You do the work, and we’ll help make sure you get paid
Water damage afflicts South Florida homes and businesses in any number of ways, including damage from hurricanes and storms, flooding, wind-driven rain, leaking roofs and water heaters, burst pipes and more. Water damage is even common after a fire due to fire suppression from sprinklers or first responders or from rain, which property owners have to deal with on top of smoke and fire damage. Emergency services are often necessary to remove debris, dry out the premises, extract water and stop further damage, including mold remediation and structural issues.
Water remediation, dry-out and restoration can be expensive, and many property owners find they can’t afford to hire a restoration professional out of their own pocket while waiting for the insurance check to arrive. An assignment of insurance benefits from the policyholder to the restoration company is a logical solution, but unfortunately disputes often arise with the insurance company. That’s where we come in. Juan Velasquez and his team at Velasquez & Associates are experienced legal professionals when it comes to dealing with insurance companies and property damage insurance claims. We work for policyholders as well as restoration professionals working on an assignment of benefits, and we take on the difficult task of recovering compensation from the insurance companies when they deny, delay or underpay a claim.
If you are a restoration professional in Miami concerned about getting paid under an assignment of benefits, call Velasquez & Associates for a free consultation. We’ll work on a contingency basis and only charge a fee after you get paid, based on what we can recover for you.
Can Florida policyholders complete an assignment of benefits under the new law?
For some reason, insurance companies don’t like it when their insureds complete an assignment of benefits. The insurance industry has been relentless in its attempts to limit the assignment of benefits either through their policy language or by lobbying the Florida legislature. The insurance lobby finally succeeded in getting the Florida legislature to enact significant restrictions on assignment of benefits. These changes went into effect on July 1, 2019.
HB7065 made extensive changes to the law by amending Florida Statutes section 627.422 on assignment of insurance policies and creating new sections 627.7152 and 627.7153. The law applies to assignments of post-loss benefits to restoration professionals and applies to both residential and commercial property insurance policies. Assignments of benefits are not prohibited under the new law, but certain steps are now required in the event of a dispute between the restoration professional and the insurance company.
The law now requires the restoration professional (the assignee) to provide a 10-day pre-suit notice to the insurance company before commencing litigation. The assignee must provide a detailed invoice or estimate and a pre-suit notice specifying the disputed damages, the amount claimed by the assignee and a settlement demand.
The insurer has ten days to respond with a settlement offer or a requirement for the assignee to participate in appraisal or some other form of dispute resolution, as provided for in the insurance policy. The assignee can be also be required to submit to an examination under oath (EUO) or give recorded statements when reasonably necessary. The insurer is required to promptly investigate, review and evaluate the dispute.
The new law also includes extensive requirements regarding the form and content of an assignment of benefits (known as an “assignment agreement”) along with requirements about when the agreement must be provided to the insurer. Our office is up to date on these requirements, so let us review your documents and practices to help avoid problems before they start.
What is Appraisal?
Appraisal is an informal form of alternative dispute resolution (ADR), or alternative to litigation. It’s most likely already included in the insurance policy you are working with. Typically, either party can request or require appraisal to settle a dispute, but you’ll need to review the particular policy to know for sure.
To start the process, each party picks an appraiser, and the two appraisers together pick an umpire. An umpire may also be selected by a judge if the appraisers can’t agree on one. Either the two appraisers together or all three will comprise an appraisal panel to decide the proper amount. The decision of the appraisal panel, which may be a 2-1 decision, is binding.
Appraisal is only used when the amount of loss is in dispute. A coverage dispute must be addressed some other way, including other forms of ADR like mediation or arbitration, or through litigation.
Policies are assignable or not assignable according to their terms
Under the new law, insurance companies can issue policies that restrict or prohibit assignment of benefits. If restricting assignment, the law requires the insurance company to also offer a policy that doesn’t restrict assignment of benefits, but this policy is required by law to have a higher premium than the restricted policy.
Either party could have to pay attorney’s fees
In the event of a lawsuit related to an assignment agreement for post-loss claims, the new law provides for the court to award one party’s attorney’s fees to be paid by the other party. If the judgment is 50% or more than the amount which was in dispute (the difference between the pre-suit settlement demand and the settlement offer), then the court awards the assignee’s attorney’s fees to be paid by the insurer. However, if the judgment is less than 25% of the amount in dispute, the insurer can get its attorney’s fees paid by the assignee. Getting attorney’s fees paid by the other side helps to maximize your award, but there is a lot at stake with the possibility of being forced to pay the other party’s fees. Be sure to hire a skilled and experienced attorney to represent you in these matters.
Legal Help for Restoration Professionals in Miami
If you are a Miami restoration professional or mitigation company in a dispute with the insurance company over an assignment of benefits, or if you need to know how the new law affects your business, call Velasquez & Associates at 786-776-0130 for a free consultation with a knowledgeable and experienced property damage insurance claims attorney.