Florida Insurance Law Blog

A good read for those with tough choices to make regarding health insurance plans.

http://money.cnn.com/2011/09/26/pf/open_enrollment.moneymag/index.htm

Some sound advice, especially during hurricane season in South Florida.

http://money.cnn.com/2011/08/09/real_estate/homeowners_insurance.moneymag/index.htm

Hi, thanks for joining me here on my maiden voyage onto the Florida Insurance Law Blog. For my first entry, I’d like to address a common misconception regarding auto insurance that I’ve repeatedly encountered during my short, yet-oh-so-illustrious, legal career: The “Full Coverage” Fallacy. “Full Coverage” is almost always the response I get when asking friends, family, or potential clients about their auto insurance coverage. “Full Coverage” is the predictable and common response across all socio-economic and educational backgrounds, gender and races. The problem with the “Full Coverage” answer is that it doesn’t make any sense…from a legal standpoint anyway.

There is no such thing “Full Coverage” in Florida.

To the contrary, Florida law only provides that drivers carry a “minimum” level of coverage - $10,000 in Personal Injury Protection (PIP), which covers your own medical expenses incurred as a result of an auto crash, and $10,000 in property damage coverage (for more info on Florida's insurance requirements see http://www.flhsmv.gov/ddl/frfaqgen.html). Note that Florida law doesn’t even require you to purchase Bodily Injury (BI) coverage, which serves as a financial safeguard in the event that you are sued for causing an accident. By way of an oversimplified example, let’s assume you have $100,000 in BI coverage; you cause an accident and get sued. In that case, your BI coverage would cover you for any amount up to, and including, $100,000 in damages that the other driver might win against you. But wait, here’s where it gets interesting….

Let’s keep running with that same example: Let’s also assume that you earn $750,000 a year (I know, I wish too), and that you have hundreds of thousands of dollars in non-homesteaded property and assets. Let’s also assume that the person suing you was seriously injured and underwent surgery as a result of the accident you caused. Now, with those facts, that $100,000 in BI coverage doesn’t sound so comforting with all of those assets on the line. With the additional facts of this example, you could now find yourself in a position where you could/would be held personally responsible to pay for the injured person’s damages which exceed your BI policy limits. In other words, if the other driver were to win, for example, a $250,000 judgment against you, you could be on the hook for the other $150,000 in excess of your policy limits. This is an example as to why THERE IS NO SUCH THING AS “FULL COVERAGE” – too much insurance for one could mean, and often does mean, dangerously inadequate insurance for another. There is no “full coverage” standard. Sufficient coverage is solely dependent on your own personal circumstances, including your current and anticipated financial circumstances. I’ve known far too many young CPA’s, lawyers and doctors, who carry far too little insurance coverage just because they want to save a buck on the premiums. Trust me, I don't enjoy handing over money to those corporate conglomerate insurers, but it makes it easier to swallow when you think about what is at stake should you purchase too little coverage. It is also important to remember that there are legal remedies available to an insured if their insurer fails to live up to its end of the bargain.

Remember, although the law does require you to purchase minimum levels of insurance, you should purchase enough insurance to fully protect your assets. In theory, if you’re truly seeking “full coverage,” then you must examine your own personal financial circumstances and obtain sufficient coverage that will protect your assets should you ever find yourself facing a lawsuit. If necessary, meet with a licensed and qualified financial and/or insurance professional to find out how much coverage is right for you.

Now, please note these examples only address the “Full Coverage” fallacy from the BI standpoint, which examines situations where you might find yourself being sued for causing bodily injury. In my next installment we’ll chat about what is known as underinsured/uninsured motorist coverage (commonly known as UM coverage), which is insurance that will protect YOU if you’re injured at the hands of an uninsured/underinsured driver.

Until then..
Have fun. Be good. Be safe. Be educated.

Mike Santana

Continue reading "The "Full Coverage" Fallacy" »

Yesterday Governor Scott signed the new insurance "reform" package into law. Our poor insurance companies have already adopted Governor Scott's slogan: "Let's get to work!"......jacking up the premiums.

