@www.jpgonzalez-sirgo.com (Blog Author)11885 — Tue, 12 May 2009 08:00:00 EST

In the U.S., obtaining long term social security disability benefits is difficult. In fact, government statistics show that the approval rate is approximately 35%. Obtaining long term disability benefits from a private policy or employer based group plan is just as difficult if not more difficult where an estimated 70% of claims are denied. As a matter of fact, an individual may get their social security disability claim approved, but get denied on their private or employer group plan disability claim.

Common denial reasons include:

Any occupation clause,
Own occupation clause,
Fraud,
Residual disability,
Zero disability,
Pre-existing condition,
Many other reasons.

In addition, if you eventually do obtain long term disability benefits, hanging on to those benefits is a challenge in and of itself. Disability insurance companies routinely terminate, cancel or cut-off disability benefits due to various reasons, sometimes years after approval.

Being Sued by your Disability Insurance Company for Refund of Long Term Disability Benefits?

blog@www.jpgonzalez-sirgo.com (Blog Author)11886 — Tue, 12 May 2009 08:00:00 EST

Long term disability insurance companies have the right to sue policyholders for all disability benefits ever paid out if policyholder fraud or other violations exist. Disability insurance companies will cut-off your benefits and possibly sue for all back payments if their investigations show that you were never really disabled and that you filed a fraudulent application for disability benefits. In addition, if their investigation show you are no longer disabled, they may seek to sue you and recover all payments they have made to you since you became well enough to engage in whatever activity an otherwise disabled person could not possibly do. Examples include working a new job, managing your own business, doing certain household chores, participating in sporting activities, and other activities. Even driving your car, walking your dog and dancing can be construed to mean you are no longer disabled. Disability insurance companies are known to hire private investigators to undertake a thorough investigation and surveillance of policyholders receiving long term disability benefits. This includes secretly visiting your home, videotaping your daily activities, following you, questioning your neighbors, researching if you're currently working or seeking employment, run your own business, or are playing tennis on Saturday afternoons. If you have a MySpace, Twitter or FaceBook account with pictures and comments about your recent ski trip, they will read it and use it against you. Disability insurance companies will use any excuse to cancel your disability payments and sue you to recover all prior payments.

If your disability insurance company has terminated your disability payments and is suing you for a refund of all back disability payments, you should seek experienced legal counsel to help you protect your rights.

When your Long Term Disability Payments are Terminated

blog@www.jpgonzalez-sirgo.com (Blog Author)11887 — Tue, 12 May 2009 08:00:00 EST

Your long term disability benefit was approved years ago. All of a sudden, you receive a letter from your disability insurance company informing you that effective immediately your monthly disability payments have been permanently terminated. Even worse, you are being sued for all past payments ever made to you, along with lost interest, costs and attorney fees. In addition, they have forwarded your case to local police authorities seeking to prosecute you for insurance fraud. Unfortunately, every day in the U.S. disability insurance companies routinely engage in this sort of behavior to some degree.

Disability insurance companies are known to abruptly cut-off monthly disability benefits after conducting surveillance, including secretly videotaping you doing activities a person with your disabilities could not possibly do. These activities could include doing yard work, playing golf or some other sport, dancing, driving, walking without a cane, etc. Other reasons disability insurance companies use to suddenly cancel disability payments include:

Helping your spouse with her business on a part-time basis,
You are working another job,
Posting your resume on the internet in hopes of seeking employment,
Running a home based internet company,
Owning and operating any business,
You're not "totally" disabled anymore,
Your disability is an illness, not an injury, (injury payments are lifetime)
Many other reasons

Disability insurance companies conduct secretive investigations into your current life and look for any reason to terminate or suspend your long term disability benefits. Investigators will "Google" your name on the internet, go through your Facebook page, MySpace page, Twitter page, or any other website or blog page you might maintain. Investigators will also search public records, including corporate records and business and professional licenses you may own. Investigators may also follow you, call you or talk with you in hopes of obtaining information that may be used against you in order to cut-off your disability monthly payments.

Appealing your Denied Long Term Disability Claim under ERISA

blog@www.jpgonzalez-sirgo.com (Blog Author)11835 — Mon, 11 May 2009 08:00:00 EST

The Employee Retirement Income Security Act (ERISA), enacted by Congress in 1974, is a federal law which governs employee benefit plans. Almost all employer group long term disability plans are governed by ERISA.

Statistics show that over 70% of long term disability claims are denied. The hiring of an experienced disability attorney is highly recommended during the appeal stage. When your long term disability claim is denied, you usually have 180 days to appeal from the date you receive the denial letter. You have the right to appeal the denial as per the instructions outlined in your employee benefits plan. The appeal must be in writing and filed with the insurance company. Usually, if your appeal is denied, you may have an opportunity to file a second and final appeal with the insurance company. The appeal process gives you an opportunity to update your medical records. The filing of an ERISA appeal is probably the most important step in the entire claim process. This can be a very difficult task for an inexperienced person to undertake.

As per ERISA, you are required to exhaust all appeals before initiating the filing of a lawsuit. It is very important to know that a federal court may not review any additional material, including witness or physician testimony or prior medical data not previously provided, and will probably be limited to the administrative record at hand. This is why it is important to submit a comprehensive submission of favorable data during the appeal process.

If the filing of a lawsuit is necessary, the suit is brought in federal court with a judge deciding the outcome of the case, not a jury. Typically, the judge reviews the administrative record, memorandums of law, pleadings submitted by lawyers on both sides and issues a summary judgment. In addition, bad faith laws and punitive damages do not apply in ERISA claims.

ERISA and Your Long Term Disability Claim

blog@www.jpgonzalez-sirgo.com (Blog Author)11837 — Mon, 11 May 2009 08:00:00 EST

Total disability is defined in your disability insurance policy. This definition can vary from policy to policy. The most commonly used definition of total disability in employer long term disability group plans is defined under the gainful occupation terminology. Under this definition, a disability insurance company will pay your claim if you are unable to perform the material and substantial duties of your occupation, or any occupation for which you are deemed reasonably qualified by education, training or experience. This means that if due to sickness or injury you are unable to work in your occupation, you must also be unable to work in any other occupation for which you may be able to work, even if it means obtaining a job with another employer. For example, if the material and substantial duties of your job is to load and unload trucks all day and due to sickness or injury you can no longer perform these duties, you still may not be considered totally disabled because you may now be able to work in a more sedentary type job, like a clerical office job.

Please understand that as part of your disability insurance company's evaluation of your claim, you may be placed under secret video surveillance, be requested to undergo an independent medical evaluation or functional capacity evaluation. Your insurance company may not have the right to request such evaluations and if they do, they may administer such tests inconsistent with the group policy and plan.

Statistics show that over 70% of long term disability claims are denied. When your long term disability claim is denied, you usually have 180 days to appeal from the date you receive the denial letter. You have the right to appeal the denial as per the instructions outlined in your employee benefits plan. The appeal must be in writing and filed with the insurance company. Usually, if your appeal is denied, you may have an opportunity to file a second and final appeal with the insurance company. The appeal process gives you an opportunity to update your medical records. The filing of an ERISA appeal is probably the most important step in the entire claim process. This can be a very difficult task for an inexperienced person to undertake. The hiring of an experienced disability attorney is highly recommended during the appeal stage.

As per ERISA, you are required to exhaust all appeals before initiating the filing of a lawsuit seeking to enforce your rights. It is very important to know that a federal court may not review any additional material, including witness statements, physician testimony or any medical data not previously provided to the insurance company and plan administrator. All information may be limited to the administrative record. If the filing of a lawsuit is necessary, the suit is brought in federal court with a judge deciding the outcome of the case, not a jury. Typically, the judge reviews the administrative record, a memorandum of law, pleadings and legal arguments submitted by all lawyers and issues a summary judgment. In addition, bad faith laws and punitive damages do not apply in ERISA claims.

Long Term Disability Claim Application Tips

blog@www.jpgonzalez-sirgo.com (Blog Author)11838 — Mon, 11 May 2009 08:00:00 EST

Obtaining long term disability benefits is not a simple task. Estimates indicate that approximately 70% of disability claims are denied. For those individuals who would like to apply for long term disability benefits without legal representation, below are some tips to follow:

1. Read your entire disability insurance policy, from cover to cover. Understand all clauses, restrictions, limitations, terms and conditions.
2. Know if your disability policy is an individual policy or employer group plan.
3. Organize and gather all medical records, including lab tests, physician reports and opinions supporting your disability claims.
4. Know and understand why your disability prevents you from doing your job or any other job.
5. Promptly file your disability claim. Fill out the disability application completely and truthfully. Add additional sheets if necessary. Follow all insurance company requests.
6. Be prepared to file all supporting evidence initially, not later as an amendment.
7. Know that you may be placed under secret video surveillance.
8. Follow up after applying. Follow up your telephone communications with a written letter. Keep detailed communication records, including person spoken to, date, time, matter discussed, and conclusion of conversation.
9. If your claim is denied, know and understand your appeal rights.
10. Know your insurance company's or employer group plan administrator's deadlines.

Lump Sum Buy-Out of your Long Term Disability Benefits

blog@www.jpgonzalez-sirgo.com (Blog Author)11840 — Mon, 11 May 2009 08:00:00 EST

A lump sum buy-out of your long term disability benefits is when a disability insurance company offers to buy-out your monthly disability benefits in exchange for a one-time lump sum amount. For example, if your 35 and are receiving $1,500 per month until the age of 65, that would equate to $540,000 in total disability benefits paid to you during the 30 year period. What if the disability insurance company were interested in negotiating a buy-out for $100,000? Would you prefer to have $100,000 today, or continue to collect $1,500 per month over the next 30 years? Determining if and how much of a one-time lump sum amount to accept can be a difficult decision.

Your disability insurance company will review and analyze your long term disability policy and other factors to determine the value of your policy. This valuation method is devised to offer you an amount that may not be in your best financial interest to accept. When calculating your buy-out offer, the insurer takes into consideration various factors including:

Mortality tables
Bond rates
Disability abatement probability
Present value calculations

As the policyholder, you may not know and understand if the buy-out proposition is fair and reasonable. You may not know how to take into consideration various factors including:

Future value of lump sum amount
Your realistic life expectancy
Risk of insurer terminating your disability benefits
Solvency of disability insurance company
Freedom from continued insurance company intimidation
Cashing out and seeking other opportunities harassment free

A disability insurance policy buy-out may or may not make sense, and it usually boils down to the buy-out offered by the insurer.

Is it Possible to Collect Long Term Disability Benefits and a Paycheck?

blog@www.jpgonzalez-sirgo.com (Blog Author)11841 — Mon, 11 May 2009 08:00:00 EST

Collecting long term disability benefits while simultaneously working a full time job that affords you the luxury of collecting a paycheck might seem contradictory to the layperson. It might also seem fraudulent to some. The truth of the matter is that it is possible and it is totally legal.

Having the ability to collect both a paycheck and long term disability benefits concurrently will depend on the legal language in your disability policy. Total disability is defined in your disability insurance policy. This definition can vary from policy to policy. Three commonly used definitions include own-occupation, modified own-occupation and gainful occupation. Modified own-occupation and gainful occupation disability policies will usually disallow such a scenario. A disability policy with own-occupation language may not.

Own-occupation is the most flexible definition of total disability for an insured. If the insured is unable to perform the material and substantial duties of his or her occupation at the time of disability, the disability insurance company will pay the claim even if you are working in some other capacity or employment. However, this new or other occupation must not be identical or even similar to the occupation from which you are claiming disability. Moreover, some own-occupation policies are not "genuine" own-occupation policies and may prevent you from collecting a paycheck in addition to your long term disability benefits. Therefore, the disability policy should be read from cover to cover to prevent disability benefits from being terminated.

In essence, under the terms of an own-occupation disability policy, the inability to perform the material and substantial duties of your occupation will entitle you to long term disability benefits, notwithstanding your ability to work in some other occupation.

A classic example is when a physician surgeon is unable to perform the material and substantial duties of the surgical procedures and due to sickness or injury files for long term disability benefits. The claim is approved and the physician surgeon now resorts to physician office work only, such as patient consultations. In this new line of work, the physician might generate $500,000 during the first year, despite drawing $25,000 per month in long term disability benefits. There are countless examples of such scenarios that apply to many occupations.

Difference between a Privately Purchased Disability Policy and an Employer Group Disability Policy

blog@www.jpgonzalez-sirgo.com (Blog Author)11842 — Mon, 11 May 2009 08:00:00 EST

An individual long term disability policy is simply a privately purchased policy. You, and not an employer, made the personal effort of shopping for a long term disability policy. The policy was sold directly to you by either the disability insurance company or through an insurance broker. As part of your disability insurance application process, you might have undergone a medical evaluation, including blood tests, blood pressure, urine samples, etc. Your monthly premium is paid directly by you and is not deducted from your employment paycheck. The policy was not issued through your employer as part of the employer's benefits package. An employer issued disability policy or group policy is simply a policy provided to employees as part of an employer group benefits plan. You are enrolled into the plan automatically and all premiums are paid by your employer or premiums are deducted directly from your employee paycheck. Different variations exist.

The main difference between individually purchased vs. employer issued policies are the specific laws and intricacies that govern the wrongful denial, delay or termination of valid claims. Individual disability policies are governed by state law. Disability employer group policies are governed by ERISA, a federal law enacted 1974.

