Insurance Claim Disputes

Insurance claim disputes are not supposed to happen. The purpose of insurance is to help you when you are in need after a tragic accident or an unfortunate event. Many times the insurance company pays you the money that is due under the insurance policy after you make your claim. Sometimes they do not, by denying claims, paying less than is due, delaying payment, or making unreasonable demands before making payment. This is when you need a lawyer such as Larry Disparti or his firm, Disparti Law Group, P.A., to provide you with the advice and guidance on the variety of Florida Insurance Claim Disputes that arise. We have experience in reviewing various insurance claims and advising you of your rights under the policy.

Types of Insurance Policies We Handle

Among the types of insurance policies, which Disparti Law Group, P.A. have reviewed and provided advice, and litigated insurance issues on behalf of its clients, include:

Automobile

Each year automobile accidents sadly cause numerous injuries and losses of life. The State of Florida mandates that Florida drivers maintain certain insurance coverage such as personal injury protection (“PIP”) and property damage liability coverage. In certain cases, a driver may be required to carry personal injury liability coverage. Unfortunately, not all drivers carry the necessary coverage or any coverage at all. A person injured by an uninsured driver’s negligent operation of a vehicle, could be left without any viable recourse against the uninsured driver. Fortunately, there may still be insurance coverage available to the insured person. This coverage could include PIP coverage and Uninsured/Underinsured Motorist (“UM”) coverage. Our attorneys can advise the client whether PIP coverage or UM coverage exists and can litigate any disputes involving these coverages, or any other issues involving automobile insurance coverage.

Disability

Some of us think that we can work forever. However, an accident or disease could temporarily or permanently prevent one from continuing to engage in his or her avocation. Disability insurance could provide benefits to allow such person to cope with the economic difficulties that may arise in the event the person is unable to continue engaging in his or her chosen profession. Our attorneys can advise the client on what benefits are available under a disability policy, and can litigate any disputes concerning the benefits payable under the policy.

Health Insurance

This area encompasses Private insurance policies that you have purchased and group health policies falling under the purview of ERISA. Questions often arise concerning what benefits an insured is entitled to under a health insurance policy. These policies usually contain complex descriptions of what is covered and certain requirements that must be met before coverage is available. In addition, issues regarding preexisting conditions occasionally arise. That is, insurers sometimes deny coverage claiming that the insured failed to properly answer a question on an application for insurance relating to a preexisting condition. Disparti Law Group, P.A. can review a health insurance policy and provide advice as to what coverage is available under the policy, and litigate any issues regarding health insurance coverage.

Homeowner’s

One issue that frequently arises regarding homeowner’s policies is whether the damage sustained by a homeowner is covered by the policy. We can review your policy and advise you on your rights and coverage. This area includes Storm Damage to your home in the event of severe weather or any other climatic damage.

Mold Damage Claims

Mold litigation first grabbed the insurance industries attention when a Florida Jury awarded $14 Million in a mold claim arising out of the construction of the Martin County courthouse.

Today, due to the increase in the number of homes and the number of environmental factors here in Florida, there is a rise in mold problems in both commercial and residential properties. Increasingly, insurance companies have been denying rightful coverage on these types of claims.

Mold problems are serious and could be potentially deadly. The lawyers at The Disparti Law Group handle commercial and residential mold claims throughout the state.

The following are some of the common questions about mold and a short answer to each. Please contact us for a more in-depth answer or other questions.

What is mold and where is it found?
Mold (fungi) is present everywhere - indoors and outdoors. There are more than 100,000 species of mold. At least 1,000 species of mold are common in the U.S. Some of the most commonly found are species of Cladosporium, Penicillium, and Aspergillus. Florida mold is most likely to grow where there is water or dampness - such as in bathrooms and basements. Some species are capable of dangerous side effects from mold damage claims.

How can mold affect your health?
Most types of mold that are routinely encountered are not hazardous to healthy individuals. However, too much exposure to mold and mold damage claims may cause or worsen conditions such as asthma, hay fever, or other allergies. The most common symptoms of overexposure are cough, congestion, runny nose, eye irritation, and aggravation of asthma. Depending on the amount of exposure and a person’s individual vulnerability, more serious health effects - such as fevers and breathing problems - can occur but are unusual.

How can you be exposed to mold?
When moldy material becomes damaged or disturbed, spores (reproductive bodies similar to seeds) can be released into the air. Exposure can occur if people inhale the spores, directly handle moldy materials, or accidentally ingest it. Also, mold can sometimes produce chemicals called mycotoxins. Mycotoxins may cause illness in people who are sensitive to them or if they are exposed to large amounts in the air. Large exposures are typically associated with certain occupations (e.g., agricultural work). If you think you are being exposed to mold in your home, contact a mold lawyer today!