I just heard from a friend, although she's had no claims, her bill for her homeowner's insurance just arrived, and it has doubled!

Welcome to the new Florida insuarance DEform...stand by everyone.

While people are delaying care, and not getting tests that they need to avoid problems.

When did your health insurance premiums go down? When did your deductible and co-payment amount shring in the past few years? You know the answer......never.

I'll tell you what I think, they need to keep overcharging premiums to fund their lobbying, and their political efforts, (the tea party is real expensive to fund, you know....), because the national health reform act is bad for their business, but better for you and your family.

Here's a link to a terrific New York Times article: http://www.nytimes.com/2011/05/14/business/14health.html?nl=todaysheadlines&emc=tha2

In this past legislative session, the Florida Legislature once again "reformed" parts of the insurance code. Reform, for the benefit of our poor insurance companies........

Anyway, there is one part of the new law that I think needs mention. The statute of limitations to file a lawsuit if a homeowner has a claim that stems from a sinkhole (yes you non-Floridians, in Florida, a sinkhole can just open up and swallow your house!). Has been shortened from 5 years to 2 years. A lawsuit arising from a claim for a hurricane loss must now be brought within 3 years after the hurricane

Also, the statute of limitations for lawsuits arising from other types of insurance breach of contract claims will now be 5 years from the date of the damage, where it was formerly 5 years from the date that the insurance company denied the claim in whole or in part.

These statute of limitations changes will definitely affect many folks who, although more and more frustrated they don't want to hire and attorney, nor a public adjuster. (I don't blame them when it comes to public adjusters, I can tell you stories......).

Those folks will jerk around with the insurance company, and the statute of limitations to go to court can run without them ever knowing it.

This video really isn't new (just new to me and perhaps to you). It was played to the Sony annual shareholder meeting in 2009.

It is a terrific and thought provoking presentation on how things have changed with increasing rapidity, and how much information is being added and communicated. As a note, it demonstrates how outdated it is in some ways.......note the mention of Myspace...
http://www.innovationamerica.us/index.php/innovation-daily/2024-what-sony-played-at-its-annual-shareholder-meeting-this-year

I wish that I had a nickel for every time in the past almost 29 years of practicing law someone came to see me complaining that they had been the victim of a fraud.

The old adage: "If it sounds too good to be true, it is!" applies more than ever now.

Ponzi schemes are not only run by big criminals like Madoff, but by small time crooks as well.

Just because the person who approaches you appears to be a highly devout and religious person, doesn't mean that he or she isn't scamming you.

Here's a link to an excellent article that was in the Washington Post the other day:

Continue reading "If you think that you could never be caught in a Ponzi scheme..." »

Today is the 100th anniversary of the fire that killed 146 young women and girls in 18 minutes. In the aftermath of the tragedy, where employers “compensated” the victims families by paying them $10.00 per dead person, the workers compensation laws in the United States was born. Francis Perkins, who as a young woman, watched the girls jumping from the ninth floor, Became the First woman Secretary of Labor under Roosevelt, and started the Occupational Health and Safety board.

Here is a link to learn about it: http://www.ilr.cornell.edu/trianglefire/

There is an old saying about the importance of studying and learning from history, that if you don't, you are bound to repeat it. Now, 100 years later, the crazies in political office, hacks for their campaign donors and patrons, are intent on further eliminating regulatory oversight, and removing private civil justice protections. Read, heed, and understand what is happening all around you.....

We've been litigating and trying cases against the insurance industry for almost 30 years now. (Time sure flies...). Many of the laws that govern insurance here in Florida and elsewhere, begin with "model acts" drafted by The National Association of Insurance Commissioners, whose members are the top insurance regulators from each of the 50 states.