Individually purchased policies have more favorable consumer laws, including a faster appeals process (if any), bringing suit in state court and suing for bad faith. Trial by jury is allowed. Employer group disability policies have less favorable consumer laws, have a lengthier appeals process, and suit must be brought in federal court with a federal judge deciding the outcome of the case. In addition, trial by jury is not allowed and witness and physician testimony may not be allowed. Furthermore, ERISA is a complicated federal law most attorneys are just not knowledgeable, experienced or skilled at interpreting or handling.

Another very notable and important difference is how disability is defined. With an individual disability policy, one can purchase a policy that provides own-occupation coverage which pays disability benefits even if you are working in another job that was not your own-occupation at the time you became disabled. Most employer group long term disability insurance policies define disability as your inability to obtain any gainful occupation. This means that in order to obtain disability benefits you must not only be unable to perform your own occupation, but also any other occupation for which you are qualified by education, training or experience. This is a much more restrictive and inflexible policy as compared to an individual policy.

Residual or partial disability is treated differently under both plans. Under an individual policy, residual disability may be paid up to age 65. This means that if you are partially disabled, you may still receive disability benefits. Under an employer group plan, residual disability may not be covered at all and some may pay for up to 2 years only. Therefore, if you are partially disabled under an employer group plan, you may not be covered at all in the event you are partially disabled.

Mental and nervous disabilities are treated differently as well. With an individual policy you can purchase a plan that covers mental and nervous disabilities like any other disability and are covered without any time restrictions, including for drug and alcohol addictions. Employer group plans cover mental and nervous disabilities for up to 2 years maximum and usually will cover drug and alcohol addictions for no more than one year.

Covered income is also treated differently. An individual policy will cover your earned income as reported on your federal tax return, which will include bonus, commissions, tips and other profit sharing income. Employer group plans will only cover your base salary, which will not include bonus, commissions, tips and other profit sharing income. Therefore, if you are a company executive and the majority of your earned income is made up of bonus and stock options income, you may be covered for much less than you think.

Even the taxation is treated differently under federal income tax rules. With an individual policy, any disability benefits received are tax free. With an employer group plan that pays your policy premiums, any disability benefits received are taxed as ordinary income. Therefore, if your policy covers up to 60% of your lost income you really earn less when federal tax rates are applied.

Other differences include portability issues, maximum limits on disability payments received and other important factors.

Insurance Bad Faith Claim? We Can Help!

blog@www.jpgonzalez-sirgo.com (Blog Author)10455 — Tue, 31 Mar 2009 08:00:00 EST

Your loved one met his or her responsibility to yourself and your family when he or she purchased life insurance to protect your family in the event of his or her death.

Life insurance serves as financial protection against the unthinkable - it is a safeguard against the losses that are suffered due to a loved one's death. A life insurance plan can make certain that the policyholder's family can continue their lives even in the face of unexpected tragedy and ensure that they have sustained and consistent support even after their loss.

But what if the unthinkable does happen and the insurance company is giving you the run around? An insurance company has a right to perform a reasonable investigation of your claim. But what do you do when the investigation is clearly unreasonable and is being used simply as a method of delaying payment. In the meantime, your bills keep coming in but your loved one's earnings are not. What happens as the weeks go by and your claim goes unpaid? What happens if your claim is outright rejected?

An estimated 10 percent of valid insurance claims are unfairly denied - but less than one percent of policyholders who make claims question the decision that their insurance company makes.

We Are Your Insurance Against the Insurance Companies
As a former claims adjuster, I understand why these situations come about. Insurance companies are in the business of making money. By delaying claims, insurance companies get to hold on to their money a little longer. Money that is invested somewhere earning them money. As far as insurance companies go, the only thing better than delaying a claim is denying a claim.

In simple terms, when your family bought a life insurance policy your insurance company entered into a contract in which they promised to pay out the life insurance benefits in the event of the policyholder's death in consideration for payment of certain premiums. Your family was responsible and sacrificed to make the insurance premiums. Don't let your insurance company get away with taking your money but refusing to follow through with their half of the deal.

Case In Point
A wife was put in a terrible situation when her husband unexpectedly passed away leaving her alone to support their five-year-old son. Shortly after his death, the wife notified the employer and life insurance company about the tragedy, but one and half years later the wife had not yet received one cent from the life insurance company. As a single working mom of a young boy she suffered not only from the death of her husband but from her family's dire financial situation. The insurance company argued that no life insurance policy even existed and artfully dodged the wife's inquiries.

The wife called our office and enlisted our help. Shortly after we became involved, we were able to prove that an insurance policy did indeed exist and we persuaded the insurance company to set aside many of the issues that they were claiming existed. Thereafter, the insurance company took the position that although a policy existed, the face amount of the policy was only $10,000.00. We proved that the husband had elected to purchase a supplemental policy for an additional $100,000.00. The case was resolved for $110,000.00. A guardianship was established for the minor that will pay for the son's education.

Insurance claims lawyer J.P Gonzalez-Sirgo has nearly 15 years experience and along with an experienced staff we hold insurance companies to their word. We do exactly what insurance companies fear: We Hold Them to Their Promises.

We routinely represent individuals and life insurance beneficiaries who have lost their loved one and now are facing a life insurance claim denial or unexplained delays in the rightful processing of their life insurance claim.

Life Insurance Claim Been Denied? We Can Help!

blog@www.jpgonzalez-sirgo.com (Blog Author)10459 — Tue, 31 Mar 2009 08:00:00 EST

Your loved one met his or her responsibility to yourself and your family when he or she purchased life insurance to protect your family in the event of his or her death.

An estimated 10 percent of valid insurance claims are unfairly denied - but less than one percent of policyholders who make claims question the decision that their insurance company makes.

Federal ERISA Law Shields Third Party Administrators and Providers

blog@www.jpgonzalez-sirgo.com (Blog Author)10004 — Mon, 16 Mar 2009 08:00:00 EST

According to Sandy Praeger, former president of the National Association of Insurance Commissioners, third party insurance providers have little legal incentive to care. Companies and their third party insurance administrators are immune from punitive damages in insurance related lawsuits. The federal Employment Retirement Income Security Act (ERISA) touted as the next big legislation for employees since the Social Security Act, has blindsided employees and helped companies and insurance companies get away with delaying, denying and underpaying valid insurance claims.

As in the story Good Morning America recently aired about a 7-Eleven employee who died of colon cancer and whose children later had their mother's life insurance claim denied.

The family eventually hired a lawyer and obtained approval for their mother's life insurance claim.

To read a little more on this topic, please click here.

Long Term Disability Approval, Not an Easy Task

blog@www.jpgonzalez-sirgo.com (Blog Author)10006 — Mon, 16 Mar 2009 08:00:00 EST

Ask Mr. Tucker about his ordeal with trying to obtain approval for long term disability insurance, and his response is "hellish." Mr. Tucker, who is an accountant, supports his wife, two daughters and a baby grandson and recently began developing multiple sclerosis. Unable to do his work, he filed for long term disability insurance benefits through his insurer, Standard Insurance Company. Eleven doctors confirmed in Mr. Tucker's medical reports that he indeed did have MS.

After submitting all his medical reports and application package to the insurance company, all he could do was wait as his insurer mailed Mr. Tucker notices requesting additional information. After months of waiting, he hired a lawyer to represent him in this matter. Good Morning America also decided to air his case on national TV.

After his lawyer obtained copies of his file from the insurer, a letter from their "in house" physician stated that Mr. Tucker could in fact continue to work in a sedentary job and that his medical reports did not support the diagnosis of MS. Mr. Tucker and his attorney were shocked considering the fact that this "in house" doctor had never seen Mr. Tucker and that his opinion went against the opinions of 11 other doctors that did confirm MS.

The claim was eventually approved the day after GMA contacted the insurer about Mr. Tucker's pending claim.

Disability and health insurance carriers hire "in house" doctors to review claims in search of ways to delay and deny valid claims. In the meantime, the insured's struggle to survive in the absence of the paid for and promised benefits.

To read a little more on this topic, please click here.

Tricks of the Trade - How Insurance Companies Delay, Deny, Confuse and Refuse.

blog@www.jpgonzalez-sirgo.com (Blog Author)8445 — Mon, 26 Jan 2009 08:00:00 EST

A very interesting article was updated today to our Library Section written by the American Association of Justice related to insurance companies' claims handling systems. The article, titled “Tricks of the Trade – How Insurance Companies Delay, Deny, Confuse and Refuse.” gives you a glimpse of some of the tactics insurance companies employ to deny your valid claims. Read it.

The article also reflects this law firm’s view on this matter and it also reflects what we preach throughout this website.

Our Website is Nominated at BestLawFirmSites.com

blog@www.jpgonzalez-sirgo.com (Blog Author)8377 — Fri, 23 Jan 2009 08:00:00 EST

Our website has been nominated to BestLawFirmSites.com in the category of best law firm website. Our website was designed by Foster Web Marketing (888-886-0939).

We work very hard at maintaining our website. If you would like to nominate our website too, please follow the link below and complete the information requested.

http://bestlawfirmsites.com/nominate-your-website

Your nomination would be very much appreciated.

Man drowns after canoe flips over

blog@www.jpgonzalez-sirgo.com (Blog Author)5594 — Mon, 17 Nov 2008 08:00:00 EST

A man drowned off Mowery Point in Biscayne National Park in Miami, FL after the canoe he was on flipped over. On September 21, 2008 Air Rescue was dispatched to search for the missing swimmer. The man was found shortly thereafter and airlifted to a local hospital where he was pronounced dead. None of the men had been wearing life vests. Please click here to read more on filing a life insurance claim.

J.P. wants to remind everyone that life vests save lives. Please ensure to have a life jacket for every passenger on board. Remember, it’s the law!

Why Your Disability Claim Could Have Been Denied

mindywein@cox.net (Blog Author)4557 — Mon, 17 Nov 2008 08:00:00 EST

It is not uncommon for long-term disability insurance claims to be denied. If you have applied for benefits and were turned down by the insurance company, you need to find out the reasons for the disability claim denial. Often, these denials can be challenged.

Long-term disability insurance is generally offered through an employer and provides benefits for an employee who meets the definition of disability in the policy. The benefits are meant to offer assistance for the injured worker and the compensation can continue for many years. For this reason, insurance companies closely scrutinize these claims.

Denials of long-term disability insurance can be caused by many factors. If there was a pre-existing condition, which led to the disability or injury, the insurance company may not provide benefits. A lack of objective medical findings could prevent the injured worker from qualifying. Insurance companies want to see, what they deem, concrete evidence that there is an ailment, such as x-rays, blood tests or MRI reports. Insurers usually will not base the proof of the illness on self-reported symptoms, which may include complaints about headaches or fatigue. Since these symptoms are difficult to document, the insurance company will frequently deny the disability claim.

Other common reasons for disability insurance denials include the claims reviewer’s belief that you can still perform your job and/or you were not under the regular care of a physician. If an insurer feels that you are not receiving proper treatment for your injury or illness, you may not be approved for benefits.

If you feel that the denial was not warranted, you have the option to challenge the decision. An experienced disability insurance claims attorney can help you with your dispute. Contact J.P. Gonzalez-Sirgo, P.A. for advice regarding your case.

For more information about disability insurance denials, read the informative article, “Common Reasons for Long-Term Disability Insurance Denials.”

Filing a Life Insurance Claim in Florida

mindywein@cox.net (Blog Author)4900 — Mon, 17 Nov 2008 08:00:00 EST

Following the death of a loved one, the last thing you want to deal with is the life insurance company. However, a life insurance settlement can provide the necessary money to cover funeral costs, medical expenses and can act as an income supplement for you and your family. It is important to understand what is involved in filing a life insurance claim, so that you can avoid a delay in the process and denial of your life insurance claim.

You should review the details of the policy to become familiar with the benefits. If you cannot locate the policy, contact the life insurance agent or company. Not only will they be able to explain the benefits under the policy, but you will also be able to receive information on how to file the life insurance claim.

There will be forms that you will need to complete. Each adult beneficiary is generally required to fill out a proof of death form. Other supporting documents will be required by the life insurance company, such as a certified copy of the death certificate and often a certified copy of the marriage certificate, if applicable. A funeral director can provide the death certificate. Once all of the forms are completed and the necessary paperwork is gathered, you will need to submit everything to the life insurance company.

It does not take long for the life insurance company to review the claim. If some documents are missing, then it could cause a delay in the processing of the life insurance claim. Occasionally, a life insurance company will deny a claim based on fraud or material misrepresentation. In that situation, you need to contact a Florida life insurance claims attorney, such as J.P. Gonzalez-Sirgo, immediately. He can help you if you have been denied a life insurance settlement or if you are in dispute with the life insurance company.

The article, Top 4 Things You Need to Do to File a Life Insurance Claim, has additional helpful information regarding filing a life insurance claim.

Can't Find a Missing Life Insurance Policy?

mindywein@cox.net (Blog Author)5439 — Mon, 17 Nov 2008 08:00:00 EST

When a loved one passes away, the last thing you want to spend your time doing is looking for the life insurance policy. It is not uncommon for the surviving family members to be unaware of the details regarding the life insurance policy, including the company who issued it. However, it is worth the effort to try to locate the missing life insurance policy, as the settlement can help pay funeral expenses, medical bills and household expenses.