How does mold grow?
All molds need water to grow. Florida mold can grow almost anywhere there is water damage, high humidity, or dampness. Most often molds are confined to areas near the source of water. Removing the source of moisture - such as through repairs or dehumidification - is critical to preventing mold growth and mold damage claims.

What is Stachybotrys chartarum?
Stachybotrys chartarum (also known as Stachybotrys atra) is a type of mold that has been associated with health effects in people. It is a greenish-black mold that can grow on materials with a high cellulose content - such as drywall sheetrock, dropped ceiling tiles, and wood - that become chronically moist or water-damaged, due to excessive humidity, water leaks, condensation, or flooding.

How can you tell if Stachybotrys chartarum is present in your home?
Many molds are black in appearance but are not Stachybotrys. For example, the black mold commonly found between bathroom tiles is not Stachybotrys. Stachybotrys can be positively identified only by specially trained professionals (e.g., mycologists) through a microscopic exam. If you think you have toxic mold in your home, contact a mold lawyer today!

How can Stachybotrys chartarum affect your health?
Typically, indoor air levels of Stachybotrys are low; however, as with other types of mold, at higher levels health effects can occur. These include allergic rhinitis (cold-like symptoms), dermatitis (rashes), sinusitis, conjunctivitis, and aggravation of asthma. Some related symptoms are more general - such as inability to concentrate and fatigue. Usually, symptoms disappear after the contamination is removed.

There has been some evidence linking Stachybotrys with pulmonary hemosiderosis in infants who are generally less than six months old. Pulmonary hemosiderosis is an uncommon condition that results from bleeding in the lungs. In studied cases of pulmonary hemosiderosis, the exposure to Stachybotrys came from highly contaminated dwellings, where the infants were continually exposed over a long period of time.

What should you do if mold is present in your home or apartment?
Although any visible mold can be sampled by an environmental consultant and/or analyzed by a laboratory specializing in microbiology, these tests can be very expensive - from hundreds to thousands of dollars. There is no simple and cheap way to sample the air in your home to find out what types of mold are present and whether they are airborne. Even if you have your home tested, it is difficult to say at what levels health effects would occur. Therefore, it is more important get rid of the mold rather than find out more about it. The most effective way to treat mold is to correct underlying water damage and clean the affected area.

How should mold be cleaned?
Mold should be cleaned as soon as it appears. Persons cleaning mold should be free of symptoms and allergies. Small areas of mold damage claims should be cleaned using a detergent/soapy solution or an appropriate household cleaner. Gloves should be worn during cleaning. The cleaned area should then be thoroughly dried. Dispose of any sponges or rags used to clean mold.

If the mold returns quickly or spreads, it may indicate an underlying problem such as a leak. Any underlying water problems must be fixed to successfully eliminate mold problems. If mold contamination is extensive, a professional abatement company may need to be consulted.

Will my health or my child’s health be affected, and should we see a physician?
If you believe that you or your children have symptoms that you suspect are caused by exposure to mold, you should see a physician. Keep in mind that many symptoms associated with mold exposure may also be caused by many other illnesses. You should tell your physician about the symptoms and about when, how, and for how long you think you or your children were exposed.

Sinkholes

Florida Law requires homeowners insurance to pay for damages to your home caused by sinkholes. There are two types of sinkhole claims. The first type is where the insurance company has denied that a sinkhole exists. Florida law requires that the insurance company conduct certain tests by specially qualified individuals. More often than not, the claim is denied.

The second type is where the insurance company agrees that the sinkhole is there, but disagrees on how to fix the problem.

Common signs of sinkhole damage include:

• Cracked or leaking pool
• Large cracking in walls around doors and window frames
• Doors or window that do not work properly anymore
• Unusually large or rapidly developing depressions in yard or driveway
• Fence posts that start sagging or slanting of trees on the property
• Separation of walls from floors or ceilings
• Tilting or sinking of a section of floor
• Tree roots that are now exposed that were not before
• Poor compaction of soil around utility poles

Sinkholes are responsible for devastating losses to homeowners and property owners, and exist throughout Florida. Signs of sinkhole activity around a home could include cracks in structures and depressions in the land. However, these signs do not always mean that a sinkhole exists and that the homeowner has a Florida sinkhole damage claim under a homeowner’s policy. Disparti Law Group, P.A. can provide advice on whether there is coverage under a homeowner’s policy for sinkhole damage sustained to a home or property, and if need be, litigate any disputed issues involving homeowner’s or other coverage.

