Insurance Broker Liability

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As a business insurance policy holder, you know you’re entitled to compensation. What you don’t know is that you’re likely entitled to more coverage than you realize. To understand your policy’s full potential can require an expertise and experience you don’t have. Worse, the cost of getting any detail wrong could have great effect on your eventual compensation. The right path needs to be set from the very beginning. An attorney is the best way to do that.

Civil Commotion: Why you should contact us first

• An attorney will be your passionate advocate. They will give your case the necessary time and attention. A good attorney will legally compel your carrier to prove their case—in court, if need be. An attorney will hold your carrier accountable to you.

• In this crisis, insurance agents are overwhelmed. Our team will give your case the time, resources, and intention to help you reach your best possible outcome.

• You need good legal advice from a qualified professional. Even better when the law firm has over 30 years of experience in successfully advocating for clients, knowing the procedures and ins and out of cases like yours, and having seasoned experience communicating and negotiating with carriers.

• Most important—having a legal team fighting on your side not only speeds the process, but insures you have an advocate fighting passionately for your interests.

• Good legal advice can lead you to make more informed and better decisions and have them faster. This will help avoid the kinds of delays that are costly to you. An attorney can also promise you a less stressful and more comprehensible experience.

Learn how to protect your business
& get your full compensation

why your first call should be to an attorney

To better evaluate your options, let Furtado Law help you with a complimentary assessment of your policy. But don’t wait: Start protecting your business now by contacting the experts at Furtado Law.

Contact us at info@.furtadolaw.com with the following information:

• A copy of your certified insurance policy
• The name of your actual insurance carrier
• The name of your insurance representative or agent

Because what you don’t know will hurt you.

Fire

Potential problems with coverage:

  • • Brush exposure, failure to remove an adequate distance from structures
  • • Neighbors or cities or counties who don’t comply with necessary standards
  • • Not meeting demands of mortgage clauses
  • • Insufficient supply of fire extinguishers
  • • Breaches of compliance by tenants or third parties

Hail

Potential problems with coverage:

  • • Hail damage is covered by standard home insurance in most states, but how that coverage is applied can vary or be excluded altogether; they can also have percent-based deductibles (based on the home’s insured value)
  • • Damage can come in the immediate and long-term; for this and other reasons, what is and isn’t covered can be a source of dispute
  • • No matter the weather or climate conditions in your area, carriers can hike your rates if more than one claim is made within a time period
  • • Your carrier may have an option to exclude payments for cosmetic damages such as exterior surfaces, walls, roofs, doors, and windows if the storm impacts the appearance but not the function of these elements; what is and isn’t coverable can be very gray—often, if something is damaged but functional, it’s not covered

Wind

Potential problems with coverage:

  • • Depending on where you live, wind damage can be subject to percentage-based deductibles—which is based on your home’s insured value—or deductibles for wind damage, rain, tornados, hurricanes, or more; these costs are another reason it’s imperative you get your best compensation
  • • For disasters qualifying for FEMA relief—presidentially-declared disasters—help tends to be short on compensation and long in time coming 
  • • High winds can also bring other related damages—storm damage, inland flooding, falling trees, etc.; the more complicated the damages, the more cover you carrier has for denying your claim

Flood

Potential problems with coverage:

  • • Your insurance policy may require you to mitigate damage once it’s discovered; such costs may be reimbursable—fixing leaks, tarping the roof, installing dehumidifiers, etc.; initial water damage can worsen with mold, fungus, wet rot, and more—these are all consequences most insurance won’t cover
  • • It may be necessary to bring in an emergency services mitigation company to limit damages 
  • • As flood damage can be complicated, so is its coverage—e.g. sinkholes and earth movement, even as a result of flooding, may not be covered or there may be limitations given to living in a “high-risk” area
  • • The particular source of water damage can be critical too as carriers may have exclusions for discharge, sewage or other water backups or overflow

Appraisers not only help determine the amount of loss, but may also help determine the cause of loss. In Auto-Owners Insurance Company v. Summit Park Townhome Association, 100 F. Supp 3d 1099 (D. Colo. 2015) the court held that the cause of loss is an essential part of determining the amount of loss. Furtdao Law PC is litigating Certain Underwriters of Lloyd’s of London v. Southwind and Eastpointe Homeowners Association, Inc. (Case No. 1:16cv01288-MJW) where this ruling has been applied.

It is important that qualified professionals assist policyholders with the appraisal process. Insurance companies often attempt to influence the process by choosing biased appraisers to assist them. Some companies undermine the process by claiming an appraiser cannot determine the scope or cause of loss, and otherwise attempt to delay the process by interfering with the appraisal.