Before you start your search, you should consider what company may have sold the policy. For example, is there a particular insurance agent you work with for your insurance needs? Is it possible that this insurance agent also sold the policy to your loved one? Employers, trade associations and unions also frequently offer life insurance to their members, so you should also check with these resources.

If you are still not sure what company issued the policy, you may want to look through your loved one’s file cabinets, storage boxes and bank deposit boxes, if applicable. An address book may even be helpful as it could list the name of an insurance agency. You might consider calling professionals you have worked with in the past, such as accountants, attorneys, insurance agents and financial advisors.

While there is no central database to locate life insurance policies, you can employ a private service to help you find the policy information. These companies will search for lost insurance policies for a fee.

Another great source is the National Association of Insurance Commissioners, which can provide you with contact information for state insurance personnel who can help identify possible insurers that may have issued the policy. Florida’s Bureau of Unclaimed Property is also worth looking into. If the life insurance company is aware of your loved one’s death, but can’t locate the beneficiaries, then it has to give the death benefit to the state.

The article, Locating a Lost Life Insurance Policy, has more information and strategies regarding finding missing policies. If you find the policy and your life insurance claim is denied, contact J.P. Gonzalez-Sirgo, a Florida life insurance claims attorney, at 866-71-CLAIM for legal advice.

No Insurable Interest Can Make a Life Insurance Policy Void

mindywein@cox.net (Blog Author)5779 — Mon, 17 Nov 2008 08:00:00 EST

Have you ever wondered what would stop a complete stranger from purchasing a life insurance on your life and causing your death? Courts and state lawmakers anticipated this potential problem and created an insurable interest requirement for life insurance policies.

Insurable interest exists when the purchaser of the policy will receive a greater benefit from the insured being alive, whether emotionally or financially. Without insurable interest, a life insurance policy is considered void from the beginning. Policies without insurable interest are also considered against public policy, as they increase the risk of murder for profit. Even though insurable interest is mandatory at the time of application, it does not have to exist at the time of the insured’s death.

Courts and state laws have created certain criteria that must be met when determining insurable interest. If you purchase your own life insurance policy, insurable interest automatically exists. Insurable interest can also be created when the purchaser has a strong relationship with the insured. For example, the relationship can be based on blood, marriage or money. Spouses are considered to have insurable interest and generally so are parents, children, grandparents, grandchildren and siblings. Depending on the state, some engaged couples are also considered to have insurable interest.

Insurable interest can also be established through monetary interests. An example would be a purchaser who insures his or her business partner. The partnership could stand to lose money if the insured passed away. Creditors are also able to have insurable interest. A creditor can purchase a life insurance policy on a debtor, with the debtor’s permission, up to the amount owed on the debt. Examples include mortgage and credit insurance.

Life insurance companies bear the liability of determining insurable interest at the time of application. If the life insurance company fails to meet this requirement, the insurer could be sued.

The article, Insurable Interest and Life Insurance Policies, has more information on this topic.

What is the Difference Between Short-Term and Long-Term Disability Insurance?

mindywein@cox.net (Blog Author)6001 — Mon, 17 Nov 2008 08:00:00 EST

Something as simple as a minor illness or injury can keep you from returning to work for several weeks, which can ultimately cause a drop in income. Disability insurance was created to provide income when you are not able to receive paychecks because of a disability. There are two forms of disability insurance – short-term and long-term. If you have been injured or become ill, you need to know the difference between these two types of disability insurance programs.

Short-term disability insurance is the most utilized and is usually offered through a group policy. Generally, you can start to receive short-term disability benefits immediately after an injury. If you are not able to work because of an illness, it may take a week or so before the benefits begin. The reason it takes longer to receive short-term disability benefits for an illness is because the insurer doesn’t want to get in the habit of paying benefits every time someone gets sick. The insurer wants to make sure that it is an illness that will keep you away from work for a while. Short-term disability insurance is available as a 3-month to 2-year benefit period.

Long-term disability insurance can be a little more complicated, because of the length of time in which you will receive benefits. It can be purchased with a 2, 5, 10-year or longer benefit period. The approval process for long-term disability benefits can take up to 6 months, but the typical waiting time is 90 days. Permanent disabilities or conditions that are not expected to recover, usually qualify for long-term disability benefits.

The majority of disability insurance policies require that you are disabled for a certain length of time before you are eligible to receive benefits. The benefits that you will receive will be a percentage of your average salary.

Sometimes disability insurance applications are denied. If you have been denied disability insurance benefits, contact J.P. Gonzalez-Sirgo at 866-71-CLAIM for legal advice.

The article, Short-Term vs. Long-Term Disability Insurance, has more information on this subject.

Disputing a Long-Term Disability Insurance Denial for Individual Policies

mindywein@cox.net (Blog Author)6196 — Mon, 17 Nov 2008 08:00:00 EST

You may have a legitimate injury or illness that prohibits you from working. However, when you file your claim for long-term disability insurance benefits, you may be denied. Long-term disability insurance providers sometimes deny disability claims because of bad faith tactics or some other reason. It is possible to dispute a long-term disability insurance denial and most insurers have an established appeals process.

It is important to note that the appeals process for long-term disability insurance varies depending on whether or not the policy is governed by the Employee Retirement Income Security Act of 1974. Many individual long-term disability insurance policies do not fall under this law. If that is the case, you may be able to move forward with your dispute, without having to exhaust all of your administrative remedies.

Individual long-term disability insurance policies are regulated by statutory and common law of the state in which it is issued. Most policies have a set appeals process for disputing long-term disability claim denials. You will need to abide by the established process, because when you signed the contract for insurance, you agreed to the terms and conditions, including the appeals process.

The insurer may not be cooperative in working with you and providing you with the exact reason for denial, in writing. The process of disputing a long-term disability insurance denial can be complicated and you may want to contact an experienced Florida long-term disability insurance claims attorney who can step in on your behalf. Lawyers specializing in this area of law know how to approach a dispute and can even file a lawsuit if necessary. J.P. Gonzalez-Sirgo is a knowledgeable disability insurance claims attorney who can help you with your case. Call 305-461-1095 in Miami Dade County or toll free at 1-866-71-CLAIM for a legal consultation.

The article, Appeals Process for Individual Long-Term Disability Insurance, has more information on this topic.

Life Insurance Companies May Owe More Than $1 Billion

blog@www.jpgonzalez-sirgo.com (News Author)23526 — Wed, 01 Jun 2011 08:00:00 EST

According to Bloomberg News, life insurance companies could be keeping over $1 billion in unclaimed life insurance benefits owed to policyholders, beneficiaries or states.

Florida Insurance Commissioner Kevin McCarty, who provided the estimate, said it was a "conservative number," in a meeting with reporters during a break in a recent hearing in Tallahassee.

"We want to ensure that insurance companies use as much effort to find and pay benefits as they do to find and collect premiums," McCarty added.

One of the questions is whether life insurance companies use Social Security Administration death records to identify life insurance policyholders who have died in the same way that they use these records to stop annuity payments.

Officials from MetLife and Nationwide Mutual Insurance Co. were subpoenaed to appear at a hearing by the Florida Office of Insurance Regulation to explain how they determine when policyholders have died. John Hancock, a unit of Toronto-based Manulife Financial Corp., settled with Florida over similar issues.

Florida Families Facing Health Insurance Premium Increases

blog@www.jpgonzalez-sirgo.com (News Author)13670 — Fri, 26 Mar 2010 08:00:00 EST

A recent study shows that Florida families, especially those in the middle-class, are feeling the brunt of health insurance premium increases. Between 2000 and 2008, families saw their insurance premiums go up as much as 89 percent.

According to the Robert Wood Johnson Foundation, the average Florida family paid on average of $2,323 for their employer-sponsored health plan. That number grew to $4,412 in 2008.

For those Floridians who are single middle-class earners, their premiums increased by as much as 78 percent. The average premium cost was $597 in 2000 and jumped to $1065 eight years later.

Unfortunately, many employees are seeing their employers put more of the financial burden on them to help save costs for companies. Some employers have stopped paying for insurance health plans altogether. Studies have shown that more middle-class earners are becoming uninsured.

"The fallout from rising health insurance costs hits everyone," said the Robert Wood Johnson president and CEO, Risa Lavizzo-Mourey. "Employers must choose between either passing on costs to workers who cannot afford the increases and therefore drop coverage or paying more for their employees' coverage at the cost of creating and preserving jobs."

Deltona House Fire Investigated

blog@www.jpgonzalez-sirgo.com (News Author)13584 — Mon, 22 Mar 2010 08:00:00 EST

A Deltona house fire occurred at approximately 6:15 PM on Monday evening, March 8, 2010. The Deltona Fire Department's Fire Loss Management Division and the State Fire Marshall's Office are now investigating the cause.

Firefighters from the City of Deltona arrived at 2121 Arrowhead Drive in Deltona to find the house engulfed in flames. These flames could be seen coming through the roof and were also visible inside the house.

According to off-duty Deltona Fire Department Paramedic/Engineer Bryan Maples, who arrived on the scene first, there were two people inside the house at the time of the fire. Fortunately, they were able to escape the inferno. However, Maples was required to treat one of the victims at the scene. The victim was transported to Florida Hospital Fish Memorial, but was later released.

Sixteen firefighters, three engines and a rescue truck were used to battle the flames. It took approximately 40 minutes to bring the house fire under control.

The house was estimated to be approximately 1,800 square feet and the fire was blamed for about $150,000 in damage to personal items.

The cause of the Deltona house fire is unknown and remains under investigation.

House fires can be serious and lead to major issues for victims involved. We are thankful that no one was seriously injured.

Florida Residential Fire Sprinkler Requirement May Be Dropped

blog@www.jpgonzalez-sirgo.com (News Author)13583 — Mon, 22 Mar 2010 08:00:00 EST

Florida lawmakers are looking to do away with an attempt to adopt a national code provision that would require residential fire sprinklers to be installed in newly constructed homes, including town homes. However, many feel this is a mistake.

The Florida Building Commission is looking to adopt a national code provision contained in the 2009 International Residential Code that will require automatic fire sprinklers to be installed in many newly constructed residential properties. However, the Florida House is looking to eliminate the proposed requirements.

"Fire sprinklers are a proven, cost-effective way to protect life and property," Julie Rochman, IBHS president and CEO, said. "Eliminating the building code requirement to install fire sprinklers in new homes is a serious and potentially very harmful decision that could place the lives of many Florida families and firefighters in grave danger."

Though the safety benefits to having residential fire sprinklers installed are not generally in dispute, there are other concerns that may have prompted the Florida House's decision to try and abolish the requirement. There are concerns over the costs associated with fire sprinkler installation, as well as potential maintenance issues and possible losses caused by improper activation of sprinkler systems.

It is unclear when the Florida House will make its final decision as to whether it will prohibit the requirement of the installation of residential fire sprinklers. Until then, the debate continues.

Punta Gorda Police Arrest Two in Stolen Boat Motor Parts Robbery

blog@www.jpgonzalez-sirgo.com (News Author)13426 — Tue, 16 Mar 2010 08:00:00 EST

The Punta Gorda police have arrested and charged two men in the theft of boat motor parts. The Florida incident took place on Friday, February 19, 2010, at Flagship Marine.

According to detectives, the two men were arrested and charged the following Monday in connection with the robbery of the high-performance boat motor parts estimated to be worth at least $230,000. The suspects have been identified as Paul Deleon Jr., 25, and Stephen R. Collins, 31, both of Port Charlotte.

An arrest report indicates that the suspects left a series of tracks at the crime scene that eventually led police to a storage facility near Flagship Marine. That is where police discovered the stolen boat motor parts. The report also reveals that Collins was the lessee of the storage facility.

Detectives have also indicated that the video surveillance system at a local recycling center show the two suspects bringing in bins containing some of the stolen motor parts to be sold as scrap aluminum.

Police have arrested the two men and charged them with grand theft, burglary and dealing in stolen property. Deleon was recently released form a Florida Department of Corrections facility for a previous crime. He was released in January.

What Happens to Stolen Cars in Florida?

blog@www.jpgonzalez-sirgo.com (News Author)13357 — Thu, 11 Mar 2010 08:00:00 EST

Have you ever considered what happens to a car after it becomes stolen in Florida? Numerous communities across the nation are battling all types of crime issues such as drugs, gangs and violent attacks. However, a major concern for Floridians is auto theft.

Many people across Florida become victims of auto theft whether it's a sedan, sport utility vehicle, pickup truck or motorcycle that has been stolen. So, where do these stolen cars go?

According to many experts, a good portion of these cars end up in Mexico or Latin America, where they are resold or dismantled for parts. There appears to be a huge resale market and criminals are profiting from American car owners.

A recent search discovered that over 3,000 cars stolen from certain U.S. cities, including Miami, were found in Guatemala. As a result, many Latin American police attended the fourth annual Transborder Conference to discuss ways to deal with this epidemic. The conference explored ways to use technology to battle auto theft.

General Motors sent an OnStar delegate to provide police with a demonstration of the "Stolen Vehicle Slow Down" service. Through the use of this service, police have the means to stop a stolen car that may be as much as 2000 miles away.

