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Due to the state of the economy, insurance claim disputes have become increasingly more common than even just a few years ago.

The bottom line is that insurance carriers must make a profit to continue to exist. The reality is that the law does not allow insurance carriers to make their profit by disputing or denying valid insurance claims by their policy holders.

While some insurance companies blatantly dispute or deny valid insurance claims for profit, others have employed the tactic of trying to get you to settle an insurance claim for far less than what your claim may actually be worth.

Cohen stands up to these insurance carriers in valid disputes involving:

  •  Contractor Insurance Claim Disputes

  •  Homeowner Insurance Claim Disputes

  •  Business Owner Insurance Claim Disputes

  •  Auto Accident and Personal Injury Insurance Claim Disputes

  •  Auto Glass Insurance Claim Disputes

 Cohen is a law firm which possesses the experience and resources necessary to effectively guide you through each and every aspect of your insurance claim dispute.

 Common types of disputes or denials of insurance claims often include:

  •  Auto Accidents, Injury & Property Damage

  •  Hurricane, Storm, Sinkhole and Lightning Damage

  •  Water Extraction

  •  Mold Contamination

  •  Damage involving Flood, Fire, Electrical, and more

As your Orlando Insurance Claim Dispute Attorney, we will listen to your story, inform you of your legal rights, thoroughly investigate and analyze the facts, and aggressively represent your rights with every legal resource available by law.  At Cohen , we are extremely detailed in our investigation of the facts of your case, which ensures we always maintain due diligence in our effort to provide each of our insurance claim dispute clients the highest standard of legal representation.

If your valid insurance claim has been denied, is being disputed, or the insurance carrier is offering far less that when the claim is actually worth, you should know your legal rights lightly.  Your rights are a privilege, and our firm considers it an honor to protect those rights by providing professional legal services you can trust and depend upon.

MYTH 1: ASSIGNMENTS OF PROPERTY INSURANCE BENEFITS ARE A RECENT PHENOMENON

FACT: ASSIGNMENTS OF POST-LOSS BENEFIT PAYMENTS HAVE BEEN RECOGNIZED BY FLORIDA LAW FOR OVER 100 YEARS

The right of insurance policyholders to assign the right to payment for services provided is deeply rooted throughout Florida law and business for over 100 years.  It is an intuitively necessary measure to expedite insurance claims and protect policyholders in areas of medical care, government entitlements, car insurance, and many other areas of day-to-day insurance-related operations.  This longstanding tradition has also existed in the area of property insurance.  In 1917, when considering whether an after-loss assignment of insurance benefitwas valid following a grocery store fire, the Florida Supreme Court stated: “…it is a well-settled rule that the provision in a policy relative to the consent of the insurer to the transfer of an interest therein does not apply to an assignment after loss.” West Florida Grocery v. Teutonia Fire Ins. Co.

MYTH 2: ASSIGNMENTS OF BENEFITS GIVE CONTRACTORS SPECIAL RIGHTS THE POLICYHOLDER WOULD NOT HAVE

FACT:ASSIGNMENTS OF BENEFITS DO NOT GIVE CONTRACTOR’S ADDITIONAL RIGHTS 

An Assignment of Benefits only transfers the homeowner’s right to receive payment for work that a contractor performed or is contracted to perform. It does not provide any special rights or privileges to contractors.  Florida Courts have long stated this principle. As explained by the Florida Supreme Courtin 2007:

“As a general rule, the assignee of a nonnegotiable instrument takes it with all the rights of the assignor, and is subject to all the equities and defenses of the debtor connected with or growing out of the obligation that the obligor had against the assignor at the time of the assignment.”Law Office of David J. Stern, P.A. v. Sec. Nat. Servicing Corp

In other words, an assignment transfers only rights to payment which the homeowner already has, and an insurance company may raise any coverage defenses they could also raise against a homeowner. There is no difference between the rights of a homeowner to receive payment and the rights of assignee-contractors to receive payment.  They are the same.

MYTH 3 :ASSIGNMENTS OF BENEFITS ALLOW CONTRACTORS TO INFLATE PRICES

FACT: ASSIGNMENTS OF BENEFITS HAVE NO IMPACT ON A CONTRACTORS ABILITY TO INFLATE PRICING

Although the overwhelming majority of Florida contractors perform quality work at a fair price, the sad reality is that there is always the exception of a contractor who “inflates” their invoice when dealing with an insurance claim. Assignments of benefits, however, do nothing to change this.  Whether or not a contractor takes an assignment of benefits does not change their ability to “inflate” their prices when dealing with an insurance claim.  Either way, their invoice is submitted to the insurer for coverage, whether it comes through the homeowner or directly from the contractor.   The only difference an Assignment makes is that, if an insurance company wishes to partially deny coverage due to an “inflated” invoice, any pending litigation will not have to go through the homeowner.  In that way,assignments of benefits protect homeowners from contractors who overprice their work because insurance companies can address the issue directly with the contractor.

