One tactic consistently used by defense attorneys on behalf of insurance companies is to complicate the issues, relying on complexity, confusion, and ambiguity to successfully defend against claims by policyholders. The purpose of confusing the issues is to prevent the judge and jury from considering the insurer’s conduct and instead turn their attention to the policy’s ambiguous language and Florida statutory law.
So, what is the best way to defeat this inevitable strategy? Rick Friedman and Patrick Malone provide the step by step method in their trial guide, Rules of the Road: A Plaintiff Lawyer’s Guide to Proving Liability.1 Specifically, the book offers a framework for policyholder attorneys to reference throughout each critical stage of the claim. This framework is comprised of a list of rules that form the foundation of building the case against the insurer. Notably, Friedman and Malone provide a list of principles that apply almost universally in all policyholder property insurance claims. Those principles are as follows:
- Must treat its policyholders’ interests with equal regard as it does its own interests. This is not an adversarial or competitive process.
- Insurance company should assist the policyholder with the claim.
- Insurance company must disclose to its insured all benefits, coverages, and time limits that may apply to the claim.
- Insurance company must conduct a full, fair, and prompt investigation of the claim at its own expense.
- Insurance company must fully, fairly, and promptly evaluate and adjust the claim.
- Company must pay all amounts not in dispute within 30 days.
- Company may not deny a claim or part of a claim based upon insufficient information, speculation, or biased information.
- If full or partial denial, must give written explanation, pointing to facts and policy provisions.
- Company may not misrepresent facts or policy provisions.
- Company may not make unreasonably low settlement offers.
- Company must give claimant written update on status of claim every 30 days, including a description of what is needed to finalize the claim.2
These “rules of the road” are examples of foundational principles that can help narrow the issues for policyholder attorneys to be utilized throughout each critical stage. Not only does the book provide valuable advice on how to formulate a personalized list of rules, but it also gives real-life examples of how their rules of the road have been used successfully. For those interested in learning how to effectively organize and focus their claim against insurance companies, Rules of the Road is a must-read.
1 Friedman, Rick, and Patrick Malone. Rules of the Road: a Plaintiff Lawyer’s Guide to Proving Liability, 2nd ed.. Trial Guides, 2010.
2 Id. At 195.