LoJack Corp Release Auto Theft Report

blog@www.jpgonzalez-sirgo.com (News Author)13045 — Wed, 24 Feb 2010 08:00:00 EST

LoJack Corporation has released its first Auto Theft Recover Report. The report was released Saturday, February 20, 2010, and highlights vehicle recoveries for LoJack in 2009.

Though there has been a decline in the number of vehicles being stolen, auto theft still remains a major issue. LoJack's Auto Theft Recover Report may provide important information concerning auto thefts across the state of Florida, as well as the country.

The statistics are staggering. It was reported that 956,846 vehicles were stolen in 2009. Of those stolen vehicles, only 545,402 were recovered, resulting in approximately 6.4 billion dollars in lost assets.

However, LoJack reports that 90 percent of vehicles equipped with their devices were successfully recovered. They stated that 11,382 vehicles utilizing their equipment were recovered in 2009. They valued these recoveries at approximately 133 million dollars.

"Our recovery report reveals some very interesting statistics that highlight the value LoJack's Stolen Vehicle Recovery System brings to vehicle owners," said Patrick Clancy, of LoJack Corporation. "First of all, our recovery rate greatly surpasses the overall national recovery rate, which has been dropping for the past several years."

The Auto Theft Recover Report showed that Hondas had the highest recovery rate for foreign vehicles and GM for domestic vehicles. California and Texas topped the list for states with the highest recovery rate.

If you are dealing with a stolen vehicle insurance claim in Florida, contact our office today (305)-461-1095 or Toll Free at 1-(866)-71-CLAIM for legal advice.

Florida Lawmakers Dealing With Insurance Mess

blog@www.jpgonzalez-sirgo.com (News Author)13043 — Wed, 24 Feb 2010 08:00:00 EST

A recent decision by State Farm to discontinue serving residential insurance policies in Florida has left state lawmakers with an insurance mess. Floridians are finding themselves at the mercy of other insurance companies who may be taking advantage of new customers.

Randi Schuknecht, a Tallahassee elementary school teacher found that his new policy issued by another company would cost him approximately $400 more annually than his previous policy with the insurance giant.

Florida lawmakers are schedule to convene on March 2, 2010, and plan to tackle the insurance mess left behind by State Farm. The goal is to figure out a way to make sure that insurance companies remain profitable while offering customers affordable insurance, especially in light of the upcoming hurricane season.

The fear for lawmakers is that if insurance companies are unable to payout then the state could be on the hook for billions of dollars. A few solutions have been brought forth by lawmakers.

"We have a long way to go," said Senate President Jeff Atwater, R-North Palm Beach. "How we get there, I don't know."

Some of the proposals that have been brought forth leave premium rates up to the discretion of the insurance companies. This could mean significant rate hikes for policyholders.

"It's time, we're going to have to come to grips with the reality we're going to pay rates equal to the risk," said Rep. Bill Proctor, R-St. Augustine.

Florida State Farm Policyholders to Receive Bad News

blog@www.jpgonzalez-sirgo.com (News Author)13040 — Wed, 24 Feb 2010 08:00:00 EST

Some Florida State Farm policyholders are about to get bad news as the insurance giant begins to send out notices as of February 1, 2010 that their polices will not be renewed. A portion of the estimated 810,000 residential policyholders is expected to be affected by this corporate decision.

According to State Farm spokesperson Chris Neal, policies with an August 1st renewal date are the first to be affected. The decision could affect approximately 125,000 policy holders. This decision stems from an agreement reached between State Farm and the state Office of Insurance Regulation.

State Farm has notified the state Office of Insurance Regulation in writing that it plans to discontinue doing business in Florida and that it intends to be insolvent by the end of 2011. The bad news for policyholders, besides the fact that their policy may be canceled, is that State Farm has the authority to issue rate increases by as much as 14.8% for homeowners and condominium unit polices.

However, there is some good news. The insurance company is permitting agents to place affected policies with other insurance companies not affiliated with State Farm.

If you or someone you know currently has a residential insurance policy with State Farm, you should contact your insurance agent to determine if your policy is going to be affected.

Our law firm can help you if you are facing a Florida homeowner's insurance dispute. Contact our office today for more information.

Three People Escape Injury in Lake Worth House Fire

blog@www.jpgonzalez-sirgo.com (News Author)12833 — Mon, 15 Feb 2010 08:00:00 EST

Three people escaped injury after a Lake Worth house fire ignited. Officials from the Greater Palm Beach Area Chapter of the American Red Cross have credited their safety to a Golden Retriever named Bubba.

The fire started in the house just before midnight on Monday, February 8, 2010, along the 200 North block of J Street in Lake Worth. The Red Cross reported that the 7-year-old dog started barking repeatedly and woke up his owner in the house. Even though the occupants in the home were not able to put the fire out, they were able to escape to safety, along with the Golden Retriever.

The house was severely damaged in the Lake Worth fire. The cause of the fire is still being investigated. One of the residents in the home said that there is a chance that another pet, a cat, may have knocked over a candle.

The Red Cross gave the residents clothing, food, cleaning materials, comfort kits and three days of housing.

House fires are extremely destructive and can lead to major loss. Every year, insurance companies pay hundreds of millions of dollars to cover fire insurance claims. However, insurance companies wrongfully handle many of these claims.

If you are having difficulty collecting on your Florida fire insurance claim, we can help. Contact a Miami fire insurance lawyer at our office today at (305) 461-1095 or toll free at 1-(866)-71-CLAIM for more information.

Stolen Car Hits Police Car in Gulfport, Florida - Insurance Lawyer

blog@www.jpgonzalez-sirgo.com (News Author)12641 — Thu, 04 Feb 2010 08:00:00 EST

A stolen car incident in Gulfport ends with a police officer suffering slight injuries after the stolen vehicle slams into the police vehicle.

According to Gulfport police, the incident started after police spotted a reported Toyota Avalon. Sgt. Mary Farrand, who was driving a police Ford Expedition, pulled her vehicle into position behind the stolen vehicle. While she was communicating to other officers via radio, the suspect put the stolen car in reverse, pressed the accelerator pedal and slammed into the police car twice. That is when the driver of the stolen car took off and fled the scene.

Rescue crews transported Farrand to a local hospital where she was treated for minor injuries sustained in the accident.

According to the police, there were no other officers in the area at the time of the incident; therefore, there was no pursuit. The stolen car was last reported being seen eastbound on Central Avenue from 58^th Street.

The stolen car had a Florida license plate. The plate number is L4606EM.

Unfortunately, stolen car incidents happen frequently in Florida. In fact, Florida ranks third in the country for stolen vehicles. If you are dealing with a stolen vehicle insurance claim and need assistance, contact a Florida stolen car insurance lawyer at the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or toll free at 1-(866)-71-CLAIM.

The Wall Street Journal Provides Insight Into Disability Insurance

blog@www.jpgonzalez-sirgo.com (News Author)12507 — Fri, 29 Jan 2010 08:00:00 EST

As companies are cutting back, fewer employees are offered disability insurance as part of their "job perks," which is true for government and non-government jobs. It is now up to workers to purchase their own disability insurance coverage that will provide much-needed income benefits, if they find themselves with a medical condition that prevents them from working.

There is no question that purchasing disability insurance can be a confusing process and it is hard to understand what exactly is covered. The Wall Street Journal has reported that policies sometimes, "include conditions that make it tough for people filing claims to actually qualify for benefits." Some policies restrict the types of illnesses that are covered.

According to the article, "Just in Case: The Skinny on Buying Disability Insurance," posted on WSJ.com, as a consumer, you need to understand what benefits you are currently able to access and think about purchasing additional coverage to fill in the gaps. For example, do some research so that you know what the government provides, then determine if your employer has anything to offer in terms of disability insurance.

If you make the decision to buy disability insurance coverage, you need to figure out your anticipated expenses, if you were to become disabled. Knowing the amount of coverage you need, will help you plan.

Carpal Tunnel Syndrome & Migraines Could be Signs of Celiac Disease

blog@www.jpgonzalez-sirgo.com (News Author)12506 — Fri, 29 Jan 2010 08:00:00 EST

A study of 72 patients showed that migraines and carpal tunnel syndrome could be indicators of celiac disease, which is a medical condition defined by MayoClinic.com as, "a digestive condition triggered by consumption of the protein gluten."

Researchers screened a group of patients who had biopsy-proven celiac disease. The patients joined the study after hearing about it through advertisements. During the study, researchers used a standard questionnaire to interview the participants.

According to the research findings, close to one in three celiac patients had a history of migraine headaches and approximately 20 percent suffered from carpal tunnel syndrome. Researchers were surprised to find that epilepsy was not as common as they had expected, as only 4 individuals had a history of generalized or focal seizures.

During the study, researchers also learned that people with celiac disease were prone to depression, personality changes and psychosis. Thirty-five percent of the patients involved in the study reported a history of these mental conditions.

If you are suffering from a medical condition that is keeping you from working, you may be entitled to disability insurance benefits. For more information or assistance with filing your disability claim, contact a Miami disability lawyer at the law firm of J.P. Gonzalez-Sirgo at 305-461-1095 or toll free at 866-71-CLAIM for more information.

Study Conducted Examining Additional Treatment of Chronic Hepatitis C

blog@www.jpgonzalez-sirgo.com (News Author)12505 — Fri, 29 Jan 2010 08:00:00 EST

There is no question that chronic hepatitis C virus (HCV) can significantly impact a patient's life. Hepatitis C is believed to be the most serious of all the hepatitis viruses. It attacks the liver and causes inflammation. The American Family Physician journal has referred to this virus as, the most common chronic blood-borne infection in the United States."

Researchers in Italy recently looked into a revised treatment option for HCV. Currently, chronic hepatitis C is treated with pegylated-interferon (PEG-IFN) and ribavirin, which has proved to be effective in about 50 to 60 percent of HCV cases. During the study, the Italian research team assessed the safety of including ketoprofen, a non-steroidal anti-inflammatory drug, with the pegylated-interferon. Researchers observed the impact this revision had on patients.

According to the study's findings, which were published in the December 21, 2009 issue of the World Journal of Gastroenterology, the addition of the non-steroidal anti-inflammatory drug did produce good results. The authors of the study have suggested that a larger study be done to continue to review the effectiveness of this three-drug combination.

If you have been diagnosed with chronic hepatitis C virus, you may be entitled to disability insurance benefits. Contact a Miami disability attorney at the law firm of J.P. Gonzalez-Sirgo at 305-461-1095 or toll free at 866-71-CLAIM for more information.

Reduced Salt Intake Can Lower Risks Associated with High Blood Pressur

blog@www.jpgonzalez-sirgo.com (News Author)12504 — Fri, 29 Jan 2010 08:00:00 EST

Most of us already know that cholesterol and trans fat are not good for the diet and can lead to health problems, but now there is something else to be concerned about - your salt intake. According to a study conducted by the University of California, San Francisco (UCSF), Stanford University and Columbia University, even a modest reduction in daily salt consumption can result in tremendous health benefits.

The authors of this recent health study noted an annual drop of nearly 120,000 heart disease cases, 66,000 stroke cases and 99,000 heart attacks, all caused by high blood pressure. This drop was the result of reducing sodium by 3 grams per day.

Lead author, Dr. Kirsten, stated that, "everyone in the U.S. is consuming salt far in excess of what is good for them. What we are suggesting is that a population-wide effort to reduce salt intake even slightly will have health benefits."

The research team used computers to analyze the impact of reducing sodium by 3 grams per day had on instances of heart disease and death. They learned that by cutting back on sodium, the benefits were as good as reducing tobacco use by half, lowering one's body mass index by 5 percent or taking medication to lower cholesterol.

Researchers also looked into the cost savings from the amount of disease that would be prevented due to lower blood pressure. They found that by reducing salt intake, the United States could save anywhere from $10 billion to $24 billion every year in health care expenses.

If you have been diagnosed with high blood pressure, you may be entitled to disability insurance benefits. Contact a Miami disability attorney at the law firm of J.P. Gonzalez-Sirgo at 305-461-1095 or toll free at 866-71-CLAIM for more information.

Wrongful Death Case Settles for $2.5 Million Dollars

blog@www.jpgonzalez-sirgo.com (News Author)12212 — Thu, 14 Jan 2010 08:00:00 EST

Attorneys Rodolfo Linares and Co-counsel J.P. Gonzalez-Sirgo of Coral Gables, Florida, who was contracted to serve as insurance bad faith claims counsel, recovered $2,500,000.00 in a wrongful death case wherein we represented a 19 year old young man who was killed as he rode his bicycle home from work late at night when he was rear ended by a drunk driver. Our client worked as a dishwasher earning a small wage. He was not a legal resident of the United States. He was not married and did not have any kids. He was survived by his parents and siblings who lived in their home country. The facts supporting liability in this case were aggravated in that the driver of the auto that struck our client also attempted to flee the scene of the accident.

Attorney J.P. Gonzalez-Sirgo has built his entire career on protecting the rights of insurance policyholders, personal injury and wrongful death victims and fighting for the rights of Florida consumers and small businesses. The firm has recovered millions of dollars for victims of denied or underpaid insurance claims, victims of catastrophic personal injuries and wrongful death and on behalf of those that have been taken advantage of by Big Business and Big Insurance. J.P. has been certified as a life member of the Million Dollar Advocates Forum and the Multi-Million Dollar Advocates Forum. The Million Dollar Advocates Forum is recognized as one of the most prestigious groups of trial lawyers in the United States. Membership is limited to attorneys who have won million and multi-million dollar verdicts, awards, and settlements. Fewer than 1% of U.S. lawyers are members. In Miami-Dade County call us at 305-461-1095 or call us toll free at 1-866-71-CLAIM or fill out the short online contact form at www.YourInsuranceLawyer.com.