MYTH 4:  ASSIGNMENTS OF BENEFITS ALLOW CONTRACTORS TO FILE LAWSUITS WITHIN DAYS OF A CLAIM BEING FILED

FACT: ASSIGNMENTS OF BENEFITS DO NOT OVERRIDE INSURANCE POLICY PROVISIONS ALLOWING CERTAIN TIME PERIODS FOR COVERAGE DETERMINATIONS

As explained above, Assignments of Benefits do not provide contractors with any special rights or abilities, nor do they allow contractors to “circumvent” policy obligations. If an insurance policy allows a certain period of time for an insurer to make a coverage decision, that same period of time applies regardless of whether the right to payment is with the homeowner or with the contractor.  If a contractor files a lawsuit pre-maturely, an insurance company has the same policy defenses available as though a homeowner filed a lawsuit pre-maturely.  If the lawsuit was, in fact, pre-mature, the Court will dismiss the case, and insurance companies even have several avenues to recover their legal fees and costs.

MYTH 5: ASSIGNMENTS OF BENEFITS ARE NOT FAIR BECAUSE THEY VIOLATE “NON-ASSIGNMENT” CLAUSES IN INSURANCE CONTRACTS

FACT: ASSIGNMENTS OF BENEFITS ONLY ASSIGN THE RIGHT TO RECEIVE PAYMENT FOR SERVICES PERFORMED, NOT THE INSURANCE POLICY ITSELF

An Assignment of Benefits does not assign the insurance policy itself to a contractor, merely the right to receive payment for the work that contractor performed.  The Florida Legislature and Supreme Court have long-held the principle that an “anti-assignment” clause does not bar the right to assignment payments due after a loss has occurred.  This is because there isno additional, unanticipated risk to an insurance company for a policyholder to simply assign their right to receive payment for services after damage to the property has already occurred.  This is particularly significant since,in many cases, a homeowner will not be able to afford or hire a contractor immediately following a loss to their home unless the contractor has an assignment of benefits to ensure payment.  This means homeowners have to wait weeks, even months, until their insurance company issues payment, until they can begin repairs.  In many cases, the damage to the property magnifies during this time-period, only worsening the strain on homeowners. Allowing assignments of benefits for contractor services after a loss has occurred protects homeowners and contractors alike, and is good policy that has been recognized in Florida for over 100 years.

MYTH 6: ASSIGNMENTS OF BENEFITS LET CONTRACTORS CIRCUMVENT POLICY OBLIGATIONS

FACT: EVEN WITH AN ASSIGNMENT, ALL POLICY OBLIGATIONS REMAIN WITH THE HOMEOWNER AND WILL BE ENFORCED BY FLORIDA COURTS

Assignments of Benefits only transfer the right to receive payment for services provided by a contractor.  Any and all policy obligations and duties remain with the homeowner, and may be raised by an insurance company in defense to any legal action.  As stated succinctly by Florida Fifth Circuit Court of Appeal in 2010, “Assignment of a right to payment under a contract does not eliminate the duty of compliance with contract conditions”.Shaw v. State Farm

MYTH 7: CONTRACTORS WHO TAKE ASSIGNMENTS OF BENEFITS ARE CLAIMING OWNERSHIP OF THE ENTIRE CLAIM, NOT JUST PAYMENT FOR SERVICES THEY PERFORM!

FACT: ASSIGNMENTS OF BENEFITS ONLY TRANSFER THE RIGHT TO RECEIVE PAYMENT FOR CONTRACTED SERVICES,NOTAN ENTIRE CLAIM

An Assignment of Benefits only transfers to contractors the right to receive payment for contracted services, regardless of whether the assignment explicitly states this limitation or not.  Florida’s 13thCircuit Court of Appeals restated this principle in 2009, stating, “It is a given that an effective assignment would convey the right to sue only for services the assignee provides.  Case law makes that clear, thus expressing that limitation is unnecessary.” United Automobile Ins. Co. v. Orozco.

