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A Commercial Property Claims Attorney at Rubinton || Simms, P.A. Can Help With Commercial Property Claims
Commercial property insurance is like homeowner’s insurance, except it is meant to cover commercial property rather than homes, including large homeowners and condominium associations. Like homeowner’s insurance claims, business owners and/or associations tend to demand repairs and replacements far beyond the actual damages.
Fortunately, the commercial property claims attorneys at Rubinton || Simms, P.A. always prefer to negotiate reasonable compromises rather than let the issues become combative or even litigious. We help commercial insurance companies investigate and review claims and applications, advise their clients on whether claimants are covered under their insurance policies, advise their clients regarding payout amounts, predict the results of potential litigation, and help prevent fraud and abuse.
Pre-Suit Investigations
Pre-suit investigations are critical when a commercial building owner and/or association is filing a claim against their insurance company. As a representative of a commercial property insurance company, you should always take the time to thoroughly investigate the facts of the claim, assess potential legal strategies, look into all of the potentially available jurisdictions, and consider the strategic benefits and costs of settlement vs. litigation. In this way, a commercial property insurance dispute is no different from any other type of lawsuit.
A comprehensive pre-suit investigation allows you to advise your clients both legally and strategically before initiating any litigation. Such investigation will allow you to gather and organize the facts needed to streamline pre-litigation motions and immediately initiate discovery, which always puts you one step ahead of your opposition, leaving them to play catch-up. Additionally, a thorough pre-suit investigation prepares you for potential, more subtle, options down the road. Finally, Rubinton Simms, PA is happy to provide timely progress reports, especially when it’s good news.
Claims Handling
Handling claims is often the responsibility of claims specialists, including those at commercial property insurance. Insurers and carriers almost always use at least one type of claims specialist for handling every claim, known as claims adjusters. The insurer may also elect to use insurance claims accountants and attorneys.
An insurer’s claim adjuster’s primary responsibilities include the following:
- Determining the cause of the claimed loss
- Determining whether the policy in question provides coverage for the claimed loss
- Determining the extent of the property damage
- Determining the cost to repair or replace the property
- Determining which items should be replaced, which items should be repaired, and what should be done with the damaged property
- Determining the amount that the insurer should payout
The insurer’s adjuster can also advise the insured on taking steps to mitigate, minimize, and prevent further damage. Adjusters may also help find cleanup and repair services in the area.
Consulting
Claims consultants may be used to process insurance claims and review new and existing insurance policies. They review client claims, applications, and adjustments and advise whether clients are covered under their insurance policies. They may also advise the amount an insurance company should payout for a claim and why.
Coverage Options and Determinations
A coverage opinion advises your client on how available case law interprets insurance policy coverage provisions of a loss. This is particularly important when there is no case directly on point. In these circumstances, the client should know how a particular court is most likely to rule upon coverage based upon known facts. Put another way, predict the likely determination of a litigated claim regarding policy interpretation.
SIUs and Fraud
An SIU, or special investigation unit, investigates insurance fraud. Their only purpose is to fight insurance fraud, which adversely affects everyone who provides or purchases commercial property insurance because fraud effectively raises costs for both sides. The potential for commercial insurance fraud is a constant concern whenever commercial property insurance claims are made. Moreover, concerns about insurance fraud tend to increase in troubled economic times because nobody can afford the damage it causes.
According to the FBI, “[t]he total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year. That means [i]nsurance [f]raud costs the average U.S. family between $400 and $700 per year in the form of increased premiums.” The FBI goes on to identify various types of insurance fraud schemes:
- Premium Diversion. Premium diversion is the embezzlement of insurance premiums. It is the most common type of insurance fraud. It happens when an insurance agent keeps the premiums money for personal use rather than sending it to the underwriter.
- Fee Churning. In fee churning, a series of intermediaries take commissions through reinsurance agreements, and the initial premium is reduced by repeated commissions until there is no longer money to pay claims.
- Asset Diversion. Asset diversion is the theft of insurance company assets that occurs almost exclusively in the context of an acquisition or merger of an existing insurance company. Asset diversion often involves acquiring control of an insurance company with borrowed funds. After making the purchase, the subject uses the acquired company’s assets to pay off the debt. The remaining assets can then be diverted to the subject.
- Workers’ Compensation Fraud. Some entities purport to provide workers’ compensation insurance at a reduced cost and then misappropriate premium funds without ever providing insurance.
Bad Faith and Class Actions
When a corporate insurer supports the treatment of bad faith claims, this is referred to as institutional bad faith. On the other hand, a class-action lawsuit is filed on behalf of a group of people who are all in the same situation.
The attorneys at Rubinton Simms, PA are skilled in defending against those individiduals and/or groups seeking to recover punitive and other extracontractual damages from the Insurance Companies. Attorneys like those at Rubinton || Simms, P.A. and Insurers alike enjoy the benefits of eliminating ill-gotten gains, which may lead to lower costs and prices.
How a Commercial Property Attorney at Rubinton || Simms, P.A. Can Help You Defend Against Unreasonable Claims
Commercial property insurance carriers, like homeowner insurance carriers, are often faced with commercial property damage claims that are unreasonable, unfounded, and sometimes simply motivated by greed. Unfortunately, various media types, including social media, have created the misconception that all insurance companies are out to cheat them. The fact is insurance carriers that routinely cheat their customers don’t stay in business for very long.
If your insurance company faces any unreasonable claims, contact the commercial property attorneys at Rubinton || Simms, P.A. We offer house calls, in-house private investigators, 24/7 phone service, 12-hour turnaround response time, after-hours scheduling, and proprietary technology. As a result, we have received numerous accolades and awards, as well as extensive media coverage.