Virus May Not Be Linked to Chronic Fatigue Syndrome After All

blog@www.jpgonzalez-sirgo.com (News Author)12192 — Wed, 13 Jan 2010 08:00:00 EST

According to an article posted on Wall Street Journal's website, a few months ago a group of scientists published a study that suggested that the XMRV virus could be associated with numerous chronic fatigue syndrome cases. These scientists drew a lot of attention for their research findings.

When the study was originally published, the reporters at The Wall Street Journal didn't feel that it clearly established a link between the virus and chronic fatigue syndrome. Recently, a different group of scientists, from the United Kingdom, published research findings from 186 patients suffering from this condition and did not find any signs of the XMRV virus.

The discrepancy between the two studies is a cause for concern, because there currently is no test that identifies chronic fatigue syndrome. This condition is diagnosed solely on symptoms. According to the U.S. Centers for Disease Control and Prevention (CDC), one of the symptoms includes six months or longer of debilitating fatigue.

Chronic fatigue syndrome can be an incapacitating ailment. If you have been diagnosed with this condition and cannot work, you may be eligible for disability insurance benefits.

Attorney J.P. Gonzalez-Sirgo Admitted Into U.S. District Court

blog@www.jpgonzalez-sirgo.com (News Author)12189 — Wed, 13 Jan 2010 08:00:00 EST

Attorney J.P. Gonzalez-Sirgo of Coral Gables, Florida has been admitted to practice before the U.S. District Court, Northern District of Florida. Attorney J.P. Gonzalez-Sirgo is now admitted to practice in all of the Federal and State courts in Florida, from the Florida Keys to Florida's Panhandle.

Posttraumatic Stress Disorder May be a Chemical Change in the Brain

blog@www.jpgonzalez-sirgo.com (News Author)11772 — Fri, 18 Dec 2009 08:00:00 EST

Two recent studies have discovered that posttraumatic stress disorder (PTSD) is actually a chemical change in the brain brought on by trauma. The studies also found, in addition to the new evidence, that PTSD might be identified through brain scans or blood tests, aiding in the diagnosis, treatment and susceptibility.

Researchers have already been aware that people suffering from posttraumatic stress disorder show differences in their neurosteroids (brain chemicals that are a factor in how the body reacts to stress), but the new studies uncovered additional evidence.

One of the studies found that veterans suffering from PTSD and other conditions, such as depression, alcohol abuse, substance abuse or suicidal ideation, had different imaging results from CT scans than people who had only been diagnosed with PTSD. According to Alexander Neumeister of Yale University School of Medicine, the findings of this study are very important in the treatment of PTSD.

The differences researchers discovered "can have huge implications for treatment," said Neumeister. He also said, "once veterans see this is a neurobiological disorder in which their brain acts differently in terms of circuitry and chemical function, oftentimes it motivates them to seek treatment."

If you have been diagnosed with posttraumatic stress disorder, you may be eligible for disability benefits. Contact insurance claims attorney J.P. Gonzalez-Sirgo at (305) 461-1095 or toll free at (866)-71-CLAIM for more information.

New Research Shows that Exercise Could Lead to Osteoarthritis

blog@www.jpgonzalez-sirgo.com (News Author)11771 — Fri, 18 Dec 2009 08:00:00 EST

A new study found that a high amount of physical activity in midlife could increase the risk of internal knee damage, ultimately leading to osteoarthritis.

According to the study, middle age people who sustain injuries had a higher probability for developing osteoarthritis, despite the fact that they showed no symptoms and had healthy weights. These injures occurred more frequently among middle age individuals who performed high levels of exercise. However, researchers did note that lower-impact physical activities, such as swimming and cycling, could be beneficial.

Dr. Joseph Guettler, an orthopedic surgeon and sports medicine specialist, was quoted in an article on U.S. News & World Report's website as saying that the findings, "speak to the importance of low-impact aerobic activity, especially in knees that are aging and may not be as resilient as they used to be."

The problem that was identified had to do with the bone and cartilage in the knee, which can crack and develop fissures that only get worse with time. Guettler said that when people start experiencing these problems, "we know that they're going to have an increased risk for arthritis later on in life."

Osteoarthritis can occur when the cartilage deteriorates in the joints and results in the bones rubbing together.

If you have been diagnosed with osteoarthritis, you may be entitled to disability benefits.

Disabled Interior Designer Who Appeared on TV Guilty of Fraud

blog@www.jpgonzalez-sirgo.com (News Author)11770 — Fri, 18 Dec 2009 08:00:00 EST

An interior designer who had claimed disability, recently pleaded guilty on two counts of fraud. He had received approximately $147,000 in disability payments, before an insurance company representative saw the man on television, working.

Fifty-six-year-old Ronald E. Hunt had claimed that he was not able to work as an interior designer and had been approved for disability benefits. However, an employee with the insurance company happened to see Hunt on an HGTV home improvement program. The employee, who was working for the insurer that was paying Hunt's disability claim, notified the state's department of insurance.

"An investigation confirmed Hunt intentionally and knowingly concealed his secondary employment from his disability insurance company by falsifying written statements and deceiving a company field representative," read the Franchise Tax Board statement.

According to officials, Hunt had made over $400,000 during the three-year time period he was claiming disability. Officials also stated that Hunt had not paid income tax during that time.

The court ordered that Hunt pay $180,000 in fines and restitution. He was also ordered to serve 60 months of probation and complete 200 hours of community service.

The Hartford Warns the Winter Season Brings Disabling Illnesses and Accidents

blog@www.jpgonzalez-sirgo.com (News Author)11769 — Fri, 18 Dec 2009 08:00:00 EST

According to The Hartford Financial Services Group, Inc., the winter season brings many disabling illnesses and accidents. In a recent press release, The Hartford states that "claims due to depression, respiratory illnesses and fractures jump in January, but not before a spike in good cheer and dip in claims around the holidays."

The Hartford conducted an analysis of over a million short-term disability claims during the past five years. The insurer discovered that disability claims appeared to be at the lowest levels during November and December. However, the New Year seemed to bring an onslaught of disability claims for depression.

Glenn Shapiro, vice president of claims for The Hartford's Group Benefits Division, said "we are warning workers about wintertime wellness risks and urging them to take steps now to protect their health and wealth." Shapiro went on to say, "in today's tough economy, a disability that lasts even a couple of weeks could be a financial hardship for many Americans."

The Hartford's press release gave some tips to employers to keep workers healthy and happy. These tips included not letting stress drain productivity, avoiding confusion about absences and providing workers with information about disability benefits.

If you are not able to work due to a disability, contact insurance claims attorney J.P. Gonzalez-Sirgo at (305) 461-1095 or toll free at (866)-71-CLAIM for legal advice.

Bipolar Disorder May Be Linked to Internal Body Clock

blog@www.jpgonzalez-sirgo.com (News Author)11666 — Wed, 09 Dec 2009 08:00:00 EST

If you have been diagnosed with bipolar disorder, then you need to be aware of a recent study. According to researchers, an internal body clock that isn't working properly could be an element in the development of bipolar disorder in children.

The study examined 152 children who have been diagnosed with bipolar disorder and 140 children who do not have the condition. Researchers focused on evaluating the children's genetic makeup. The findings linked variations in a gene termed, RORB, to the children with bipolar.

The study's co-author, Dr. Alexander Niculescu with the Indiana University School of Medicine, said in a news release that, "Our findings suggest that clock genes in general, and RORB in particular, may be important candidates for further investigation in the search for the molecular basis of bipolar disorder."

The RORB gene is generally expressed in the eye, pineal gland and brain. It is believed to be associated with the body's circadian rhythm, which is defined by Encyclopedia Britannica as, "the cyclical 24-hour period of human biological activity."

If you suffer from bipolar disorder, you may be eligible to receive disability benefits. You should speak with an experienced Miami disability insurance lawyer for advice on how to proceed with filing your disability claim. The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective of whether the policy was purchased individually or issued through an employer group policy. The firm is available to assist individuals with the initial application process, during the administrative appeals process, handling denials of claims or termination of benefits, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out. Contact the Law Firm of J.P. Gonzalez-Sirgo, P.A. at (305) 461-1095 or toll free (866) 71-CLAIM for more information.

Lazy Immune Cells May Cause Crohn's Disease

blog@www.jpgonzalez-sirgo.com (News Author)11459 — Wed, 25 Nov 2009 08:00:00 EST

A recent article posted on New Scientist’s website suggests that Crohn’s disease may actually be caused by immune cells that aren’t doing enough in the beginning phases of bacterial infection. This theory is in contrast to what was originally believed, which is that Crohn’s disease is caused by an over-exuberant immune system.

Approximately 1 in 1000 people in the United States and Europe suffer from Crohn’s disease. Some of the symptoms of this medical condition include abdominal pain, gastrointestinal bleeding, diarrhea, fatigue and cramping.

Anthony Segal from the University College of London, along with his colleagues, discovered that there was a weaker immune response in patients with Crohn’s disease than healthy people after both groups were injected with heat-killed Escherichia coli.

Based on the new findings, it is possible that some of the treatments for Crohn’s disease may be making things worse, instead of helping. Treatments for Crohn’s disease often focus on suppressing the immune system.

If you suffer from Crohn’s disease, you may be eligible for disability benefits. The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective of whether the policy was purchased individually or issued through an employer group policy. The firm is available to assist individuals with the initial application process, during the administrative appeals process, handling denials of claims or termination of benefits, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out. Please contact our office to discuss your case in more detail.

Disabled Man Caught on Video Eating a Taco Chip

blog@www.jpgonzalez-sirgo.com (News Author)11458 — Wed, 25 Nov 2009 08:00:00 EST

Insurance companies have been known to employ sneaky tactics to deny disability payments. Insurers have even gone as far as to hire private investigators to videotape the disabled. The hope is that the disabled person will be caught doing something that would go against his or her disability. One recent story shows that insurance companies sometimes go too far.

Jack “Rocky” Whitten claims that his disability benefits from The Hartford were terminated partly because he was caught eating a taco chip on video. Whitten suffers from pain and memory loss and had been receiving disability payments.

A private investigator was hired by the insurance company to follow Whitten. He was captured on video reading a magazine, getting into a car, and eating a chip dipped into salsa. This video cost Whitten his disability payments.

Whitten had broken his neck in a fall seven years ago. His doctor said that he did everything he could to try to get back to work. Luckily, Whitten had purchased a disability insurance policy with The Hartford ten years ago.

A representative from The Hartford visited Whitten and his wife. During the visit the representative asked a lot of questions and then showed the video surveillance tape. Whitten’s payments were later terminated.

The Hartford stated that it uses surveillance to prevent fraud and that this tactic is used in less than 5 percent of claims. However, ABC News discovered that there had been more than a dozen cases where federal courts ruled that The Hartford improperly overemphasized their surveillance video.

Eventually, The Hartford reinstated Whitten’s disability payments, which was eight days after “Good Morning America” contacted the insurer to ask about Whitten’s case.

About 40,000 People Afflicted with Bell's Palsy Every Year

blog@www.jpgonzalez-sirgo.com (News Author)11432 — Tue, 24 Nov 2009 08:00:00 EST

Bell’s Palsy is a terrifying condition. You may go to sleep feeling fine, only to wake up the next day with an eye that cannot open and numbness on one side of your face. Approximately 40,000 Americans experience this condition every year.

The symptoms of Bell’s Palsy can hit suddenly – in a matter of just a few hours. Someone who has Bell’s Palsy may notice that the muscles on one side of the face become weak or paralyzed. This condition is sometimes mistaken for stroke.

Bell’s Palsy continuous to be a mysterious condition that comes on quickly, but is generally only temporary. Some people have multiple episodes of Bell’s Palsy and others are faced with permanent problems resulting from the condition.

According to medical professionals, it is estimated that approximately 85 percent of patients with Bell’s Palsy recover. The majority of these patients would recover regardless of whether they were treated or not.

While the exact cause of Bell’s Palsy is still unknown, some doctors believe that it is the result of facial nerve damage. It has even been suggested that this condition could be somehow linked to a herpes virus.

If you suffer from Bell’s Palsy and are unable to work, you may qualify for disability benefits. The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective of whether the policy was purchased individually or issued through an employer group policy. The firm is available to assist individuals with the initial application process, during the administrative appeals process, handling denials of claims or termination of benefits, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out. Please contact our office to discuss your case in more detail.

Demand for Supplemental Disability Insurance is Growing

blog@www.jpgonzalez-sirgo.com (News Author)11431 — Tue, 24 Nov 2009 08:00:00 EST

The recession has caused many businesses to cut back on employee benefits, which has left some areas of insurance that need to be filled. To fill these gaps, some employers are offering voluntary supplemental benefits, including accident and disability, to their plans. Generally, employees are responsible for the entire premium and can choose how much money they want taken out of their paychecks to go toward the insurance coverage.

According to Karen Riedel, Aflac second vice president, the most popular types of voluntary supplemental insurance coverage that employees are buying include life insurance, dental insurance and disability.

