This blog frequently focuses on legal principals and common practices in the insurance industry that confront policyholders who submit claims.  However, this “big picture” perspective can ignore the devastating impact of an insurer’s decision to deny the claim of an insured.  A recent story in the Claims Journal highlights the tragic consequences of a claim denial and policy cancellation on an elderly woman.  Although the woman’s home was destroyed by the criminal act of arson committed by her son, the woman was an innocent victim of her adult son’s conduct.

The 81-year-old senior initially did not believe her eyes when she saw that her home was destroyed by fire.  The senior thought she would be okay because she had homeowner’s insurance.  However, the situation changed with the arrest of the senior’s 53-year-old son, who lived in the home, several months after the fire.  Arson investigators concluded that the adult son intentionally started the fire by leaving a hot curling iron turned on.  There was no evidence that the homeowner was involved in the alleged arson.  In fact, the affidavit in the arson case indicated that the elderly woman also was a victim of the theft of $1,500 in jewelry by her son months prior to the fire.

The senior initially resided in a temporary apartment with funds provided by her insurer while she arranged for a contractor to rebuild the home.  However, she received notice from her insurance carrier that it was denying her claim and canceling her policy several months after it was filed.  To add insult to injury, the elderly homeowner received notice her insurance carrier also was canceling her car insurance.  Although there was no dispute that the elderly woman had no idea that the fire had been intentionally set until the arrest of her son, the insurance company refused to reverse its decision to deny the claim.

This woman might well have saved and worked diligently her entire life, so she would have a home to reside in during her senior years.  However, she was victimized by her son who essentially stole or destroyed all of the property she had acquired over a lifetime.  The impact of this tragedy was magnified by the insurance company’s denial and cancelation which ultimately resulted in the woman residing in a nursing home.

Although the reason for the denial in this case was not clear, homeowners with a claim they believe is legitimate can fight back.  Insurance carriers routinely deny claims despite the hardships imposed by such a denial.  Carriers have a strong financial incentive to deny, underpay, and delay claims to increase shareholder profits.  An experienced insurance claims lawyer can evaluate the insurance company’s rationale for denying the claim and guide you through the process of obtaining benefits owed under the policy.  This approach might range from negotiating with your insurance company to filing a lawsuit for breach of contract and insurance bad faith.

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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