Denied or Delayed Life Insurance Claims in Naples
If you live in Naples, Florida, and are faced with a life insurance claim that has been denied or delayed our law firm is available to help. The denial of a life insurance claim can be devastating to the would-be beneficiary and their family. For this reason, a trained attorney who specializes in life insurance should evaluate your claim.
Our firm implements a methodical, step-by-step approach to evaluate a potential life insurance claim. The steps are as follows:
Step One – Assess Claim Viability
The first step is to determine whether your life insurance claim is viable. To do this, we will review, at no cost to you, the pertinent documents relating to your claim. These documents include, but are not limited to, the denial letter, the life insurance policy, pertinent correspondence, and the death certificate. Upon review, our Naples life insurance attorney will determine if the claim is viable and has potential to succeed.
Step Two – Retain Counsel and Prosecute the Naples Life Insurance Claim
Once we have determined that the claim is viable, we will propose to the client a fair and affordable contingency fee arrangement. If the client agrees we will begin to prosecute the claim. Initially, we will conduct any required legal research to fully prepare the claim.
Step Three – The Pre-suit Stage
At the pre-suit stage, the attorney will contact the insurance company in writing with a fully supported claim. Supporting documents will be attached as necessary. At the pre-suit stage our attorney will prepare a thorough letter, supported by the policy, statute, and/or case law, which will be sent to the insurance carrier. We will provide the insurance carrier with a reasonable opportunity to respond to the claim.
If the insurance company refuses to honor the claim, or if they engage in purposeful delay, our Naples life insurance lawyer will take the matter to the next legal step.
Step Four – Filing a Civil Remedy Notice for Bad Faith (only if appropriate)
In certain situations, but not all, the insurance carrier’s denial of the claim can be so outrageous or egregious that it is tantamount to bad faith. Under Florida law, an insurance carrier may not engage in bad faith when denying an insurance claim.
If the insurance carrier demonstrates bad faith we will file a civil remedy notice (“CRN”) with the Florida Department of Financial Services. The “notice” is not a lawsuit. Rather, it is a formal document which places the insurance company on notice that it may have committed bad faith.
Once the notice is filed, the carrier has 60 days by statute to pay the claim or submit a response.
While a lawsuit may still be required to be filed against the carrier the use of the CRN can be a helpful tool in getting the insurance company to comply with their responsibilities to the policy.
Step Five – Civil Litigation
Sometimes the legal process will be needed to resolve your life insurance claim. Most life insurance claims are litigated in state court. However, a smaller portion of claims are heard in federal court.
Going to Court in Naples, Florida
In Naples, the state court is part of the 20th Judicial Circuit of Florida. If the life insurance claim exceeds $50,000, the suit will be filed in the Circuit Court. If the life insurance claim is subject to federal jurisdiction, however, the case may instead be filed in the U.S. District Court for the Middle District of Florida. The Middle District of Florida covers Naples.
What is removal?
Often times, a life insurance claim that is filed by the plaintiff in state court will be removed by the insurance carrier’s attorneys to federal court. That means that the case will ultimately be heard in federal court. Removal is only available if the federal court has subject matter jurisdiction over the case.
While every case is different most cases are typically resolved within 6 months of filing. However, the more difficult cases could go through litigation for as long as one year, if not longer.
It is the goal of our firm to obtain the best possible result for the client given the legal challenges involved. Each case is unique and has its own set of risks.
How does the litigation process work for a Naples life insurance claim?
Litigating a life insurance claim usually involves the following process:
- Plaintiff files a complaint.
- The Defendant answers the complaint or files a motion to dismiss.
- The parties engage in the discovery process. Discovery is where the parties exchange information, collect documents and gather evidence.
- Depositions may be taken by either side.
- The parties participate in mediation via court order. The parties usually share the cost of the mediator.
- If the parties don’t settle, the case is either adjudicated with a pre-trial order or the case goes to trial.
What types of Naples life insurance disputes do we handle?
Application Misrepresentation Claims. These claims usually involve an alleged omission or misstatement on the life insurance application. The carrier will contend that the policy is void because of the misstatement. This defense is only available to the carrier during the first 2 years of the policy.
Policy Lapse. This occurs where a premium payment was missed. The missing premium payment could cause the policy to terminate or lapse. Lapse cases usually turn on whether a premium notice should have been received by the insured. Premium notice requirements can be governed by the policy or by statute.
Accidental Death Claims. Some policies will only pay benefits when the insured dies from an accident. An accidental death usually involves physical injury to the insured which eventually leads to his or her death. These policies usually have “sickness exclusion” clauses. The insurance company will sometimes argue that the death was not caused by the accident, but by a preexisting medical condition.
Accelerated Death Benefit and/or Critical Illness Claims. Some life insurance policies allow the insured to recover benefits while they are still living. If the insured is suffering from a critical illness or from a chronic medical condition, benefits can be paid from the policy during the insured’s lifetime. The insured will have to make application to the carrier to the recover the benefit.
Group Life & ERISA claims. We handle benefit claims that involve group life insurance. Group life insurance policies usually derive from employment. If the insured has a group life insurance policy through his or her employer we can handle the claim if there is a denial or delay in payment. In this context there are usually three parties involved: the insurance company, the employer and the beneficiary of the group policy.
Why should you choose our attorney to handle your Naples life insurance claim?
- Our attorney (Joseph Rosen) will directly handle your claim. Your matter will not be passed on to someone else.
- We do not promise results. We do our best to be fully transparent with the client about the case and its prospects.
- We only practice in Florida. Our offices are physically located in Florida.
- We pay attention to detail and strive to listen to the client’s concerns.
- Our fee structure is fair and affordable.
- We do our best to offer personalized legal services.