Most group disability insurance plans offered through employers cover about two-thirds of the worker’s income. Supplemental coverage can be purchased to cover the difference.

Supplemental insurance is considered to be a niche market consisting of middle-income wage earners. These employees can afford to pay a little more in insurance premiums.

It is estimated that more female workers buy the coverage than males, which is believed to be due to the fact that women tend to pay the household expenses.

Better Business Bureau of South Florida (BBB) issues an A+ Rating to J.P. Gonzalez-Sirgo, P.A.

blog@www.jpgonzalez-sirgo.com (News Author)11237 — Tue, 10 Nov 2009 08:00:00 EST

The Law Firm of J.P. Gonzalez-Sirgo, P.A. is proud to announce that the Better Business Bureau serving the Southeast Florida and the Caribbean has certified our firm as an accredited business with an A+ rating, the highest rating given by the BBB.

The firm hereby endorses and agrees to:

1. To adhere to simple truth and integrity in advertising and all transactions.
2. To provide sound professional advice.
3. To provide service after the sale.
4. To provide prompt attention to any guarantee or warranty work.
5. To cooperate with the BBB in eliminating misleading or deceptive selling practices.
6. To respond promptly to any complaint with all efforts toward reaching a mutually satisfying agreement.
7. To accept and honor the Bureau's decision in the event an acceptable agreement is not reached directly with the customer.
8. To cooperate with the Bureau to eliminate the cause of any pattern of customer complaints.

Please go here to see our BBB Certificate in pdf format. In addition, please go here to see our online BBB Reliability Report.

Cutting Corners When It Comes to Disability Insurance is a Bad Idea

blog@www.jpgonzalez-sirgo.com (News Author)11217 — Mon, 09 Nov 2009 08:00:00 EST

Disability insurance is offered by many insurance companies and is designed to protect workers against financial burdens when they become disabled. Many employers offer disability insurance coverage through a group plan.

If you become disabled and find yourself unable to work, the insurance company is supposed to pay you disability benefits that are a percentage of your salary. The average employer-based disability plan will cover 60 percent of your salary. An individual plan usually pays more, anywhere from 70 to 80 percent of your salary.

The chances are high that at some point in your career, you will become disabled. The Council for Disability Awareness estimates that as many as three in 10 workers will become disabled before they retire. You cannot afford to cut corners when it comes to disability insurance.

Always do your homework before purchasing a disability insurance plan. Keep in mind that the lesser expensive policies will not provide as much coverage if you become disabled. Cheaper plans often have stringent guidelines as to what constitutes a disability and how long you can obtain disability benefits. Make sure you know what is and is not covered by reading the fine print.

If you have become disabled and are having difficulty obtaining benefits under your disability insurance plan, you should contact Attorney J.P. Gonzalez-Sirgo at (305) 461-1095 or toll free at 1-(866)-71-CLAIM for advice.

Insurance Information Institute Answers the Question: "Will My Employer Provide Disability Coverage?"

blog@www.jpgonzalez-sirgo.com (News Author)11026 — Tue, 27 Oct 2009 08:00:00 EST

If you are a new employee or an existing employee, you may have questions regarding disability coverage provided by your employer. In a recent article, the Insurance Information Institute answered the question, "will my employer provide disability coverage?"

According to the Insurance Information Institute, before you file a disability claim, you need to find out what your employer offers when it comes to this type of insurance. The majority of employers permit short-term sick leave, which can range from a few days to six months.

Contact your benefits department to find out if you are covered. You also need to ask how long you have to wait to begin receiving payments and how long the benefits are expected to last. Some employers' disability plans will also take other disability programs into account when calculating your payments.

Nearly half of mid-size and large companies offer long-term disability coverage, although they are not required to do so by law. Generally, a group long-term disability policy will offer benefits that pay about 60 percent of the workers' average salary. Long-term disability benefits usually kick in when short-term benefits have been exhausted. Typically, group long-term disability insurance is paid in full by the employer and employees do not have to make contributions.

The article by the Insurance Information Institute also mentioned that you are required to pay federal and state tax on the long-term disability benefits, unless your employer pays it for you.

Most Americans Not Covered by Disability Insurance

blog@www.jpgonzalez-sirgo.com (News Author)11025 — Tue, 27 Oct 2009 08:00:00 EST

According to the Council for Disability Awareness, someone becomes disabled every 49 minutes in the United States. What is frightening is that most Americans are not covered by disability insurance.

The Council for Disability Awareness compiled an extensive list of disability statistics in the United States, which included the following startling facts:

More than 51 million people are classified as disabled in the United States
Three in 10 workers will become disabled before they retire
One in 7 workers will be disabled for more than five years
One in 5 workers will miss work for at least a year before they turn 65 because of an accident or illness
The average long-term disability lasts 2 ½ years
71 percent of Americans live from paycheck to paycheck
70 percent of employees in the private sector have no long-term disability insurance

Disability can cause a serious financial hardship, as it prevents people from earning a much needed paycheck. The majority of employees are not financially prepared when a disability occurs and they mistakenly believe that Social Security or Florida workers' compensation will cover their expenses. The average monthly benefit paid by Social Security is only $1,004 a month and many claims are denied. Only about 10 percent of disabling accidents and illnesses are work-related, meaning workers' compensation will not cover the disability.

Florida Insurance Commissioner Comments on Troubling Insurance Development

blog@www.jpgonzalez-sirgo.com (News Author)10999 — Mon, 26 Oct 2009 08:00:00 EST

Kevin McCarty, the Florida Insurance Commissioner, referred to the growth of "life settlement" products as a troubling development. The insurance industry in Florida already has a history of financial problems and consumer complaints.

Life settlement products pay for people's life insurance policies and in exchange, the policyholders name these investors as beneficiaries. Once the insured passes away, the investor collects the Florida life insurance proceeds. The life settlement industry has been around since the 1980s.

Recently, seniors have been targeted by investors. They are being encouraged to buy life insurance with the sole intent of reselling these policies to an investor. These types of arrangements are known as stranger-originated life insurance (STOLI) and are illegal under Florida law, because they violate the "insurable interest" requirement.

McCarty also commented that in addition to being illegal, these arrangements may be fraudulent. Seniors may be persuaded by investors to omit or misrepresent information on the application. For example, the senior may misrepresent his or her net worth to get a larger life insurance policy.

According to McCarty, state regulators are confronted with the problem of differentiating life settlements with STOLIs. He mentions that legislation should be pursued that will balance a person's right to sell his or her policy, while at the same time, discouraging STOLI arrangements.

Open Enrollment for Employee Benefits Means Deciding on Disability Insurance

blog@www.jpgonzalez-sirgo.com (News Author)10998 — Mon, 26 Oct 2009 08:00:00 EST

According to Michelle Singletary, the columnist for the Color of Money, it is the time of year for open enrollment for employment benefits. This is the time that employees need to decide if they will participate in their employer-sponsored life insurance or disability insurance plans. It is also the time when workers need to determine if they will stick to the same health insurance plan or change.

Hewitt Associates, a human resources consulting company, has reported that only 40 percent of employees actively make a decision about open enrollment choices, even if they decide to keep everything the same as the previous year.

Disability insurance can be very valuable for individuals who find themselves facing a disability that prevents them from working. Long-term disability benefits can provide the much needed financial support for the disabled worker's family.

Life insurance is another type of coverage that workers may want to consider, as it can provide money to surviving family members who relied on the deceased's income to pay the bills.

Singletary recommends that employees review their open enrollment materials. It should not be assumed that employees will be offered the same coverage as the previous year. Employees may want to investigate other options if their employers made changes to the insurance plan, according to Singletary and Hewitt.

South Florida Sun Sentinel Reports on When Life Insurance May Be Needed

blog@www.jpgonzalez-sirgo.com (News Author)10997 — Mon, 26 Oct 2009 08:00:00 EST

Certain milestones in life can increase the need for life insurance in Florida. According to an article posted on Sun-Sentinel.com, some of these life changes include having a baby, getting married, sending children to college and retirement.

Life insurance is meant to offer financial support for the people left behind after a loved one passes away. Industry experts have stated that the rates for term life insurance are at current lows. However, cost of life insurance shouldn't be the only determining factor when choosing a policy.

Some of the most sought after types of life insurance coverage include term life insurance and permanent insurance. Term life insurance is less expensive, and for many people, more attractive in this slow economy when budgets are already tight. People who have term life insurance pay a premium and their beneficiaries receive the benefits upon death. Permanent insurance is higher in cost, but includes an investment feature, such as whole life, variable life and universal life.

Insurers are known for committing bad faith tactics to avoid paying claims, so it is important to always check out a company before signing up for a policy. Consumers can learn more about an insurance company's reputation by contacting the Better Business Bureau, Florida Office of Insurance Regulation or A.M. Best, the credit rating organization.

CBS' MoneyWatch.com Identifies Disability Insurance Myth

blog@www.jpgonzalez-sirgo.com (News Author)10932 — Thu, 22 Oct 2009 08:00:00 EST

Employees have a one-in-three chance of becoming disabled during their careers, meaning they won't be able to work for 90 days or longer. However, according to an article on CBS' MoneyWatch.com, most people have the misconception that their employer-provided disability insurance will cover them.

Brian Ashe, past chairman of the Life and Health Insurance Foundation for Education, was quoted in the article as saying, "a typical group policy pays 60 percent of your salary up to a specified limit, such as $5,000 per month." This amount is not always sufficient. Also, group disability insurance usually does not replace bonuses or commissions when the employee becomes disabled.

It is important for employees to get the right amount of coverage. A calculation should be made that determines the amount needed to maintain the same standard of living if a disability occurs. Workers are sometimes able to purchase supplemental coverage if they are underinsured. Another option is to buy an individual plan that will pay up to 70 to 80 percent of the salary.

Employees should make sure to read the policy details. Disability insurance plans vary in coverage and some policies pay benefits if the employee can't do his or her current job, while others only pay if the employee is not able to work at all.

According to the article, common misconceptions about insurance, such as this disability insurance myth, can cost consumers money.

Insurers Are More Likely to Deny Coverage to Seniors

blog@www.jpgonzalez-sirgo.com (News Author)10931 — Thu, 22 Oct 2009 08:00:00 EST

When it comes to individual insurance policies, senior citizens are more likely to be denied coverage. Older Americans are often denied based on "pre-existing conditions," as they usually have at least one chronic condition.

The rate of insurance denial only goes up with age. According to statistics within the insurance industry from 2006, 17.4 percent of people ages 50 to 54 were denied individual insurance coverage and 22.3 percent of people ages 55 to 59 were turned down. Individuals in the 60 to 64 age bracket had a denial rate of 28.7 percent. The Kaiser Family Foundation discovered that the denial rate for individual policies in the age group, 60 to 64, was three times higher than people ages 35 to 39.

For the lucky few who are able to obtain individual coverage, the plans often include something known as an "elimination rider." Basically, it is a clause that states that the insurer does not have to pay any claims associated with the policyholder's pre-existing condition. Florida is among the 37 states that currently allow these types of clauses. That means that seniors could have to pay high medical costs, even if they have insurance coverage.

"Dead Peasants" Life Insurance Policies Under Scrutiny

blog@www.jpgonzalez-sirgo.com (News Author)10675 — Fri, 02 Oct 2009 08:00:00 EST

According to an October 1, 2009 news article on ChicagoPublicRadio.org, Representative Luis Gutierrez (D-Chicago) introduced legislation that would ban employer-owned life insurance policies unless the employee earns at least one million dollars a year from the employer.

Currently, countless employers purchase so called janitor or dead peasants life insurance policies without the consent of the employee despite a 2006 federal law requiring the employer to obtain such consent. For instance, based on public filings, Bank of America owns approximately $17.4 billion dollars in life policies on its employees, and Wells Fargo owns $12.1 billion.

In Michael Moore's new film, "Capitalism: A Love Story," Moore details how employers can benefit by providing poor health insurance benefits while simultaneously collecting life insurance proceeds when employees die. Moore claims this can be done while providing working conditions that are unsafe and result in stress related illnesses and disorders. Employers' counter that the collection of life insurance proceeds helps offset the high cost of health insurance benefits.

To read the full article, please click below.

Life Insurance Company of North America Settles Claims Handling Violations

blog@www.jpgonzalez-sirgo.com (News Author)10674 — Fri, 02 Oct 2009 08:00:00 EST

According to a September 30, 2009 news article on Insurance Journal.com, Life Insurance Company of North American (LINA) has settled with the California Department of Insurance for $600,000. LINA agreed to pay in order to reach a conclusion on alleged disability insurance claims handling violations. In addition, LINA will improve its disability claims procedures and also re-open prior claims to determine if additional benefits are due.

Violations included denying claims before reviewing medical records and adjusters ignoring important new information after initially denying the claim.

To read the full article, please click below.

Insurance Information Institute Answers the Question – Will my Employer Provide Disability Coverage?

blog@www.jpgonzalez-sirgo.com (News Author)6283 — Tue, 21 Jul 2009 08:00:00 EST

The Insurance Information Institute, which provides the public with information regarding insurance, addressed the following question on its website - “Will my employer provide disability coverage?”

According to the Insurance Information Institute, most employers offer some form of disability coverage, but it is important to understand what is covered, especially before you file a disability claim. Some of the disability insurance policies allow short-term sick leave, which can last anywhere from a few days to six months. Many states, including Hawaii, New Jersey, New York and Rhode Island, require that employers offer disability benefits for up to 26 weeks.

