Advocacy

Both insurer claim personnel and agents should know that suspicious claims have common attributes collated into lists called, The Red Flags of Fraud. Created as training aids, these lists are used to determine whether further investigation may be required to determine if a claim is false or fraudulent.  Categories vary, ranging from those associated with the claim itself or with insureds, to indicators of specific types of fraud, such as bodily injury or arson for profit. Particularly in a state like Florida where fraud is prevalent, it behooves everyone to be familiar with these lists and to act accordingly–courtesy of JS Contributor, Barry Zalma. Enjoy!

By JS Contributor, Don Brown

The recent Law360 article titled “Fla. Report Draws Serious Accusations of Insurer Misconduct” raises significant concerns about the financial practices of certain Florida insurance companies (See Note #3 below). Specifically, the article highlights how some insurers may be using Managing General Agents (MGAs) and other affiliated entities to mask profits while simultaneously justifying rate increases to regulators. This practice presents a legitimate concern for Florida’s policyholders and merits thorough investigation.

Last year I participated in a televised panel (WEDU PBS) with trial lawyer Chip Merlin and Journalist Lawrence Mower. Counting the moderator, I was outnumbered three to one but, still held my own debating those who only see their side of every insurance issue. 

Watch that program here and decide for yourself. Maybe you’ll agree that trial lawyers and journalists and broadcasters who do their bidding, will deny any benefit of recent tort reforms despite an insurance commissioner, Chief Financial Officer (CFO) and every credible unbiased source I can think of demonstrating that rates are going down and capital is returning to Florida.  

By JS Contributor Don Brown

As hurricanes become stronger and more frequent, building resilience into the homes and businesses along our coastlines has become a critical priority. This post explores the concept of “Code Plus,” a set of enhanced building standards specifically designed to help buildings withstand the ravages of hurricane winds, rain, and storm surge more effectively than traditional codes. Using Florida as a prime example, the “Code Plus” approach showcases how proactive building standards can make coastal living safer and, in the long term, more affordable by helping to reduce skyrocketing insurance premiums.

The question asked in the title above is answered in a paper written by JS Contributor Don Brown and offered here as the perfect primer for those who must occasionally explain Parametric insurance, especially to the public.  

You’ll find a downloadable PDF complete with footnotes using either the Home page under the “Library” tab titled “Miscellaneous Documents” (under Don Brown—Parametric Insurance) or by going here.

Assignment of Benefits Suit Fails for Lack of Standing

By Barry Zalma

Holding Insurance Companies Accountable, LLC (“HICA”) challenged the entry of summary judgment for American Integrity Insurance Company of Florida (“American Integrity”). HICA, as an assignee of post-loss insurance benefits, sued American Integrity for breach of contract. The trial court ruled that HICA lacked standing to sue because the assignment that it relied on did not follow the governing statute.

Holding Insurance Companies Accountable, LLC a/a/o Leonard Caruso v. American Integrity Insurance Company of Florida, No. 5D2023-2810, Florida Court of Appeals, Fifth District (January 3, 2025) resolved the dispute.

This article is from JS contributor Bill Wilson and pertains to a subject that falls within a topic area best described as… Insurance is only one form of Risk Management. Here, we are all reminded of needed protection via one homeowners experience–and that insurance can (should) be a last resort. Hope you enjoy this bit of wisdom (with some modifications) from Bill Wilson regarding check fraud and forgery, available at www.InsuranceCommentary.com.

The rain and wind had barely stopped when I received my first inquiry regarding Public Adjusters (PA’s).  Then came Milton and more inquiries, mostly from agents contacted by their clients who had been contacted by a PA, sometimes several PA’s.