Jeffrey Greyber

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When Is A Policyholder Eligible To Receive L&O And ALE Benefits?

Ordinance or law (“L&O”) coverage is “[c]overage for loss caused by enforcement of ordinances or laws regulating construction and repair of damaged buildings.”1 Additional living expense (“ALE”) coverage “reimburses the insured for the cost of maintaining a comparable standard of living following a covered loss that exceeds the insured’s normal expenses prior to the loss.”2… Continue Reading

Sunshine State Insurance Company … No Longer Shining

Yesterday, Judge Kevin Carroll of the Leon County Circuit Court, entered a Consent Order placing Sunshine State Insurance Company (“Sunshine State”) into receivership for liquidation, and stayed all current litigation against the company. Learning of this situation prompted me to call up some folks involved with a recent Sunshine State claim settlement I negotiated to … Continue Reading

Is A Surviving Spouse Liable For The Deceased Spouse’s “Uninsured” Medical Bills?

In my health insurance, life insurance, and long-term care insurance practice, I sometimes encounter the tangential issue of keeping the deceased insured’s creditors, such as hospitals and doctors, at bay from the deceased’s spouse until it is determined whether the creditors’ bills should have been paid by the insurance company. This begs the question: notwithstanding … Continue Reading

What Happens When A Claimant Passes Away?

Insurance companies will not hesitate to try to capitalize (pre- or post-litigation) on a claimant’s death … take it from a guy who has (twice in the last month alone) encountered carrier efforts to get out from underneath a claim through procedural technicalities following a claimant’s passing. However, if properly handled, the claimant’s death does … Continue Reading

Insurance Litigation Generally Should Not Occur In A Foreign Insurer’s Backyard

Earlier this week, I had to travel over 3,500 miles round trip to Minneapolis to take issue with a health insurance company suing my Florida policyholder client in Minnesota federal court in an effort to gain an unwarranted strategic and economic advantage. During my several years of insurance policyholder representation, the well-reasoned rule of thumb … Continue Reading

Legislative “Disability” Does Not Necessarily Equal Insurance “Disability”

My disability insurance clients often ask me whether being deemed “disabled” under the Social Security Disability Benefits Reform Act, the Family Medical Leave Act, or the Americans with Disabilities Act, necessitates approval of their disability insurance claim. Because I am often asked this question, I thought it worthwhile to blog about.… Continue Reading

Compliance With Examinations Under Oath – Supreme Court of Florida Authority Hot Off The Press

Many moons ago (on October 26, 2012, to be precise), I blogged about compliance with examination conditions. That blog noted conflicting views as to what is required of a policyholder under the policy’s condition for examination under oath (in the property insurance context) or compulsory medical examination (in the health, disability, or long-term care insurance … Continue Reading

The Location of Your Long-Term Care Can Be Make-or-Break

Regardless of the kind of insurance claim at issue, the wording of the insurance policy is indispensable to the coverage analysis, and many insurance companies will strive to avoid coverage by parsing policy words. To illustrate this point and contemporaneously caution those interested in procuring long-term care insurance, I now discuss the dogmatic interpretation and … Continue Reading

Buyer Beware: Is Your Insurance Premium Payment Worthless?

While researching a long-term care insurance issue the other day, I came across a decision revolving around another, unrelated issue that struck me as both disconcerting and blog worthy. Generally speaking, when you pay money for something, you expect to actually get that something in return, right? More specifically, when you pay an insurance premium … Continue Reading

Post-Application Manifestation Of A “Pre-Existing” Health Condition: No, You Are Not Necessarily Up The Creek Without A Paddle As The Carrier May Be Suggesting

Here is the hypothetical, yet all-too-common real life, scenario around which this blog revolves: you represent to a disability or life insurance company during the insurance application process that you do not have any noteworthy pre-existing conditions, but you find out for the first time after inception of your coverage that you had a malignant … Continue Reading

State Farm’s ACE Program

I have previously blogged about the decisions coming out of the United States District Court of Arizona in the Barten v. State Farm case. Recall, my Barten blogs have largely concerned State Farm’s corporate profit augmentation programs, whether the programs are called ACE or something else. Well, good orders just keep coming out of the … Continue Reading

Long-Term Care Insurance: The Pre-Existing Condition Dilemma

A reader of last week’s blog, Get Back To School – Long-Term Care Insurance 101, asked me if the Affordable Care Act removes insurance company pre-existing condition discrimination from Long-Term Care (“LTC”) insurance policy underwriting as it has from health insurance underwriting. Regrettably, the answer is “no,” as the government felt it was going to … Continue Reading

Get Back To School – Long-Term Care Insurance 101

I hope many of you have by now become aware of the launch of the Merlin Law Group’s disability, life, health, and long-term care insurance website:  I am going to start blogging on disability, life, health, and long-term care insurance issues on this Property Insurance Coverage Blog until we get a blog set up … Continue Reading

Innocent Co-Insured Doctrine

A recent situation reminded me of an often overlooked and underutilized legal gem – the innocent co-insured doctrine. This blog post is aimed at reminding policyholders and policyholder advocates of this doctrine, which could breathe life into a claim that, at first blush, seems untenable due to the alleged misconduct of one of multiple named … Continue Reading