When homeowners find that their insurance carrier refuses to cooperate in paying their damage claim in a timely manner, an aggrieved property owner has a variety of potential options.  These approaches to obtaining full payment for a property loss often begin with escalating the claim within the insurance company.  When this strategy does not yield results, you might consider appraisal or negotiation with the insurance company.  Many policyholders find that these efforts to resolve an insurance claim dispute fall on deaf ears.  In this situation, the insured’s best possibility for obtaining satisfaction of his claim might be filing a lawsuit.

While an experienced Florida insurance attorney can provide legal advice and guide you through alternate dispute resolution (ADR) procedures, legal representation is essential if you pursue a lawsuit.  The litigation process is subject to extensive procedural, evidentiary, and timing deadlines.  These technicalities require extensive knowledge and experience taking on large insurance companies in and out of the courtroom. 

The Florida Third District Court of Appeal case of Linares v. Universal provides an example of the types of complex issues unrelated to the merits of the insurance claim.  The insured suffered damage to his home during Hurricane Wilma in 2005.  When the insured filed a claim for damage caused by the storm, the insurance carrier sent the policyholder a letter in February of 2006 indicating that the value of the loss was less than the deductible.  The insurer did not provide any indication that the claim would not have been covered if the loss had exceeded the deductible amount.  Rather, the insurer requested that the policyholder submit additional information to support the claim if it was discovered by the policyholder.

In 2009, the policyholder submitted a report prepared by a public adjuster indicating that the loss was substantially more than the deductible.  The policyholder subsequently complied with the insurer's request for a sworn proof of loss and an examination under oath.  The carrier formally denied the claim in August of 2012.  The policyholder filed a lawsuit against its homeowner’s insurance company thereafter. 

The insurance carrier defended against the lawsuit by alleging the insured’s lawsuit was filed after the statute of limitations had run (i.e. expired).  The appellate court rejected this claim based on the principle that a claim for breach of contract does not accrue until the last element of the cause of action has occurred.  The court noted the last element of a breach of contract claim will usually be the actual breach.  The court concluded that the breach of contract did not occur until the denial letter was sent in August of 2012.  The earlier letter indicating that the amount of the claim did not exceed the deductible did not constitute a breach of contract triggering commencement of the limitation period.

Many insurance coverage disputes turn on technical issues like this one that have little or no connection to the merits of the claim.  Policyholders attempting to take on experienced insurance defense attorneys on legal technicalities like this one without legal representation are at a distinct disadvantage.  

You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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