Furtado Law PC has sucessfully navigated the appraisal process for its clients.

Indemnity and defense provisions are so common, yet can be easily misinterpreted and misapplied. The terms defense and indemnify can often appear in the same clause, but each is understood to impose different obligations. These can be further compounded due to variations in statutes as well as case law that exists state to state.

The experienced attorneys at Furtado Law PC know the difference between the duty to indemnify and the duty to defend. We also know that there are some jurisdictions in which an indemnity obligation automatically carries with it the duty to defend regardless of whether the duty to defend is expressly stated.  We understand what is at stake, which is why we are committed to doing a thorough evaluation of your case to identify any ambiguities in the contract and determine how the governing law can be applied to your individual case.

Disputes between a policyholder and their insurance company about the “amount of loss” can be stressful and confusing. Furtado Law PC is committed to holding insurance companies accountable for a fair and cost-effective appraisal process.

This includes a “Proof of Loss” declaration under penalty of perjury. It is wise to consult with a qualified professional when submitting this document. If the “Proof of Loss” is found to be inaccurate, coverage under the policy may be voided.

Appraisers not only help determine the amount of loss, but may also help determine the cause of loss. In Auto-Owners Insurance Company v. Summit Park Townhome Association, 100 F. Supp 3d 1099 (D. Colo. 2015) the court held that the cause of loss is an essential part of determining the amount of loss. Furtdao Law PC is litigating Certain Underwriters of Lloyd’s of London v. Southwind and Eastpointe Homeowners Association, Inc. (Case No. 1:16cv01288-MJW) where this ruling has been applied.

It is important that qualified professionals assist policyholders with the appraisal process. Insurance companies often attempt to influence the process by choosing biased appraisers to assist them. Some companies undermine the process by claiming an appraiser cannot determine the scope or cause of loss, and otherwise attempt to delay the process by interfering with the appraisal.

Furtado Law PC has sucessfully navigated the appraisal process for its clients.

Too often, life insurance companies deny claims without justifiable reasons. Not all life insurance companies are created equal, and not all life insurance claims are treated fairly. There are a number of reasons that an insurance may deny a claim, such as no beneficiary named on the policy, policy lapse due to non-payment, divorce, “incontestability clauses”, or an assortment of tactics the company believes to be misrepresentation by the insured. In some cases, the insurance company pays the claim to the wrong beneficiary, leaving the intended beneficiary from collecting payments rightfully intended for them. Life insurance companies gain a financial benefit by collecting insurance payments and then either denying or paying substantially less when the claim is filed.  This conflict of interest can often result in a broken promise by the insurance company, denying loved ones the benefits to which they are entitled. 

 

What If Your Insurance Coverage Was Denied?

Can you sue the person who sold you the policy? 

There are substantive differences between the actions and liabilities of insurance agents and the actions and the liabilities of insurance brokers . Understanding who is liable is difficult, and our experienced attorneys are here to help you. 

Do you know the difference between an insurance agent and an insurance broker? 

An easy way to understand the distinction between an agent and a broker is that an agent typically represents insurers to sell you products, whereas a broker is generally hired by you to represent you when deciding between insurance policies.  

There are also differences in the types of insurance agents.  Some agents work with multiple insurers while other agents may work exclusively with one insurer.  

Can you sue your insurance agent for the uninsured loss? 

There are differences in the types of insurance agents.  Some agents work with multiple insurers while other agents may work exclusively with one insurer.  

Typically, agents who work exclusively for one insurance company are not liable merely for negligence in performing their duty on behalf of the insurance company.  Actions of the agent are attributed to the insurance company, not to the individual agent. 

An agent is also not liable for a failure to advise you on what the most appropriate coverage would be. The job of the insurance agent is to sell insurance products.  Agents do not recommend additional coverage, purchase additional coverage on your behalf, or advise you on the availability of additional coverage. 

Claiming negligence against an insurance agent can be complex, and these claims have a statute of limitations. Seeking the immediate advice of an experienced attorney is critical to ensure that your legal rights are protected.  

There are circumstances under which you can sue an insurance agent who: 

  • ● Misrepresents the nature, extent, or scope of coverage being offered or sold, either intentionally or negligently 
  • ● Negligently fails to disclose material information regarding insurance coverage that the insured requested 
  • ● Fails to obtain a particular type of coverage that was requested by the insured 
  • • Expressly or ostensibly represents themselves as having expertise in a specific type of insurance being sold and thus takes on a “special duty” to the insured

What is Insurance Broker Liability?  