Most often these "model acts" weaken the rights of individuals, families, and small businesses who buy insurance. This year there is a proposal to shield insurance agents from the mandates of the federal insurance reform. I expect that the industry folks will, unfortunately for the rest of us, have many friends in that group: http://thehill.com/images/stories/blogs/naicindustryties.pdf

If the regulators are so close to the industry that they regulate, I guess it is good for our business, since we can still represent people who have been wronged by insurers, but bad for most everybody in the long run.

The general public expects that the government, federal, state, and local, is really "watching the store", and will agressively prosecute and punish wrongdoers.

That just isn't the case.

During the past 30 years, we have eliminated, privatized, and weakened government watchdog and prosecution functions to the point that they are almost laughable. If things weren't so scary now, it would be an enormous joke......on the people.

In the March 3rd edition of Rolling Stone magazine, Matt Taibbi, who is a terrific investigative journalist, (one of the few today), wrote this article on what did not happen to Wall Street and the bankers:

Continue reading "Please explain to me why we need civil justice "reform", exactly?" »

Another example of advertising and reality being diametrically opposed. Nothing I write can add to this story: http://www.heraldtribune.com/article/20101205/ARTICLE/12051021/2062/NEWS?p=all&tc=pgall

Now, of course the insurance industry and it lobbyists are asking the legislature for more "reform". Now who do you think that "reform" will favor? Individuals, families, small businesses? ........and I've got some swampland in the Everglades to sell you......

A great word, "reform" too bad that in most cases, "reform" hurts the little guy, and instead "reforms" the bottom line of big business.

Over the years, we've all seen an explosion of TV advertising for injured people. Almost all of the ads involve a variation of a promise to get the injured person what they "deserve". Aside from the fact that "deserving" compensation does not necessarily follow from an injury, the sad truth is that this constant "we'll get you what you deserve" advertising has negatively impacted truly hurt people, and their ability to manage their injury treatment and finances until they can recover.

Also, in my opinion, this "we'll get you what you deserve" advertising has had a truly negative impact on the general public. If an injury case goes to a jury trial, it creates the largest hurdle that a victim must overcome; that is, differentiating themselves, their attorneys, and their health care providers from others in the litigation lottery "get what you deserve" industry. Indeed the vast majority of the "we'll get you what you deserve" type of lawyers wouldn't know what the inside of a courtroom looks like, but they sure tell their clients what great "trial lawyers" they are.

Believe me, as a Past President of the Florida Trial Lawyers (now the Florida Justice Association), I've had the honor of getting to know and being associated with the true trial lawyers here in Florida, and elsewhere in the nation, and not one of them is in the "get what you deserve" advertising game.

A real trial lawyer is ethical, honest, straight shooting, and not afraid to wait for the knock on the door when a jury reaches a verdict in trial.

Remember the old Syms clothing store commercials: "An educated consumer is our best customer"? It is so easy now with the ability to search and shop on the internet, to really check out lawyers and health care providers if you need help. Why every person who has been injured or damaged by a wrongful act of others doesn't do this is beyond me?

Yesterday, the Miami New Times newspaper printed a terrific story about a large injury advertising network here in South Florida: http://www.miaminewtimes.com/2010-12-09/news/crash-course-411-pain-network-will-line-their-pockets-with-your-insurance-money/

Having spent much of our practice representing folks against health insurers and HMO'S, we know first and why the health system is broken and needs reform.

It is astounding how anyone can vote against their own best interests.

In the USA, no one should bankrupt themselves and ruin their family's finances because they are sick and have health problems. No one, when they are sick and weak, and fighting for their own life and health should have to fight their own insurer or HMO at the same time.

Money talks to the politicians alright, and the voters who voted for them or didn't care enough to vote at all. Here's the Bloomberg News link: http://www.bloomberg.com/news/print/2010-11-17/insurers-gave-u-s-chamber-86-million-used-to-oppose-obama-s-health-law.html

How many consumers recognize that when they "agree" to a licensing agreement, when they get a new cell phone, when they open an account at a bank, when they buy a new computer, or a new software program, that they are "agreeing" to waive their rights to go to court, if they are cheated, and they may not have consumer protections that the state legislature has provided to them?

