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.
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 was 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.”
An Assignment of Benefits only transfers the homeowner’s right to receive payment for work that a contractor performed or is contracted to perform. Florida Courts have long stated this principle. in 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.”
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.
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. 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,.
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 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.
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 is This is particularly significant since, 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.
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”.
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 13Circuit 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.”
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. 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.
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.
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 Grossman Attorneys at Law if you
have any questions regarding your insurance claims. Its about justice.