Insurance brokers often come under scrutiny as a result of their actions or their inactions. Allegations of failure to recommend coverages or failure to add requested coverages are becoming increasingly common.  Insurance brokers work with multiple underwriters, and important details regarding the type, extent and amount of coverage can easily be overlooked or intentionally left out.  As the insured, it is your responsibility to review your policy to ensure that your coverage needs are accurately reflected in your insurance policy. These policies can be daunting to read and understand, and are clearly not written in easy language that is well understood by the policyholder. 

 The liability of a broker is similar to that of an insurance agent but not completely identical.  It’s important to know that a broker does not have a duty to inform you of the financial stability, or instability, of an insurance company before providing you a policy from that insurer. Even worse, errors by a broker can actually lead to liability by you, the insured. There is an assortment of legal complexities that determine if an insurance broker can or cannot be held liable.  For this reason, you need an experienced attorney to help you understand your legal options. 

A broker is liable to an insured when: 

  • • The broker misrepresents the nature, extent or scope of coverage 
  • • The insured specifically requests a certain type of extent of coverage and the broker does not obtain it 
  • • The broker expressly or ostensibly holds themselves out as an expert in a given field of insurance 
  • • The broker reduces coverage limits without the insured’s consent 

 

What If Your Insurance Coverage Was Denied?

Can you sue the person who sold you the policy? 

There are substantive differences between the actions and liabilities of insurance agents and the actions and the liabilities of insurance brokers . Understanding who is liable is difficult, and our experienced attorneys are here to help you. 

Do you know the difference between an insurance agent and an insurance broker? 

An easy way to understand the distinction between an agent and a broker is that an agent typically represents insurers to sell you products, whereas a broker is generally hired by you to represent you when deciding between insurance policies.  

There are also differences in the types of insurance agents.  Some agents work with multiple insurers while other agents may work exclusively with one insurer.  

Can you sue your insurance agent for the uninsured loss? 

There are differences in the types of insurance agents.  Some agents work with multiple insurers while other agents may work exclusively with one insurer.  

Typically, agents who work exclusively for one insurance company are not liable merely for negligence in performing their duty on behalf of the insurance company.  Actions of the agent are attributed to the insurance company, not to the individual agent. 

An agent is also not liable for a failure to advise you on what the most appropriate coverage would be. The job of the insurance agent is to sell insurance products.  Agents do not recommend additional coverage, purchase additional coverage on your behalf, or advise you on the availability of additional coverage. 

Claiming negligence against an insurance agent can be complex, and these claims have a statute of limitations. Seeking the immediate advice of an experienced attorney is critical to ensure that your legal rights are protected.  

There are circumstances under which you can sue an insurance agent who: 

  • ● Misrepresents the nature, extent, or scope of coverage being offered or sold, either intentionally or negligently 
  • ● Negligently fails to disclose material information regarding insurance coverage that the insured requested 
  • ● Fails to obtain a particular type of coverage that was requested by the insured 
  • • Expressly or ostensibly represents themselves as having expertise in a specific type of insurance being sold and thus takes on a “special duty” to the insured

What is Insurance Broker Liability?  

Insurance brokers often come under scrutiny as a result of their actions or their inactions. Allegations of failure to recommend coverages or failure to add requested coverages are becoming increasingly common.  Insurance brokers work with multiple underwriters, and important details regarding the type, extent and amount of coverage can easily be overlooked or intentionally left out.  As the insured, it is your responsibility to review your policy to ensure that your coverage needs are accurately reflected in your insurance policy. These policies can be daunting to read and understand, and are clearly not written in easy language that is well understood by the policyholder. 

 The liability of a broker is similar to that of an insurance agent but not completely identical.  It’s important to know that a broker does not have a duty to inform you of the financial stability, or instability, of an insurance company before providing you a policy from that insurer. Even worse, errors by a broker can actually lead to liability by you, the insured. There is an assortment of legal complexities that determine if an insurance broker can or cannot be held liable.  For this reason, you need an experienced attorney to help you understand your legal options. 

A broker is liable to an insured when: 

  • • The broker misrepresents the nature, extent or scope of coverage 
  • • The insured specifically requests a certain type of extent of coverage and the broker does not obtain it 
  • • The broker expressly or ostensibly holds themselves out as an expert in a given field of insurance 
  • • The broker reduces coverage limits without the insured’s consent 

 

Schedule a Complimentary Consultation at
(866) 497-6106