Even after we agreed to accept more risk in our policies, big insurance not only reneged on their promise to lower rates for Floridians, they continued to increase them. And while the Office of Insurance Regulation should be applauded for its decision to hold hearings to find why we were lied to, they are also getting a real sample of what lengths insurance companies will endure to fatten their bottom lines at the expense of consumers. Furthermore, having chaired the American Association for Justice's Bad Faith Group, I also have been witness to the much-sought-after Allstate-McKinsey documents along with similar unfair claims tactics used by carriers as far back as the early 1990s.

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The Mississippi Sun Herald reported that the Merlin Law Group settled claims against State Farm Insurance Co. on behalf of 103 Mississippi policyholders over the company's refusal to cover damage to their homes from Hurricane Katrina.

The settlement brought closure to a Diamondhead couple that had already gone to state-sponsored mediation with State Farm twice, where they turned down offers of $100,000 and then $110,000 for destruction of their home in South Diamondhead. A third offer of $40,000 came while being represented by another law firm the couple had hired prior to retaining the Merlin Law Group.  "You can imagine what we thought when we were handed a check for $40,000," Curtis Lee said. "We told them what to do with it."

The St. Petersburg Times chronicled the struggles of 43 low-income central Florida policyholders since Hurricane Charlie hit in 2004. The Merlin Law Group filed lawsuits against United Casualty on behalf of each of the Arcadia area policyholders, alleging that claims were underpaid, and indicated that more suits could be forthcoming. "Punitive damages could be a significant number," said David Pettinato, a Merlin Law Group attorney representing the policyholders. "If you look at the dwellings, most are in the same condition as after the storm. We want them (United Casualty) to at least pay the policy limits and reimburse each of the policyholders for additional damages."

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In this case, the insureds sustained a theft loss and made a claim under their homeowner’s policy, which provided for replacement cost coverage for their personal property.  The insureds took the position that they were entitled to receive the replacement value of the loss once they produced receipts for the replacement items.  Although the insureds did replace some of the items, the insurer later suspected that some of the claimed replacement had not occurred, and that some of the orders to purchase replacement items were cancelled. 

In Grife, the federal district court addressed an issue of insurance policy interpretation concerning a condominium unit owner’s insurance policy’s loss assessment provision.  The court concluded that the policy language in question provided loss assessment coverage for losses in excess of the association’s master policy limit. 

Ceballo dealt with the interpretation of the 2004 version of Florida’s Valued Policy Law.  Here, the Florida Supreme Court analyzed whether the payment of additional coverages, such as Ordinance or Law coverage, is owed without a showing that any such expense was actually “incurred,” as the policy language in that case required.  The Court concluded that the purpose of the Valued Policy Law did not extend to these supplemental coverages. 

In Cox, the question was whether Florida’s Valued Policy Law, section 627.701(1), Florida Statutes (2004), required an insurance carrier to pay the face amount of the policy when a building is deemed a total loss, even if the building is damaged in part by both a covered peril and by an excluded peril.   Although the intermediate appellate court and the widely-recognized Mierzwa opinion had previously concluded that the answer would be yes, the Florida Supreme Court decided the opposite, and disapproved the previous appellate opinions on the subject. 

In September of 2002, Tscharner Myrick ("Myrick") noticed cracking to her home and made a claim with her homeowner's insurance carrier, First Floridian Auto & Home Insurance Company ("First Floridian"). First Floridian retained Rimkus Consulting Group, Inc. ("Rimkus"), to investigate the cause of damage. In October of 2002, Rimkus confirmed sinkhole activity and recommended compaction grouting to stabilize the property. First Floridian advised the insured the loss was covered, and it was securing grouting bids.

Before joining MLG, Robert “Bob” Reynolds was a defense attorney for insurance carriers. Spending time in his opponent’s camp has taught him a thing or two…

How did experience on the inside prepare you as a protector of policyholder rights?
It allowed me to become familiar with the policies and tactics of the insurers and their counsel.  As such, I feel like I’m far better prepared to answer the arguments they may put forth because I’ve been in their shoes.  In general, it allows me some basis to anticipate what their next moves might be and provides me with insight on how to counter for my client.

In Starling, the homeowner’s policy required the insured to provide a sworn proof of loss and also required compliance with all policy terms before suit could be brought to enforce the insurance policy.  After the insured sustained a fire loss, the carrier reminded the insured of the policy requirement regarding the sworn proof, but the insured filed suit without having complied with this policy condition.  Three months after filing suit, the insured submitted a sworn proof, and she did not submit a contents inventory until six months after that.