Hurricane Irma Insurance Claim Help

Category: Miami Lawyer Blog
Written by Patrick Russell Hits: 61

Delay Deny Defend - Insurance Claims

 

If you were frustrated by the slow disaster assistance after Hurricane Irma, you better buckle your seatbelts and get ready for the insurance claim process. Much like the stages of grieving, many of you after the storm went through shock and denial. Watch out, anger is next and your insurance company is most likely not going to help with that. 

Delay Deny Defend

The concept of Delay, Deny, and Defend is something that was established through the insurance industry's own business documents and practices as outlined in the similarly titled book Delay Deny Defend by Jay M. Feinman. This is an excellent book that exposes the insurance industry for coming up with a business model solely to maximize profits at the expense of wrongfully delaying, denying and then defending insurance claims. The long story made short is that insurance companies pooled their resources and hired a business consulting firm to streamline the claims process for the specific purpose of minimizing payments. After a lengthy research process, the consulting firm found that the longer the insurance company made the process, the more likely people would simply take whatever they were given or give up their claims completely. As a result, the insurance companies literally made the insurance claim process a war of attrition and exercise in restraint and patience. 

Delay

The first stage is delay. In this stage, insurance companies will take their sweet time in processing your claim. There will be no inherent rush or urgency to resolve your claim. Getting information or a commitment from the insurance company will be next to impossible. The first person you will normally meet will be an "independent" adjuster who ironically ONLY works for insurance companies. Most of the time, and more so in times of natural disasters like hurricanes, the "independent" adjuster will be inexperienced or newly trained. We are seeing "independent" adjusters in Florida that are being brought in from Texas, Alabama, and other neighboring states who have never adjusted claims in Florida before. More likely than not, this first adjuster is going to make mistakes, miss items, or deny coverage. The insurance company almost expects you to demand a better estimate or response, and that is why a second adjuster will routinely be sent to view the property. This begs the question why a better adjuster is just not sent right from the start. The second adjuster will routinely add more items to the repair estimate that were "missed" by his first colleague. If you as the property owner even get this far, this is normally where you stop since you believe this is the end of the claims process.

Deny

What you might not know is a desk adjuster is available to review claims for a third time if you ask. A desk adjuster is a more senior claims adjuster that normally works in the corporate offices of the insurance company. The desk adjuster has the ability to review all of the estimates, request more research, and adjust the estimate accordingly. Between the desk adjuster and a claims examiner, this is usually where the final decision is made to either deny a claim or what amount the insurance company will finally pay. Once they make a decision to either deny a claim or to pay only a certain amount, usually any other attempts to change that decision are denied. At this stage of the claims process, the insurance company exercises their leverage over you knowing that you are most likely not inclined to hire a lawyer to fight them. Even if their decision is wrong and they know it, they also know many people will simply give up at this point figuring they have no other options or simply do not want to hire a lawyer.

Defend

The final phase of the insurance claim gauntlet is to defend any lawsuits filed by property owners who feel they were wrongfully denied or underpaid for their insurance claims. Very few property owners ever get to this stage. Either they do not know that they have been wrongfully treated or they simply relied upon the insurance company as having dealt with them in good faith. Others simply have an aversion to hiring lawyers or feel that they cannot afford to fight the insurance company. In both cases, the insurance company wins and you lose. For those that proceed, the road can be long and frustrating, make no mistake about it. The insurance company has budgeted money from the premiums you have paid them to now fight you for your insurance claim. The lawyers the insurance company hires to defend them have no incentive to handle this cases quickly and so the legal case just like the insurance claim process drags on. Again, the goal is to make this process as long and as painful as possible so you simply give up. 

Do Not Give Up

No one said that processing your insurance claim and getting exactly what you are owed from the insurance company would be easy. Rarely is anything worth pursuing easy. That being said, you do have options that can help level the playing field against the insurance company. First, properly document your damages with the help of a Florida public adjuster so you know what you are in fact rightfully owed. Second, secure the help of a Florida insurance lawyer when your insurance claim has been either denied or underpaid.

Know that most reputable insurance lawyers will not charge you an hourly rate nor should they charge you a contingency fee based on the amount of the damages that they secure for you. Rather, a Florida insurance lawyer should charge you a contingency fee based on an hourly rate that he/she charges against the insurance company. In this way, the insurance lawyer is not taking any of your insurance claim monies but only securing a separate legal fee directly from the insurance company if he/she is successful in the lawsuit. This is possible because Florida has a fee-shifting statute for insurance companies that forces insurance companies to pay your legal fees if you should prevail in a lawsuit against them. Hopefully, you can use this playbook against the insurance company to level the playing field. If you have any questions, feel free to leave them below in the comments section or go ahead and contact me directly.


About the Author: Patrick Russell, Esq., has been a member of The Florida Bar since 1994 and is an experienced Florida insurance lawyer. Patrick started his insurance law practice more than twenty years ago when he represented homeowners and business owners for their Hurricane Andrew insurance claims. The purpose of this article is educational and not for the solicitation of legal services. The goal is to avoid the mistakes learned from the past, specifically those from previous windstorms. Knowledge is power. Information is free. Mistakes are costly. If you would like more tips on how to process your Florida insurance claim, Patrick can be reached at (305) 608-2977 or here.

 

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