DEFINITIONS
Comparative Negligence
Negligence of a plaintiff in a civil suit which decreases his/her recovery by his/her percentage of fault compared to a defendant's degree of negligence and/or fault. In Florida, when more than one party contributed to the accident, the percentage of fault is compared, which is known as comparative negligence. Basically, the at-fault party's liability for the accident is determined by comparing their carelessness to the carelessness, if any, of the injured claimant to derive a percentage that must be paid for the resulting damage(s).
Complaint
In a civil case, it is the initial document entered by the plaintiff (i.e. "claimant"), which states the claims (i.e., "causes of action") against the defendant (e.g., "at-fault party" or "tortfeasor").
Improper Claim Denials
There are a number of signs in an insurer's denial letter that may indicate the denial is improper such as the following:
Specific insurance policy provisions are not referenced in the denial;
Language that does not exist in the policy is referenced to support the denial;
Copies of the policies are not provided to the policy holder for which coverage is denied;
Claim-related facts are not stated in the coverage denial, which may be indicative of an inadequate investigation prior to denial;
Policy exclusions or conditions are referenced in the denial that are not relevant to the claim;
Attempts are made to reserve additional policy defenses after the denial of coverage; and,
more information is requested even though the claim has been denied.
Low-balling
Low-balling refers to the practice of an insurance company paying only a percentage of the full value of an insurance claim. For example, if you are in an auto accident, clearly not liable, and incurred substantial injuries, then a settlement offer that is too low may constitute "low-balling". As applied in the property loss context, if a car is totaled and the insurance company assessed the actual cash value of that car at $25,000.00 but the insured cannot find a replacement vehicle in the market place for $25,000.00, then this is a type of case that may give rise to "low-balling" by the insurance company. Some common low balling techniques include:
Ignoring the claimant and failing to acknowledge damage;
Acknowledging damage but failing to include all of the claimaint's damages; and,
Acknowledging all the damages but failing to compensate the claimant for its full value.
Low-balling can incur in a large variety of contexts such as motor vehicle, theft, fire, hurricane, sinkhole, flood, lighning, other types of casualty, and many more.
Stonewalling
Stonewalling occurs when an insurance company takes an unreasonable period of time in which to process a given claim. For example, if the claim is reported to the claims department but the claim is not assigned to a claims representative, then “stonewalling” may arise. Similarly, claims representatives may be overworked, inexperienced, inadequately trained, and reassigned, which may lead to an unreasonable amount of time in processing the reported claim. Stonewalling may also occur when the insurance company denies that its insured is at fault or is otherwise covered for the type of accident and/or loss that is at issue. In sum, “stonewalling” is like talking to a stone wall.
Comparative Negligence
Negligence of a plaintiff in a civil suit which decreases his/her recovery by his/her percentage of fault compared to a defendant's degree of negligence and/or fault. In Florida, when more than one party contributed to the accident, the percentage of fault is compared, which is known as comparative negligence. Basically, the at-fault party's liability for the accident is determined by comparing their carelessness to the carelessness, if any, of the injured claimant to derive a percentage that must be paid for the resulting damage(s).
Complaint
In a civil case, it is the initial document entered by the plaintiff (i.e. "claimant"), which states the claims (i.e., "causes of action") against the defendant (e.g., "at-fault party" or "tortfeasor").
Improper Claim Denials
There are a number of signs in an insurer's denial letter that may indicate the denial is improper such as the following:
Low-balling
Low-balling refers to the practice of an insurance company paying only a percentage of the full value of an insurance claim. For example, if you are in an auto accident, clearly not liable, and incurred substantial injuries, then a settlement offer that is too low may constitute "low-balling". As applied in the property loss context, if a car is totaled and the insurance company assessed the actual cash value of that car at $25,000.00 but the insured cannot find a replacement vehicle in the market place for $25,000.00, then this is a type of case that may give rise to "low-balling" by the insurance company. Some common low balling techniques include:
Low-balling can incur in a large variety of contexts such as motor vehicle, theft, fire, hurricane, sinkhole, flood, lighning, other types of casualty, and many more.
Stonewalling
Stonewalling occurs when an insurance company takes an unreasonable period of time in which to process a given claim. For example, if the claim is reported to the claims department but the claim is not assigned to a claims representative, then “stonewalling” may arise. Similarly, claims representatives may be overworked, inexperienced, inadequately trained, and reassigned, which may lead to an unreasonable amount of time in processing the reported claim. Stonewalling may also occur when the insurance company denies that its insured is at fault or is otherwise covered for the type of accident and/or loss that is at issue. In sum, “stonewalling” is like talking to a stone wall.