Credit Card Companies, Banks, cell phone companies, computer manufacturers, software companies all want to force the consumer to arbitrate any disputes with them, with very limited rights, for a cost that most times exceeds the damages, instead of going to court, under the state law consumer protection statutes. This isn't an exhaustive list by any means, almost all big corporations do this.

In our own practice we have successfully litigated against a health insurance company, that, without ever disclosing that the policy required arbitration of any disputes, included a drastic one sided requirement that any disputes between the health insurer and an an insured policyholder, including the requirement that the arbitrator(s) could only be a current or former insurance company employee with at least 5 years experience! (How's that for the fox guarding the hen house??) If you'd like to see the case documents, our Wallant v Freedom Life case they are here, on our website: http://www.liggiolaw.com/lawyer-attorney-1440071.html

This term, the U.S. Supreme Court will hear the case of AT&T Mobility v Concepcion, which can, in one decision, wipe out many consumer protections. Here is the link tot he excellent Alliance for Justice Report that explains how important the Concepcion case is for all of us. http://www.afj.org/judicial-selection/arbitration-report-final.pdf

I haven't posted on this blog in a while, but I read this Op Ed by Bob Herbert in the New York Times last week that I just had to share:

http://www.nytimes.com/2010/09/18/opinion/18herbert.html?_r=1&partner=rssnyt&emc=rss

Mr. Herbert in a few words, without any political hyperbole, described how the leaders of our country are disconnected with how bad things really are for Americans. Thank you for your wonderful column, Mr. Herbert!

More often than not, I feel like the Dutch Boy in the old story putting his finger in the dyke to stop it from bursting.

It is often that bad.

Our whole purpose is to try to help folks who are in danger of being swept away by a tide caused by greed, indifference, and downright evil conduct by rich and powerful interests.

Well, there are a few words in this Non Sequitor cartoon, but just a few!

I never can quite understand how voters elect politicians who support legislation that favors big corporations over the little guy. Some folks continually vote against their own better interest.

How some legislators propose legislation that is drafted by the insurance industry and their lobbyists, and against their own constituents, is beyond any logic.

This cartoon just about says it all...... http://www.seattlepi.com/dayart/20100708/cartoon20100708_fixed.jpg

I am so excited to announce that Florida is still right at the top........at the top of the list of states that have the most people without health insurance.

Actually, we're number 3, behind Texas and New Mexico. Here's the link to the Washington Post article regarding the new U.S Census report: http://www.washingtonpost.com/wp-dyn/content/article/2010/07/27/AR2010072705835.html?wpisrc=nl_cuzhead

What the article does not mention, is how the cost of all the uninsured folks is passed to the state and the taxpayers, mainly through care that uninsured folks seek at public hospitals and emergency rooms.

Also, the article doesn't address the problem that we, at Liggio Benrubi see, and fight every day: denied claims by health insurers and HMOS for folks that DO have health insurance coverage, wrongful cancellations of coverage, and failure to pay and underpayment of medical and hospital charges.

Another dubious we're number one(three), for Florida!

Yesterday, the Consumer federation of America issued a report on various types of "add on" insurance. Here's the link to this excellent report: http://admin.consumerfed.org/elements/www.consumerfed.org/File/Insurance_add-on_consumer_alert.pdf

We've handled many cases over the years when claims were denied under these "add on" insurance companies, credit life and disability insurance, title insurance, travel insurance, bextended warranties, and others.

Unfortunately, the "good deal" and "peace of mind" sold to our clients when they purchased the insurance ended up to be a sour deal and a real headache, when they needed the insurance and retained us.

I highly recommend this terrific report, and the report itself has links that will help you to educate yourself even more.

The politicians who were against the recent Health Care Reform Act, and the health insurance industry, kept repeating the myth that most people are happy with their health insurance.

Yeah right! Uh huh.........