The following provides some background information about sinkholes. Please contact Disparti Law Group, P.A. if you have questions about a sinkhole claim.

In the geologic past, sea level has fluctuated significantly above and below its current elevation. As a result, limestone formations in Florida were exposed at the ground surface and subject to erosion and solutioning by rainwater, which is naturally slightly acidic. The erosion and solutioning caused cracks, cavities, and fractures to form in the limestone – producing a weathered and irregular limestone surface. After subsequent rises in sea level, the undulating limestone surface was buried and filled by younger deposits of clay, sand and silt. Even though the limestone is now covered with soils and clastic sediments, solutioning of the limestone by ground water continues. This chemical action tends to be concentrated along preferential paths for ground water flow such as joints, bedding planes, and pre-existing fractures and voids. The rate of dissolution is an imperceptibly slow process, requiring several thousand years for the formation of significant caverns or voids.

Non-cohesive soils and sediments (sands and silts), which overlie the limestone may move downward, or ravel, into the enlarged voids and cavities. The raveling may propagate upward to the surface as the overlying sediments move downward into the cavity. Sinkholes occur when the raveling reaches a point where the surficial soils cannot support the load at the surface, resulting in collapse or subsidence.

In this part of Florida, sinkholes occur by several mechanisms; cover-collapse, cover-subsidence, limestone-collapse, or limestone-solution (Sinclair et al., 1985). Cover-collapse sinkholes form where a thick, competent and generally impermeable clay layer overlies limestone bedrock. Initially the clay has sufficient strength to bridge a developing cavity in the underlying limestone. A cover-collapse sinkhole occurs as a result of sudden failure of the clay unit and catastrophic downward movement of the overlying sandy soils into the cavity (i.e., raveling). Cover-subsidence sinkholes may form by the gradual downward raveling of non-cohesive sediments (usually sand and silt) into actively forming cavities. The raveling reduces soil density, which is manifested at the surface by an area of slow, gradual, subsidence.

Limestone-collapse and limestone-solution sinkholes typically occur in terrains where limestone bedrock is covered by a relatively thin (25 ft.) layer of soil or overburden (sand and clay). A limestone-collapse sinkhole forms when a solution cavity expands to the point where the limestone roof collapses. The collapse is usually abrupt and sinkhole damage claims may be catastrophic in nature. A significant factor in the formation of limestone-collapse sinkholes is a low water table, typically below the limestone surface. Limestone-collapse sinkholes are relatively rare occurrences since dissolution is more likely to occur at the limestone surface. Contact a sinkhole claim lawyer today!

Limestone-solution sinkholes form through a mechanism of gradual solutioning of the buried limestone surface under relatively high water table conditions. Surface depressions generally form at a gradual rate as the limestone dissolves, usually without the formation of significant voids or sudden raveling of overlying sediments. Over geologic time this process results in a general, regional lowering of the land surface.

Subsidence investigations usually involve determination of the probability of cover-subsidence or limestone solution sinkholes, since the catastrophic nature of sinkhole damage from cover-collapse and limestone-collapse sinkholes leaves little doubt as to their identity. Because slow, gentle subsidence can result from other mechanisms, such as decay and compaction of buried organic material or movement of shrink/swell clays, identifying cover-subsidence (or limestone solution) sinkhole development as the cause of subsidence-related damage to a structure can be difficult. This is especially true in cases where there are no obvious signs of subsidence at the surface. Contact a sinkhole claim lawyer today!

A key element in identifying karst activity as the cause of damage is to establish the presence of a raveling zone of soft or loose soils that extends from limestone bedrock sufficiently close to the surface to cause subsidence. Alternatively, significant evidence of downward movement of surficial soils may also be indicative of karst-related subsidence. It should be noted that local zones of circulation loss in SPT borings, isolated soft or loose soil layers, or buried depressions in the clay or bedrock surface, in the absence of significant raveling or other evidence of downward movement of soils, is not necessarily positive evidence of sinkhole activity.

If you or a loved one is in need of legal assistance, call Disparti Law Group, P.A. toll free at (800) 633-4091 or submit an online questionnaire. The initial consultation is free of charge, and if we agree to handle your case, we will work on a contingency fee basis, which means we get paid for our services only if there is a monetary recovery of funds. In many cases, a lawsuit must be filed before an applicable expiration date, known as a statute of limitations. Please call right away to ensure that you do not waive your right to possible compensation.