Insurance Recovery & Counseling for Policyholders

Overview

Greenspoon Marder’s national Insurance Recovery and Counseling practice group represents policyholders in all types of insurance matters. We offer a practical, real-world approach to both assessing and addressing your insurance needs and securing insurance recovery in connection with both first- and third-party insurance policies. Greenspoon Marder lawyers are strong advocates for policyholders in cases involving nearly every type of insurance coverage for both corporate and individual clients all over the country. We have successfully secured hundreds of millions of dollars in defense costs, settlements, and indemnity payments on behalf of our clients. Our goal is to maximize your insurance payout as efficiently and expeditiously as possible.

Insurance policies are written by the companies that pay claims, which puts most policyholders at a disadvantage when a dispute arises. Insurers often deny claims based on narrow readings of policy language, delay payment while requesting repeated documentation, or offer a settlement well below the actual value of the loss. Recognizing these patterns early can make a significant difference in the outcome of an insurance claim.

A denial letter is not always the final word. Many claims that are initially rejected can be resolved through a formal appeal, a demand letter citing the specific policy provisions that support coverage, or litigation when the insurer will not reconsider. Reviewing the policy language against the reason for denial is often the first step in determining whether a claim was handled properly.

Policyholders who understand their rights before a loss occurs are in a stronger position when a claim is filed. This includes knowing what documentation to keep, what deadlines apply under the policy and under state law, and when a reservation of rights letter requires a response. Greenspoon Marder’s Insurance Recovery and Counseling group works with clients at every stage of this process, from reviewing policy language before a loss to pursuing recovery after a denial.

We can assist with all aspects of the insurance recovery process, from procuring policies and coverages through final resolution of any claims that might arise. This includes providing you with the following services, among many others:

• Reviewing your current insurance policies
• Helping to negotiate the wording of policy provisions and terms
• Crafting specialized endorsements focused on your particular business or situation
• Advising on the claim process and assisting with the presentation of a claim
• Responding to requests for information or examinations under oath
• Challenging any denial of coverage
• Responding to reservation of rights letters and analyzing potential conflicts of interest
• Negotiating interim or partial payments
• Ensuring that any statutory and policy deadlines and obligations are met
• Advocating for coverage
• When necessary, mediating, arbitrating, or litigating your claim to completion

Our Insurance Recovery & Counseling team also provide guidance on business issues, such as risk management strategies, the interplay between insurance and contractual and statutory indemnification issues, reviewing the insurance language included in your standard contract documents to maximize your insurance coverage and protection, identifying emerging insurance trends, and providing practical advice and solutions for your insurance needs.

Representative Experience for Insurance Recovery Claims

• Secured over $120 million in defense and indemnity payments from an insurer on behalf of a Fortune 500 client in a Qui Tam action involving over a dozen written court opinions.
• Secured tens of millions of dollars in payouts on behalf of MLB, NBA, NFL and NHL players under permanent disability, loss-of-value, temporary total disability, and critical injury insurance policies and coverages.
• Successfully sued parent insurance company for bad faith and breach of fiduciary duties in connection with the sale of a life insurance subsidiary to a buyer known for denying claims.
• Counseled professional sports teams and leagues in connection with their COVID-19 business interruption insurance claims and cases.
• Secured six-figure disability insurance payouts and significant health care coverage payouts for actors and musicians under individual disability policies and the SAG/AFTRA Health Plan.
• Crafted cost-of-insurance nationwide class action complaint involving hundreds of thousands of potential class plaintiffs arising out of employer-provided universal life policies.
• Represented motion picture and television companies in connection with COVID-19 business interruption claims as well as claims triggering coverage under Entertainment Insurance programs, Production policies, Producer and Entertainment policies, workers’ compensation and contingent workers’ compensation insurance policies, general liability policies, employer’s liability coverages, directors and officers coverages, and excess/umbrella coverages.
• Secured $20 million in insurance coverage from Environmental, D&O, P&C and Business Interruption insurers, in a case involving criminal indictments and proceedings.
• Involved with first-party natural disaster and catastrophic insurance claims and coverages, including representing individual homeowners impacted by California’s annual wildfires.
• Counseled college and professional athletes concerning the availability of insurance coverage for endorsement deals with pay-for-play provisions.
• Represented health care providers in securing defense and indemnity recoveries from insurance companies and joint powers authorities.

Insurance Recovery FAQs

What should I do if my insurance claim is denied?

Start by requesting the denial in writing and asking the insurer to cite the specific policy language it relied on. Review your policy for the deadlines that apply to appeals or disputes, since many states set strict time limits. An insurance recovery attorney can review the denial letter and the policy together to determine whether the denial was proper.

What is a reservation of rights letter?

A reservation of rights letter is a notice from your insurer stating it will investigate or defend a claim while reserving the right to deny coverage later based on specific policy provisions. Receiving one does not mean your claim has been denied. It means the insurer wants to keep its options open, and you may want legal guidance on how to respond.

How long does an insurance company have to respond to a claim?

Response deadlines vary by state and by the type of policy. Many states require insurers to acknowledge a claim within 10 to 30 days and to accept or deny it within a set period after receiving proof of loss. An attorney familiar with your state’s insurance code can confirm the deadlines that apply to your claim.

What is insurance bad faith?

Insurance bad faith occurs when an insurer fails to handle a claim fairly, such as by delaying payment without justification, misrepresenting policy terms, or denying a valid claim without a reasonable basis. Policyholders in some states can pursue separate legal claims against an insurer for bad faith conduct.

Do I need a lawyer to negotiate an insurance claim?

You are not required to hire a lawyer to file or negotiate a claim. Many policyholders bring in an attorney when a claim is denied, undervalued, or delayed, since insurers often have legal teams reviewing the same claim from their side.