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Practice areas

Insurance Coverage Disputes & Denials of Coverage

The insurance attorneys at Clark & Martino, P.A. handle both first-party coverage disputes and third-party coverage disputes.

Definitions of Insurance Terms

  • First-party insurance: Type of insurance policy under which an insured (the first party) is covered by his or her insurer (the second party) in the event of an accident, injury, or loss whether caused by itself or someone else (the third party). Said differently, it is generally a claim you have against insurance you or a relative purchased. Another example would be when you are involved in an automobile accident and you have underinsured / uninsured motorist coverage or the owner / driver of the vehicle has underinsured / uninsured motorist coverage.
  • First-party insurance coverage disputes arise when a claim is made against the policy and the insurance company and the policy holder disagree over what is covered by the policy or to the extent to which coverage applies.
  • Third-party insurance: Liability insurance purchased by an insured (the first party) from an insurer (the second party) for protection against the claims of another (the third party). The first party is responsible, through their insurance, for damages or losses caused to the third party. An example would be when you are injured by someone else who has an insurance policy which provides coverage for your losses.
  • Third-party insurance coverage disputes usually refer to disputes between you and the insurance company of the other person involved in an accident or injured by negligence, or the third party. Third-party disputes typically involve allegations that an insurer failed to pay a claim. In many disputes, the case revolves around the interpretation of the policy language, including policy definitions.
  • Underinsured/Uninsured Motorist (“UM”) Coverage is a form of automobile insurance that applies if someone causes a crash and injures you but has no insurance or not enough insurance. This is a type of first-party insurance.
  • Homeowners Insurance Coverage is a form of property insurance to protect your home against damages to the house itself, or to possessions in the home. It generally also provides liability coverage against accidents in the home or on the property. This is a type of first-party insurance.
  • Disability Insurance provides supplementary income in the event of an illness or accident resulting in a disability that prevents you from working. This is a type of first-party insurance.
  • Life Insurance protects against the loss of income that would result if the insured passed away. A named beneficiary receives the proceeds to minimize the impact the death of the insured.

Florida Insurance Disputes and Declaratory Judgments

In Florida, most insurance coverage disputes that cannot be resolved through negotiations between the parties are resolved by the courts through declaratory judgment actions. In a typical declaratory judgment action, the court issues a ruling as to what is covered in the policy at issue or what certain policy language means under current laws and case rulings.

In certain cases like first party cases, you may be entitled to have your attorney’s fees paid by the insurance company. See Fla. Stat. 627.428 (Upon the rendition of a judgment or decree by any of the courts of this state against an insurer and in favor of any named or omnibus insured or the named beneficiary under a policy or contract executed by the insurer, the trial court shall adjudge or decree against the insurer and in favor of the insured or beneficiary a reasonable sum as fees or compensation for the insured’s or beneficiary’s attorney prosecuting the suit in which the recovery is had.)

After the judgment is issued, the coverage dispute is usually resolved between the parties and they are bound to follow the courts interpretation of the policy language. As highly experienced insurance attorneys, we help injured people and insured parties analyze and interpret insurance policies to determine what is covered and seek declaratory judgments when coverage is unclear or wrongfully denied.

Common Types of Insurance Coverage Disputes

Clark & Martino, P.A. handles all types of coverage disputes, including allegations involving the following:

  • Scope of coverage and coverage exclusions
  • Underinsured Motorist Insurance
  • Denial of claim
  • Homeowners Insurance Claim
  • Disability Insurance Claim
  • Life Insurance Claim
  • Third-party coverage
  • Stacking insurance policy provisions
  • Bad faith denial of claims
  • Wrongful refusal to settle
  • Duty to defend
  • Undervaluation of insurance claims
  • Excess insurance disputes

Contact us to tell us more about your dispute.