A company’s benefits department usually has the information regarding what is covered under the employer’s group disability policy. There is generally a waiting period before benefits begin being paid and it is helpful to know this timeframe before having to file a claim. It is also crucial to know how long benefits can be paid. Some disability insurance policies take into account other disability programs, such as Social Security, when determining the disability payments. This information is also beneficial.

There are no laws in place that require employers to offer long-term disability insurance coverage, but many employers do offer this type of policy. It is estimated that approximately 50 percent of large and mid-sized employers offer long-term disability insurance to their employees. The average long-term disability pay equals approximately 60 percent of the worker’s normal salary. Long-term disability benefits typically begin after short-term disability insurance runs out. It can last anywhere from five years to life.

Employer-paid disability income is generally subject to federal and state income tax.

Will Your Life Insurance Company Pay Your Beneficiaries?

blog@www.jpgonzalez-sirgo.com (News Author)7444 — Wed, 15 Jul 2009 08:00:00 EST

A recent ABC-TV newscast showcased a valid life insurance claim wrongfully denied. The insurance company later corrected the situation citing an error by their third party administrator. Unfortunately, third party administrators do not fall under the umbrella of state insurance commissioner regulation. As of late, there has been a surge with insurance companies denying claims on life insurance and other policies such as long-term care insurance, health insurance, disability insurance, homeowners and business insurance policies.

To avoid leaving your life insurance beneficiaries in financial debacles, it is suggested you follow the below recommendations:

Check the license of the insurer with your state's insurance regulator.
Read and understand your policy.
Check insurer financial strength.
Check insurer rating given by rating agencies.
Does your State's guaranty association ensure your policy against insurer bankruptcy?
Check complaints against the insurance company.
Besides the named beneficiaries, do you have any contingent beneficiaries?

To read the full article, please click below.

Multiple Sclerosis Patient Fights for Long Term Disability Insurance Payout

blog@www.jpgonzalez-sirgo.com (News Author)7742 — Wed, 15 Jul 2009 08:00:00 EST

Recently Good Morning America broke a story on a man diagnosed with multiple sclerosis who couldn't get his long term disability coverage approved from his insurer, Standard Insurance Company. The delay and deny tactics lasted for nearly 6 months. In the meantime, the insured, Charles Tucker, was unable to work and struggled to support his family.

During the 6 month wait, all Mr. Tucker received from his insurer were notices requesting additional information. Tired of waiting and concerned about running out of savings, he hired an attorney.

The attorney requested a copy of his file and within the file found a letter from the insurance company's physician basically stating that Mr. Tucker's medical reports did not support the diagnosis of multiple sclerosis. This opinion was against the 11 other medical opinions confirming multiple sclerosis Mr. Tucker had previously sought and provided to the insurer.

After Mr. Tucker's attorney and Good Morning America contacted Standard to inquire about this matter, the claim was finally approved the next day.

To read the full article, please click below.

Just Another Long Term Disability Insurance Claims Battle

blog@www.jpgonzalez-sirgo.com (News Author)7447 — Wed, 15 Jul 2009 08:00:00 EST

Recently, Good Morning America broke a story on a woman diagnosed with cancer that was denied short term and long term disability coverage by her insurer Cigna. The delay and deny tactics lasted for over 18 months. In the meantime, the insured, Susan Kristoff, was unable to work and struggled to pay bills. She cried plenty and had thoughts of committing suicide. Ms. Kristoff was stricken with stage 4 metastatic breast cancer.

The turning point was when she decided to hire a long term disability insurance claims lawyer to represent her in this matter. Shortly thereafter, Cigna paid her on her short term disability policy. Months after that, Cigna decided to approve her long term disability payments of 60% of her salary.

To read the full article, please click below.

Life Insurance Claim Denied after Mother Dies of Cancer

blog@www.jpgonzalez-sirgo.com (News Author)7741 — Wed, 15 Jul 2009 08:00:00 EST

Recently Good Morning America broke a story on a mother who died after a nine month colon cancer battle. While working as an employee at a 7-Eleven store, Sarwara Faruque bought and paid for a $45,500 life insurance policy. In the event of her untimely death, she wanted her children to have sufficient money for college. After her death, her children applied for her mother's life insurance proceeds. To their awe, their life insurance claim was denied based on the fact that their mother missed a few monthly payments while she lay sick in a hospital bed. Because of these missed payments, the life insurance policy had been cancelled months before.

After going back and forth for nine months with the insurance company and getting nowhere, the family decided to hire a lawyer.

The lawyer was able to obtain a copy of the policy and determined that the policy contained a clause that in the event the insured is sick and unable to work due to a medical condition, the monthly premiums would not have to be paid and the policy would remain in effect.

Less than a week later, the children received word that their mother's life insurance claim had been approved.

To read the full article, please click below.

New Type of Life Insurance is Being Investigated

blog@www.jpgonzalez-sirgo.com (News Author)5703 — Tue, 14 Jul 2009 08:00:00 EST

Florida insurance regulators are taking a closer look at a fairly new type of life insurance that is targeted at seniors. It is called “stranger-owned” life insurance or STOLI.

Basically, these life insurance policies are taken out by investors on the elderly. The investor pays the premiums and eventually becomes the beneficiary of the policy, usually after a couple of years. Policyholders are given incentives by investors, which generally come in the form of lump-sum payments. Critics of these life insurance policies say that it is nothing more than a scheme by speculators to make big money off older people.

Florida law does allow people to sell their life insurance policies. State regulators admit that selling a policy can be beneficial for individuals who may have terminal illnesses. The law does state though that when a life insurance policy is purchased, the person must have an interest in the person who is insured.

These policies are usually done in private, which makes it difficult to regulate. State regulators do have concerns and are looking into this practice. A hearing was held by the state Office of Insurance Regulation regarding stranger-owned life insurance. Information is being gathered to determine if new laws are needed to regulate this practice.

Heath Ledger's Life Insurance Company is Being Sued

blog@www.jpgonzalez-sirgo.com (News Author)5877 — Tue, 14 Jul 2009 08:00:00 EST

The insurance company who wrote Heath Ledger’s $10 million life insurance policy is being sued after alleging the possibility that the actor’s death was a suicide, even though his death was determined to be accidental by officials. Attorneys for Ledger’s daughter, Matilda, claim that the insurance company is trying to avoid paying the settlement.

ReliaStar Life Insurance Company wrote the policy in June 2007, just six months before Ledger’s death. The beneficiary of the policy is a trustee who would hold the money for Ledger’s daughter. The insurer began investigating whether Ledger committed suicide, despite the fact that the New York City Medical Examiner found his death to be accidental.

The lawsuit claims that ReliaStar acted in bad faith by not promptly paying the settlement and for wrongfully prying into the life of Heath Ledger after his death. The insurance company’s lawyers state that Ledger’s death was suspicious and the insurer responded to the lawsuit by saying that it has a right to investigate the claim to determine if the suicide provision is applicable.

ReliaStar is questioning some of the responses on the insurance application, which it believes may have been false – specifically the questions where Ledger was asked if he took prescription drugs and if he ever used illegal drugs. The insurer’s attorneys say that they intend to take the depositions of Mary-Kate Olsen, the masseuse, Ledger’s colleagues on his last film, his agents, doctors, psychologists and others.

Lawyers representing Ledger’s daughter believe that ReliaStar is trying to prolong the process, which could end up taking years, in an attempt to avoid paying the money. The lawyers also claim that ReliaStar is violating California law, which prohibits insurance companies from re-examining insurance applications after the policyholder dies.

Insure.com interviews attorney J.P. Gonzalez-Sirgo regarding disputing a life insurance beneficiary.

blog@www.jpgonzalez-sirgo.com (News Author)6948 — Tue, 14 Jul 2009 08:00:00 EST

Attorney J.P. Gonzalez-Sirgo was recently interviewed by Insure.com about an article they were writing about disputing a life insurance beneficiary. Please read the article on the link below.

Variable Annuities Drag Profits in the Life Insurance Sector

blog@www.jpgonzalez-sirgo.com (News Author)5998 — Tue, 14 Jul 2009 08:00:00 EST

Variable annuities, which are tax-advantaged investments that once fueled profits at life insurance companies, are starting to drag profits as the stock market declines. This recent activity is the result of insurers taking losses on the massive investment portfolios that back their insurance policies. A large number of the losses have come from holdings in the financial sector, including Lehman Brothers securities, and from falling values in some mortgage-backed securities.

Insurance companies have also been hit hard with billions of dollars in unrealized losses as investment-grade corporate bonds have all suffered big declines in recent weeks. Since the stock market has dropped, insurers are facing reduced fee revenue as their annuity assets under management decrease. In the past four weeks, the Dow Jones Life Insurance Index has dropped 47 percent, while there was a 26 percent drop in the DJIA during the same period.

According to Morgan Stanley analyst Nigel Dally, he expects “the most challenging quarter for the life insurers in many years.”

Lincoln National Corp. was the last insurer to state that its retirement business will negatively impact its third-quarter earnings. A 10 percent drop from the same quarter last year in retail deposits into its retirement and insurance products was reported by Lincoln National.

An increase in cost to insurers is also being caused by a popular innovation in variable annuities. Insurance companies created hedging programs to manage the risk of market volatility associated with the minimum-income guarantees that many annuities carry. The cost of hedges have greatly increased during this market volatility, which is cutting into insurance companies’ profit margins, explained Fred Crawford, Lincoln National’s chief financial officer in an interview on Friday, October 10, 2008. Crawford also stated that the company’s fixed annuities, which offer a minimum interest rate to the investor, have recently performed better.

Last Friday, Standard & Poor’s revised its outlook on the life-insurance sector to “negative” from “stable” on higher credit losses, lower fee-based revenues and reduced financial flexibility.

Supreme Court Rules on Case Regarding Insurer's Conflict of Interest in Claim Denial

blog@www.jpgonzalez-sirgo.com (News Author)6458 — Tue, 14 Jul 2009 08:00:00 EST

Last spring, a significant case was brought before the U.S. Supreme Court involving an insurance company’s conflict of interest in denying an employee’s health or disability benefits claim. The Supreme Court later ruled that insurance companies or employers have a conflict of interest when they both decide claims under employee benefit plans and pay the benefits.

The lawsuit was filed against MetLife Inc., arguing that the insurance companies have a financial incentive to deny benefit claims. The justices made a ruling that federal court should consider that conflict when deciding whether the plan administrator has abused its discretion in denying benefits under an employee’s health or disability claim.

According to the Employee Retirement Income Security Act (ERISA) a person who is denied benefits under an employee benefit plan is allowed to dispute the denial in federal court.

The Supreme Court decided the plan’s administrator, including insurance companies such as MetLife or an employer, has a conflict when it performed the dual role of determining whether an employee is eligible for benefits and then pays the benefits.

The court majority was written by Justice Stephen Breyer, which indicated that a reviewing federal court should take into consideration that conflict in determining whether the plan administrator abused its discretion in denying benefits. However, the significance of the conflict depends on the details of each case.

Wanda Glenn filed the lawsuit against MetLife after she was denied long-term disability benefits. Glenn had worked at a company now called Sears Holdings Corp. for 14 years when she pursued disability benefits due to a heart condition. MetLife paid disability benefits to Glenn for two years, but later denied her requests for benefits under her long-term disability plan. MetLife was serving as both the administrator and insurer of the Sears long-term disability insurance plan and disputed her claim that she was totally disabled.

American Chronicle Addresses the Question – Why Don't More People Own Disability Insurance?

blog@www.jpgonzalez-sirgo.com (News Author)6405 — Tue, 14 Jul 2009 08:00:00 EST

According to MetLife, more than 80 percent of working Americans do not have adequate disability coverage or no coverage at all.

There are many different theories as to why so many working individuals do not own disability insurance, which offers protection if the employee is injured or becomes ill and cannot return to work. Many people believe that they do not need disability insurance. If someone were to become disabled, his or her assets can become at risk as income drops dramatically. Studies have shown that a 20-year-old worker has a 3-in-10 chance of becoming disabled before reaching retirement age.

A common belief exists among workers that Social Security will provide the necessary income in case of a disability. Unfortunately, Social Security does not pay for partial disability or short-term disability. The Social Security Administration defines a disability as an inability to work. That means that if a person can work in any capacity, even if that person can longer perform the job in which he or she was trained, the chances of receiving Social Security benefits are slim.

Some workers feel that if they cannot work for any length of time, they can just tap into their savings. Most people only have enough saved to cover emergencies, such as car repairs, a broken air conditioner, temporary unemployment and so on. Financial experts usually recommend setting aside 3 to 6 months of living expenses. Even if a worker is able to save that amount, if the disability lasts longer than that time period, there is a strong potential of financial disaster.

Employers often provide group long-term disability insurance, which generally pays benefits equal to approximately 50 to 66 2/3 percent of the worker’s salary. For some families, this amount is not enough and further coverage may be needed.

The article posted on American Chronicle’s website recommends that workers look into private disability insurance as an addition to their financial plans.