People are tickled when their claims aren't paid, or the insurer pays a fraction of their bills.

People are tickled when they can't get medical care recommended by their doctor because the health insurance won't approve it.

People are tickled when their physician prescribes a medicine, but their health insurance company changes the prescription to a cheaper, less effective generic drug.

People are REALLY jumping for joy each year on renewal, when the coverage is limited, again, and they get a premium increase: more money for less benefits.

.........and now this: Consumers Union issued a report that shows, while they are limiting care and benefits, and jacking up premiums, a number of the Blue Cross "nonprofit" insurers are sitting on huge surpluses of cash.

Here's the link to the Washington Post story, which itself contains the link to the study itself:
http://www.washingtonpost.com/wp-dyn/content/article/2010/07/25/AR2010072503295.html?wpisrc=nl_cuzhead

Over the years, we've had many cases, where our client cared enough for themselves and their loved ones to purchase health insurance or an HMO plan, only to learn, when they need the benefits, that the insurance company of HMO has decided to rescind their insurance because they supposedly failed to disclose something in their medical history when they applied for the coverage in the first place.

The person and their loved ones are forced to fight with the insurance company or HMO when they are sick, and in debt. In other words, they must fight the insurance company or HMO when they are least able to do so, at their lowest ebb.

One of the more important aspects of the recent Health Care Reform act is its Patients Bill of Rights, that will stop insurance companies and HMOs from rescinding coverage unless the insured actually commits fraud (intentionally lies) when the coverage is applied for. Here is the link to the Health Care Reform website that will explain it more fully: http://healthreform.gov/newsroom/new_patients_bill_of_rights.html

Jeff Liggio

In 2007 we had the opportunity to represent a terrific young lady, Larose McLoyd, who had been the victim of a fraud perpetrated on her by the National Indemnity Company of the South and one of it's claims personnel, Ms. Dworak. Here is the link to our brief description of the underlying facts and litigation: http://www.liggiolaw.com/lawyer-attorney-1246051.html

Today, the Florida 1st District Court of Appeals rejected National Indemnity Company's appeal of that verdict.

This case is proof that our justice system can level the playing field between the corporation and the individual, and between the rich and powerful and the less fortunate members of our society.

It's been some time since I posted on this Blog, and I apologize for that. We've been just a little busy with some of our ongoing bad faith suits and class actions. I'll certainly try to do better.

There was something in the media today that I think is very important reading.

To put things in context: While the Florida property /homeowners insurers make it extremely difficult for any homeowner who has the temerity to make a claim, and while they are asking the legislature to remove any restraints on their rates, this is what they actually do with the premiums paid by Florida homeowners: http://www.heraldtribune.com/apps/pbcs.dll/article?AID=/20100315/ARTICLE/3141081/2107/BUSINESS&Title=How-insurers-make-millions-on-the-side&tc=ar&template=printpicart

I have previously posted about the ongoing and anticipated effects of the current financial crisis on the insurance industry as a whole. Now, it's getting personal.

In 1984, my wife and I purchased Universal Life Insurance on both of our lives with Shenandoah Life Insurance Company. We have faithfully paid the premiums for the policies for the 25 years since that time. In fact, for a period of time we even paid more than the required minimum premium. In my calculation, we have paid at least $50,000 in premiums to them since the inception of the policy.

I just learned that the Virginia Department of Insurance has placed them under supervision. Here is the link to the documents in regard to the receivership.

According to the "Questions and Answers" document, the receivership was necessary due to the declining value of some of the company's investments. In other words, they took premiums from policyholders and invested the premiums, and the investments of those funds didn't pan out.

As I posted earlier, whether you are shopping for insurance, paying for an insurance policy, or making or litigating claims.......be aware of the insurance company's financial status.

Unfortunately for all of us, this ain't nearly over yet, we still can't see the bottom and how deep it is for the insurance industry.

Following on from an entry last week, The insurance industry continues to report that employees are being laid off, and the reviewing services seem to be constantly downgrading the financial strength ratings of the various insurers.