MYTH 8: CONTRACTORS WHO RECEIVE ASSIGNMENTS OF BENEFITS VIOLATE FLORIDA’S “PUBLIC ADJUSTING” STATUTE

FACT: AN ASSIGNMENT OF BENEFITS IS LEGALLY DISTINCT FROM PUBLIC ADJUSTING

Florida’s “public adjusting” statute requires those acting as public adjusters to be properly regulated and certified by the State of Florida.  A public adjuster is someone who represents homeowners, similar to attorneys who represent clients, in their adjustment of an insurance claim with an insurance company, in exchange for money. Contractors who take assignments of benefits are not acting as public adjusters because they are not acting on behalf of homeowners, they are acting on behalf of their own right to payment for the work they performed, limited only to the work they performed.  They are not negotiating money a homeowner may be owed for their furniture damage, or their lost wages, or their additional living expenses, representing the homeowner throughout the claim process in exchange for a fee.  Contractors who take assignments are only negotiating their own bill, and own the right to payment for that bill.  They are representing themselves, not homeowners, and are not charging additional fees/money for doing so.  Anyone who has worked with a public adjuster would immediately recognize the difference between a public adjuster and a contractor who took an assignment of benefits for their services.

MYTH 9: AN ASSIGNMENT OF BENEFITS VIOLATES FLORIDA STATUTE 627.405 BECAUSE CONTRACTORS DON’T HAVE AN “INSURABLE INTEREST” IN THE PROPERTY

FACT: FLORIDA STATUTE 627.405 ONLY REQUIRES THAT THEPOLICYHOLDERHAVE AN INSURABLE INTERESTAT THE TIME OF THE LOSS

This is one of the more outrageous claims made by insurers against the assignment of benefits, as it is a gross, flagrant misinterpretation of Florida law.  Simply put, Florida Statute 627.405 is the law which states, “you can’t buy insurance for things you don’t own.”  In other words, you cannot purchase insurance on your neighbor’s house, your friend’s car, or anything you don’t own.  Which is basically common sense; you cannot collect insurance proceeds for damage to property you don’t own at the time it is damaged.  Thus, in order for an assignment of benefits to be valid, this Statute merely requires that the policyholder/assignor have had an ownership interest in the property at the time of the loss.  Once the loss has occurred, if the policyholder had an insurance interest, their right to receive payment is freely assignable.  The insurance company interpretation would mean Public Adjusters wouldn’t even exist, since they never had an insurance interest in the property, but are seeking payment on behalf of homeowners.  As such, this is a particularly ignorant/terrible argument being used by insurance companies to avoid their obligations under the insurance contract.

MYTH 10: AN ASSIGNMENT OF BENEFITS VIOLATES FLORIDA’S “LIEN LAWS” PURSUANT TO FLORIDA STATUTE 713.32

FACT: FLORIDA STATUTE 713.32 ONLY DEALS WITH APPLICATIONS TO PLACE A LIEN ON PROPERTY; AN ASSIGNMENT OF BENEFITS IS NOT A LIEN OR AN APPLICATION FOR A LIEN.

Florida Statute 713.32, Florida “Lien Laws,” regulates the standards and process of placing a lien on a property for an alleged debt.  When contractors seek payment through an assignment of benefits, they are not seeking to lien the homeowner’s property.  In fact, they are not enforcing a debt against the homeowner at all, they are enforcing a debt against the insurance company.  The purpose of Florida Lien Laws is to protect homeowners from unjustified hindrances upon the title of their property.  An assignment of benefits, in no way, represents a hindrance or lien upon the homeowner or their property.

Distinction(s) between AOBs and Directions to Pay
Under the law, an assignment is a transfer of rights or property.
Similarly, a direction to pay is a document that directs an insurer to make
payment to a separate entity. The following post will detail the general
differences between these two distinct legal principals. 

As stated above, an assignment of benefits (AOB) is a transfer of rights
that allows the assignee to stand in the shoes of the assignor for the
benefit of payment. In Florida, an assignment provides the assignee with
legal standing to bring a claim related to the assigned benefits.
Essentially, the AOB allows the assignee to bring a claim for any unpaid
benefits related to services rendered.

Alternatively, a direction to pay is a clause in a contract that directs a
party to make payment in a specific manner. Unlike an AOB, the direction to
pay does not confer legal standing upon the parties. In other words, a
direction to pay, by itself, will not be enough to bring a claim against an
insurance company that refuses to properly pay a claim. 

Feel free to contact Cohen Law Group if you
have any questions regarding your insurance claims. It’s about justice.

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