Is Liberty National Life Discriminating Against Policyholder Applicants?

blog@www.jpgonzalez-sirgo.com (News Author)8932 — Tue, 14 Jul 2009 08:00:00 EST

An audit of Liberty National Life Insurance Company's life insurance applications by the Florida Office of Insurance Regulation (FLOIR) has revealed the insurer may have discriminated against those applicants of Haitian or Colombian descent by denying their applications for life insurance. For example, over 50% of Haitian applicants were denied life insurance compared to only 18% of other foreign born applicants.

Over the course of the 5 month investigation and over 7,000 applications reviewed by FOIR, nearly 1,149 violations were noted.

FOIR has given Liberty National 21 days to provide evidence that it did not violate any anti discriminatory state laws.

Unum to Pay $676 Million Dollars

blog@www.jpgonzalez-sirgo.com (News Author)6453 — Tue, 14 Jul 2009 08:00:00 EST

The largest disability insurer in the U.S., Unum Group, has agreed to pay an additional $676 million dollars to some 9,500 policyholders as part of their settlement agreement reached in 2004.

Investigations by state regulators found that Unum routinely forced its very own customers to prove their disability claims were indeed valid, causing undo hardship to the policyholder during the claims process. This practice caused many valid disability claims to go unpaid, underpaid and extensively delayed.

Study Finds Many Americans Uncertain about Disability Insurance

blog@www.jpgonzalez-sirgo.com (News Author)6355 — Tue, 14 Jul 2009 08:00:00 EST

According to a survey by the American Council of Life Insurers (ACLI) and the Consumer Federation of America, most American workers have little or no disability coverage.

The survey included 500 U.S. employees and found that 40 percent of those surveyed had no coverage and 41 percent had coverage they believed to be inadequate to cover their family’s financial needs if they were to become disabled. Among the workers surveyed, 58 percent were covered by an employer-sponsored long-term disability plan and only 1 percent had an individual disability policy. Nearly 50 percent of the respondents to the survey stated that they did not know what percentage of income would be replaced by their long-term disability policies.

Researchers found that 32 percent of employees surveyed believed that a disability lasting one year or more was deemed “somewhat likely” and only 7 percent deemed it “very likely.” Based on information from the National Association of Insurance Commissioners, a 35-year-old worker has a 24 percent chance of becoming disabled for more than 90 days during his or her working life.

Long-term disability insurance is designed to cover expenses for an employee and his or her family if the employee is unable to work due to an illness or injury. Usually long-term disability policies pay two-thirds of the employee’s wage if that employee is unable to work for three to six months and the benefits last for a specified time period or until the employee reaches retirement age. Long-term disability benefits begin after short-term disability coverage has been exhausted, which is typically 90 days.

Employers are now slowly beginning to sign up for group disability policies for their employees. Group disability sales have increased over the years for both long-term and short-term policies. John Hewitt & Associates, a Portland, Maine-based consulting firm, says that most companies offer disability insurance to attract employees or retain them.

ConsumerReports.org Releases Information on Disability Insurance

blog@www.jpgonzalez-sirgo.com (News Author)6236 — Tue, 14 Jul 2009 08:00:00 EST

For many employees, fall signifies open enrollment in employer-sponsored benefit plans. Some employers offer group disability insurance to employees to provide protection against loss of income during the time of a disability. Approximately one third of employers offer disability insurance.

Disability insurance is designed to provide income when an individual is unable to return to work and experiences a drop in income. ConsumerReports.org recommends that employees take advantage of this benefit if it is offered by employers, as it can be valuable.

Bill Baldwin, president of Pillar Financial Advisors in Waltham, Mass., was quoted as saying, “Disability is more likely to occur than death in any one year." The chances that a professional, executive or white-collar worker will be disabled for 90 days or longer at some point between the ages of 35 and 65 is 27 percent for men and 31 percent for women, according to a Seattle consulting firm, Milliman.

Some employers will fully pay for group disability coverage. Other employers may fund a basic plan and give employees the opportunity to purchase supplemental coverage. Ginny Stanley, a principal at REDW Stanley Financial Advisors in Albuquerque, New Mexico says, “Sometimes the employer-provided coverage isn't enough to cover family needs when long-term disability strikes."

If your employer offers group disability insurance, you have the option to purchase that coverage or look for an individual policy. A policy you purchase on your own may have easier guidelines for approving disability benefits and the coverage will stay with you, even if you switch jobs. However, if you are older or have health conditions, an individual policy may be expensive.

You can get more coverage from your disability insurance policy by paying the premiums with after-tax dollars. That way, any disability benefits you receive will not be subject to income tax and you will be able to maximize the amount that will be paid to you, if you become disabled.

Nation's Largest Disability Provider Found Guilty of Defrauding the United States

blog@www.jpgonzalez-sirgo.com (News Author)6123 — Tue, 14 Jul 2009 08:00:00 EST

Unum, the nation’s largest disability provider, was found guilty of defrauding the United States by a Boston jury last week. Unum forced its customers to submit false claims to the Social Security Administration, in an attempt to receive disability benefits. According to the case against Unum, the company knew that these customers were not eligible for government benefits.

As a result of Unum’s actions, a substantial burden was placed on the Social Security program, causing taxpayers to spend money to process and deny the false claims.

The case against Unum was brought on behalf of the government by a whistleblower, Patrick Loughren, under the federal False Claims Act. According to Loughren, "Unum's conduct in threatening people to apply for Social Security under penalty of losing a significant portion of their private disability benefits is wrong. After five years of intense litigation during which Unum refused to admit it was defrauding the United States, I am gratified that a Boston jury has called them to account."

Loughren filed the “qui tam” (whistleblower) lawsuit in 2003. Under the False Claim Act, private individuals can sue companies that are defrauding the government to recover funds on the government’s behalf.

Unum, which is based in Portland, Maine and Chattanooga, Tennessee, encouraged customers who were seeking disability benefits to apply for Social Security disability benefits even though these individuals already informed Unum that they were not eligible. Social Security has stricter guidelines for qualifying for benefits than private insurance companies like Unum. This insurer went as far as to tell thousands of claimants that they would cut their private disability benefits in half or more if they did not comply with Unum’s directive.

The jury did not accept Unum’s claim that the insurer made individuals file frivolous Social Security claims because employers who purchased group disability benefits from Unum wanted the company to impose that requirement on their employees.

AIG Insurance Customers Shouldn't Worry Yet

blog@www.jpgonzalez-sirgo.com (News Author)5757 — Tue, 14 Jul 2009 08:00:00 EST

Many consumers who have life insurance policies through AIG are becoming increasingly nervous as news is released about the company’s financial troubles. Currently, AIG continues to operate and has not filed for bankruptcy protection or been declared insolvent. Even if the insurance division was declared insolvent, there are protections in place similar to the FDIC Insurance that back bank deposits.

Life and health insurance annuities are covered by insurance guarantee associations that have been established in every state. These associations will step in when insurance regulars in a state declare an insurance company insolvent and it is placed in receivership.

The level of coverage varies by state, but every state association provides withdrawal and cash value coverage for annuities of at least $100,000. Some states even offer up to $300,000 or $500,000.

In the last 25 years, more than $20 billion in coverage benefits have been provided by the state associations for policyholders and annuity clients of dissolved insurance companies. During that time, protection had been provided for more than 2 million policyholders.

Stolen Car Claim Yields a $55 Million Verdict Against Metlife

blog@www.jpgonzalez-sirgo.com (News Author)13198 — Wed, 15 Apr 2009 08:00:00 EST

Recently, after a one month trial, a jury in Arizona returned a verdict against MetLife's Auto and Home Division for over $55 million dollars. The claim could have been settled for a mere $30,400, the actual cash value (ACV) of the car at the time of loss. Instead, Metlife got hit with a 10 member unanimous jury verdict for $155,000 in compensatory damages and $55 million for punitive damages from their insurance bad faith handling of this case.

Back in 2002, the insured's had their car stolen from a shopping center parking lot. A few weeks later, the car was found in Mexico severely damaged. Despite the fact that the car had extensive damage, stripped of its VIN plate, electrical wires cut, car seats were slashed and the engine destroyed, Metlife refused to declare the auto a total loss and pay the ACV. Instead, Metlife offered $10,759 for repairs, approximately $19,673 less than what was owed to their auto finance company.

The lawyers for the insured's argued that Metlife handled the claim unfairly and put their aggressive profit projections ahead of the prompt payment of valid claims. In addition, the insured suffered credit damage when they were forced to stop making payments on their damaged vehicle resulting in the car being repossessed.

Metlife will appeal the verdict.

Insurance claims lawyer J.P. Gonzalez-Sirgo handles stolen car, boat or any other stolen motor vehicle insurance claim in which your insurance company has denied. For a free consultation, please call 305-461-1095 or 1-866-71-CLAIM.

$20 Million Settlement Reached by Aetna

blog@www.jpgonzalez-sirgo.com (News Author)13174 — Thu, 15 Jan 2009 08:00:00 EST

Hospitals and doctors that were short changed by Aetna for services rendered to patients that were out-of-network will receive $20 million.

The $20 million settlement is to be paid by Aetna in installments over 5 years, at Cuomo's request.

If your health insurance claims are denied, delayed or underpaid, insurance claim attorney J.P. Gonzalez-Sirgo may be able to help. Please dial 305-461-1095 or 1-866-71CLAIM

America's Most Stolen Cars- 2008

blog@www.jpgonzalez-sirgo.com (News Author)13175 — Tue, 25 Nov 2008 08:00:00 EST

According to the Federal Bureau of Investigation's (FBI) Uniform Crime Reports, a motor vehicle is stolen in the United States every 28 seconds. Forbes.com recently released an article on America's most stolen cars. Topping the list were mostly SUV's and big trucks. Below is a breakdown of the top 10 most stolen cars:

1. Cadillac Escalade ESV
2. Ford F-250 SuperCrew
3. Cadillac Escalade
4. Dodge Charger
5. Ford F-350 SuperCrew
6. Hummer H2 SUT
7. Dodge Magnum
8. Hummer H2
9. Dodge Durango
10. Honda S2000 Convertible

The Cadillac Escalade ESV's theft claim frequency is 15 for every 1000 insured vehicles, while Honda S2000 Convertible's theft claim frequency is 8.1 for every 1000 insured vehicles.

Car theft can by stymied if owners use common sense like locking car doors, rolling up windows and parking in well-lit areas. Parking your car inside your home's garage is recommended since nearly a third of all stolen cars are stolen right from your home's front driveway. Using anti-theft devices is also highly recommended.

If your car is stolen and your insurance company is not cooperating with your insurance claim, insurance claim lawyer J.P. Gonzalez-Sirgo can help. Please call 305-461-1095 or 1-866-71-CLAIM for a free consultation.

$35 Million Dollar Settlement - Louisiana Citizens Insurance Settles T

blog@www.jpgonzalez-sirgo.com (News Author)13204 — Wed, 15 Oct 2008 08:00:00 EST

Louisiana Citizens chose to settle two class action lawsuits for $35 million dollars after evidence presented showed that the insurer failed to provide written offers to settle policyholder claims within 30 days after being notified. The claims relate to damages policyholders incurred after hurricanes Katrina and Rita. Each of the 70,000 policyholders that participated in the class action lawsuits will receive approximately $1,000.

If your insurance company has denied or underpaid your valid insurance claims, please feel free to contact attorney J.P. Gonzalez-Sirgo at 305-461-1095 or 1-866-71-CLAIM for a free consultation.

Health Insurer Settles for $215 Million Dollars

blog@www.jpgonzalez-sirgo.com (News Author)13205 — Thu, 24 Jul 2008 08:00:00 EST

Three class action lawsuits seeking unspecified damages were settled by Health Net Inc for $215 million dollars plus an additional $40 million dollars that will go to improve the manner the insurer handles claims.

Over 2 million customers were affected by Health Net's claims handling practices that systematically underpaid its very own customers health insurance claims.

If your health insurance claim has been wrongfully denied or underpaid, please feel free to consult with insurance claims lawyer J.P. Gonzalez-Sirgo at 305-461-1095 or 1-866-71-CLAIM.

Insurer Settles Lawsuit with Real Estate Developer for $42.5 Million D

blog@www.jpgonzalez-sirgo.com (News Author)13202 — Mon, 28 Jan 2008 08:00:00 EST

Hurricane Dennis made landfall on the Florida panhandle on July 9, 2005. After the storm dissipated, a real estate developer's 31 story, 570 unit condominium project was significantly damaged. After the developer filed an insurance claim under its builder risk policy, the insurer, Axis Surplus Insurance Company, not only denied the claim in its entirety but also refused to renew the developer's policy.

If your insurance company is not cooperating to fullfill its obligations to you as a policyholder, please contact insurance claims attorney J.P. Gonzalez-Sirgo at 305-461-1095 or 1-866-71-CLAIM.

$80 Million Dollar Business Interruption Claim Settled

blog@www.jpgonzalez-sirgo.com (News Author)13206 — Mon, 17 Apr 2006 08:00:00 EST

Zurich American Insurance Company decided to settle a business interruption claim brought by ABM Industries after the World Trade Center disaster on 9/11. The $80 million dollar agreement reached by both companies negates the continued need for a lengthy court trial.

If your business interruption insurance claim has been denied or underpaid, please feel free to arrange a confidential consultation with insurance claims lawyer J.P. Gonzalez-Sirgo to discuss your legal options. Please dial 305-461-1095 or 1-866-71-CLAIM to schedule an appointment.