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Coverage Disputes


An Experienced Attorney Handling Coverage Disputes

Delivering personal attention and responsive service to your business

An insurance policy is accepted as a contract between the insured and the insurer, in which the insurer agrees to financially protect the insured from loss, damage or liability. From time to time, however, insurance companies and their customers disagree about whether or not certain expenses should be covered, resulting in coverage disputes that often need to be settled in court. If this is the case for you, seek the guidance of the experienced litigators at Loughren, Doyle and Reising, P.A. We offer individualized attention and personal service to you or your business, delivering the answers you need when you need them.

Corporate coverage disputes

When it comes to employer-sponsored health insurance and workers’ compensation claims, there are many ways in which poor communication and misunderstandings can lead to insurance coverage disputes.

  • Employer-sponsored health insurance. Employers offering health insurance are required to provide benchmark coverage, which is level of coverage that is equal to one of several federally approved benefit packages. Regardless of the benefit package, insurance policy language can be difficult to understand and contract revisions modifying benefits happen regularly. It might be beneficial for policyholders to consult with an attorney to ensure current benefit guidelines are clearly understood.
  • Workers’ compensation insurance. According to Florida legal statutes, if an employee is injured or dies while performing work within the scope of his or her employment, the employer needs to pay compensation or benefits. However, it must be established that the work injury is the major contributing cause (responsible for more than 50 percent) of the resulting injury, and the process of making this determination can often lead to disputes.

Property owner coverage disputes

According to Florida law, if a person is injured while on another person or entity’s property, the property owner may be held liable for injuries. Many homeowner’s insurance policies offer limited personal injury liability coverage, but disputes may arise concerning the circumstances of the injury and whether or not the property owner was actually liable for the injury.

If the visitor is invited to a public space or a business, or invited into a home as a social guest, the property owner is required to maintain the premises to a reasonable degree, to correct or warn of any known dangers and to guard against any foreseeable third-party crimes. A skilled insurance litigation attorney can help with these complex issues.

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