Most ERISA disability policies state that the insurer has “discretionary authority” to make all decisions regarding whether to award or deny disability benefits.  If the policy contains this “discretionary authority” provision then the disability claimant can usually only overcome a denial if we are able to prove that the denial was: 1) wrong; and 2) the decision was arbitrary and capricious.  This is an extremely difficult burden to meet.  “Wrong” is not enough.   It has to be wrong, and arbitrary…

On the afternoon and evening of March 26, 2016 a major hail and wind storm pummeled the Poinciana and Kissimmee, Florida area.  Coincidentally, this was on the 24th anniversary of the catastrophic Central Florida Hail storm of March 26, 1992.  It was that 1992 storm that launched me into specializing in insurance claims for homeowners.  Since 1992, I’ve helped 1,000’s of people with homeowners insurance claims against their homeowners insurance companies.        …

In Taylor v. Admiral Insurance Company, ____ S.3d ____ (Fla. 3rd DCA February 10, 2016), Ms. Taylor sued Hello Florida, Villa Vizcaya and Miami-Dade County as a result of a slip and fall injury. Hello Florida was the named insured under the Admiral Comprehensive General Liability Insurance policy.  Hello Florida was Ms. Taylor’s employer. Villa Vizcaya and the County qualified as additional insureds under the policy. Admiral Insurance refused to defend or indemnify Hello Florida,…

In Shands Jacksonville Medical Center, Inc. v. State Farm Automobile Insurance Company,  40 FLW D1447a (Fla. 1st DCA June 22, 2015), the First District Court of Appeals ruled on the ways a PIP carrier can obtain information from PIP medical providers in Florida pre-litigation. In this case, State Farm, sent a pre-litigation request to Shands pursuant to Florida Statute Section 627.736(6)(b) asking for:…

In Roker v. Tower Hill Preferred Insurance Co., 40 FLW D764b (Fla. 2nd DCA March 27, 2015), the Second District Court of Appeal was asked to review a Summary Judgment granted to the homeowners insurer in a sinkhole case. …

My clients purchased a replacement cost homeowners insurance policy.  On July 12, 2014, their roof sustained hail damage.  As in many of these cases, the insurance company hired an engineer to inspect the roof.  The engineer inspected the roof and wrote an extensive report concluding that there was no hail damage.  Instead, according to the insurance company’s engineer, the roof was old and suffered from manufacturing defects, and damage from foot traffic.  (This is almost…

As I’ve written before, on March 24, 2013, a severe unnamed wind and hail storm hit the Central Florida area.  The storm caused significant damage to area homes and businesses.  In this case, our clients purchased replacement costs homeowners insurance coverage for their home.  Replacement cost insurance coverage pays the cost of replacement if any part of your home is damaged.  Replacement cost coverage pays the replacement cost without any deduction for age, and there…