insurance coverage issues

September 19, 2019

Tips on Dealing with an Insurance Adjuster After a Florida Car Accident

Dealing with an insurer’s claims adjuster may be the last thing on your mind after suffering injuries in a Miami auto crash, but you can expect the phone to ring in the days that follow. Though you may view the conversation as an annoyance, keep in mind that it is a necessary part of the process when you are filing an injury claim. Typically, the insurance adjuster will be seeking information regarding fault and the severity of your injuries, so what you say – and DO NOT say – is critical. It is always important to seek the advice of a Miami car accidents attorney before you answer the call, but you may find some tips to be useful.

Be Calm and Courteous

Start things off on the right foot, even if you are angry, anxious, or frustrated. You should stay calm during the conversation and be polite. The person on the other end of the call is just doing his or her job, even if you do have opposing interests in the claim.

July 31, 2019

Reasons Insurers Reject Miami Car Accident Claims

by Gerson & Schwartz, P.A.

When you are hurt in a Miami auto collision, your first step in seeking compensation for your losses is to file a claim with the responsible driver’s insurance company. Like many victims, you might expect the process to be clear and simple — complete the necessary forms, send them to the insurer, and wait to receive payment. You may be shocked and dismayed when the response is an outright rejection of what you believe is a valid, legitimate claim.

Though it may provide seemingly valid reasons for a denial, the primary motivation of the insurance company is to look out for its own interests. Your claim is a threat to profits, so the insurer will seek any possible reason to reject or make a low counteroffer to resolve your claim. Do not put your rights at risk by accepting anything less than what is fair and reasonable to compensate you for your losses. With help from a Miami car accident attorney, you can recover the highest amount of compensation allowed by law – even when the insurance company responds to with any of these excuses.

You Delayed Filing Your Claim: It is true that Florida has a four-year statute of limitations on motor vehicle crashes based upon negligence, but this time period refers to filing a lawsuit in civil court. You should file a claim with the responsible driver’s insurance company as soon as possible after an accident. When you wait, key evidence may be unavailable and your recollection about the collision will become foggy.

December 7, 2017

GEICO Files $15 Million Lawsuit Against Path Medical & 411 Pain

by Gerson & Schwartz, P.A.

Last week Government Employees Insurance Co., known as GEICO, filed a massive lawsuit against Path Medical and Pain 411, alleging that since 2014 the defendants defrauded the company for millions of dollars worth of medical procedures that were, “medically unnecessary, illusory, unlawful, and otherwise unreimbursable health care services, including initial examinations, follow-up examinations, diagnostic imaging, and physical therapy, and chiropractic services [], that purportedly were provided to automobile accident victims (“Insureds”) who were eligible for coverage under GEICO Florida no-fault insurance policies.”

In addition to seeking compensatory damages for the allegedly fraudulent payments, GEICO is also seeking declaratory judgment that it is not legally obligated to reimburse the more than $200,000 in additional pending, allegedly fraudulent no-fault insurance claims.

February 20, 2015

Insurance Policy Exclusions May Interfere With A Personal Injury Claim and Why You should Read the Lanugage in Your Insurance Policy.

by Gerson & Schwartz, P.A.

If you are injured in an accident, and the negligent party was drunk and under the influence of alcohol, it may appear that your case is a slam dunk. Generally speaking from a liability standpoint this may be true. However, collecting from the insurance company for the full amount of your damages may not be as simple as you think. Some insurance policies have exclusions for certain acts. This means the insurance company may not be required to cover an insured’s negligence such as an intentional act, or if there is a claim that arises based on conduct that is excluded or not covered under the insurance plan language. This can include a claim that arises out of a fight in a night club, use of alcohol, or even for punitive damages such as an insured in a drunk driving accident. These exclusions are common in premises liability cases, such as bars, nightclubs, and other commercial property insurance policies. For these reasons, it is always a good idea to ask for a free consultation with a personal injury lawyer in Miami to discuss if any of these potential issues may apply to your case.

Recent Case Enforces Alcohol Exclusion

This does not mean that the tort feasor is entirely off the hook. Injury victims can always pursue legal action regardless of insurance that is available. It just means that the an action to collect some or all of a judgment for claims that are not covered under insurance may have to come directly from the at fault party, as opposed to the insurance company. However, the reality of collecting against an uninsured or under insured defendant directly just may not make sense.