More Misconceptions Perpetuated by Carriers About Insurance Claims

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

The insurance industry in the U.S. generated over a trillion dollars in profits during a recent one year period.  Approximately 44 percent of this amount (i.e., $502.6 billion) was generated by policies covering property and casualty losses according to the Insurance Information Institute (III).  Given the massive financial influence of insurance carriers, they exercise political power by using a significant portion of the premiums to pay lobbyist who promote legal changes that are adverse to policyholders.  Insurance carriers face an inherent conflict of interest because they are paid to provide financial security against loss, but they maximize their profitability by minimizing any such payouts.  Given the influence and financial power of the insurance industry, consumers should be aware of a number of commonly held misconceptions about insurance coverage and claims, such as:

An insurer can and will turn down your claim if the loss is caused by an “Act of God.”

So-called “Acts of God” often fall squarely within the scope of perils that motivate consumers to purchase insurance policies.  Although a hurricane, flood, or earthquake might be thought of as an “Act of God” over which insurance companies have no influence, these are the exact type of hazards that merits carrying insurance coverage.  The issue of coverage for such risks has nothing to do with whether the event can be considered an “Act of God.”  Rather, the relevant analysis involves whether the risk falls within the scope of covered perils and the existence of an applicable exclusion.

Homeowners insurance will provide coverage if your residence is flooded during a storm.

While homeowners insurance typically covers many types of storm related damage, such as damage caused by lightning, wind or rain, flood damage falls outside the scope of coverage of standard homeowner policies.  Homeowners should consider purchasing flood insurance through the National Flood Insurance Program especially if their residence is located in hurricane-prone areas.

Money spent to retain an attorney to assist with my insurance claims dispute will mean I have insufficient funds to repair my home.

This claim is particularly nefarious because it is designed to help insurance companies maintain their advantage in legal expertise and financial resources in claims disputes with policyholders.  Our Florida insurance claims law firm generally does not accept any money up front when representing policyholders in claims disputes.  Further, our law firm typically only gets paid attorney fees if we obtain a recovery from the insurance company.  The process of fighting a carrier armed with insurance defense attorneys, experts, adjusters, and virtually unlimited litigation resources is extremely difficult without legal representation, so policyholders benefit from shifting the financial risk of litigation to a law firm by retaining an experienced insurance claims lawyer.

My claim can be exaggerated to some extent because I have been paying premiums for years without filing a claim.

The decision to file a claim that is overstated in terms of the items listed or the value of the claim is a risky practice that can result in denial of your claim and more.  Many policyholders are unaware that “padding” an insurance claim can constitute insurance fraud.  Aside from the financial consequences of having your claim denied, insurance fraud constitutes a crime in Florida.

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].

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