In times like these, the atmosphere is ripe for consumers to make the wrong decision when their insurance policy is either being trmeinated by the insurance company, or they are up for renewal, and they must decide whether to renew their present coverage, or to seek a cheaper alternative.

Recently an insurer called "Peoples Trust" has been aggressively advertising in Florida. Here is what the Florida Association of Insurance Agents has to say about Peoples Trust: "Peoples Trust Insurance Company, The Truth About Peoples Trust"

The old saw goes something like: "If it seems to good to be true, it probably is!". Insurance is too important to buy based on slick advertising, and bold promises. In this computerized, information age it is easy for a consumer to research an insurance company's track record, and financial solvency. Unfortunatley, when it comes to insurance a consumer finds out that they bought the wrong coverage, from the wrong insurance company when it is too late......when they actually need the coverage.

We've been watching the homeowners insurance market in Florida for more than 20 years now. The latest news is that State Farm announced today that it will not renew any homeowners policies in Florida.
The impact on Florida homeowners is significant, 703,357 homeowners’ policies, written for $1,054,918,245.00, will be affected.

This follows a trend that began after Hurricane Andrew, in 1992. Prior to Hurricane Andrew, there had not been a major hurricane that had hit Florida for 25 years. That means that the homeowners insurers had made an enormous profit on the homeowners premiums for those 25 mild years. You would think that they would have been prudent and conservative with their policyholder's premiums during that time, so that they would be able to easily withstand a major hurricane loss....... (Do you really think that they were any better or smarter at investing your premiums then than they are now?)

Instead, after Hurricane Andrew, the homeowner insurers cried out that Hurricane Andrew had created huge money problems for them, and lobbied the Florida legislature for changes to the law, which permitted them to form "Florida" domiciled subsidiaries,like State Farm "Florida" thus allowing them to decouple their homeowners and auto business. The legislature also formed the state owned insurance company, Citizens, and subsequently the market has deteriorated to the point that all of the major carriers have now pulled out of the homeowners insurance market in Florida,

Homeowners have very little choice today, there have been problems with some of the smaller carriers that entered the market, and prices for homeowners insurance have done nothing but go up, and for less coverage.

This does not bode well for the availability and affordability of coverage, and it certainly will affect what happens if you are a homeowner with a smaller insurer in the event that you need to make a claim.

Everybody should realize that insurance companies make money by investing the money they receve in premiums paid by their insureds. Does anyone think that insurance companies are any better at investing their money than any of the wall street investment banks that made such bad decisions?

Aside from all the press coverage of AIG's problems, the media has basically overlooked the fact that many insurance companies are having significant financial problems. In fact just by a little internet searching, I learned that AIG is not the only insurance company that is requesting Federal bailout money, and that A.M. Best has downgraded its credit ratings of some prominent insurance companies and their coprporate parents (your insurance company may be a subsidiary of a much larger group/holding company).

Over the years we have seen insurer's adjusting claims in indefensible ways when the insurance company is in financial trouble.

One example that sticks in my mind was a small one man roofing contractor, who basically worked out of his home. He had resurfaced a roof on a warehouse. We had several days of torrential rains, and the roof collapsed. The roofing contractor was sued, and he turned the claim in to his liability insurer. The insurer denied the claim on the silly basis that the only roof that the liability policy would cover was the roof on his own office!

We sued the carrier, and forced them to cover the suit and pay the loss, and very shortly after we finished, the insurer went into receivership, and was declared insolvent.

The point is, that whether you are an insured looking to your own insurance company to protect you, or you are a victim making a claim, the reality is you'd better be aware of the insurer's conduct, and pay attention to whether the conduct is because of financial problems the insurer is having outside of your personal situation.

We have been successfully litigating a Class Action against Medical Savings Insurance which was recently taken over by regulators. We believe this is the tip of the iceberg: Indiana regulator takes over 2nd insurer