Insurance Benefit Recovery of Up To $100,000
- Twenty-two percent (22%) of clients’ insurance benefit payment if claim is paid before a lawsuit or arbitration is filed;
- One-third (1/3) of clients’ insurance benefit payment if claim is paid after a lawsuit or arbitration is filed but before the first day of trial or arbitration;
- Forty percent (40%) of clients’ insurance benefit payment if claim is paid on or after the first day of trial or arbitration
Insurance Benefit Recovery of $100,000 to $1,000,000
- Seventeen-and-a-half percent (17.5%) of clients’ insurance benefit payment if claim is paid before a lawsuit or arbitration is filed;
- Twenty-five percent (25%) of clients’ insurance benefit payment if claim is paid after a lawsuit or arbitration is filed but before the first day of trial or arbitration;
- One-third (1/3) of clients’ insurance benefit payment if claim is paid on or after the first day of trial or arbitration.
Insurance Benefit Recovery over $1,000,000
- Twelve-and-a-half percent (12.5%) of clients’ insurance benefit payment if claim is paid before a lawsuit or arbitration is filed;
- Twenty-two-and-a-half percent (22.5%) of clients’ insurance benefit payment if claim is paid after a lawsuit or arbitration is filed but before the first day of trial or arbitration;
- Twenty-eighty percent (28%) of clients’ insurance benefit payment if claim is paid on or after the first day of trial or arbitration.
Insurance companies nationwide are uniformly denying, delaying and low-balling business customers with legitimate COVID-19 business interruption coverage claims. This has occurred in the past when insurers collectively try to dodge mass claims, such as those arising from hurricane catastrophes or environmental disasters.
We understand that these benefits can help save your business.
Here is our business interruption insurance claim checklist for overcoming unfair insurance practices that lead to bogus claim denials.
1. Business Insurance Policy Review
- We will carefully review your entire business insurance policy, including endorsements and policy addendums.
- We will advise you whether your business insurance policy covers your pandemic-related business losses and costs incurred (e.g., PPE, testing, disinfecting your plant, etc).
- There is no fee for this policy review.
2. Decision To Proceed
- In most cases, business losses/costs are covered (and should be paid) when business interruption insurance coverage is included in a policy.
- We will agree to represent you if we determine that your insurance company owes your business these benefits.
- If you choose to allow us to represent you going forward, we’re all in.
- Here is our Contingent Fee Agreement. As this fee agreement sets forth:
- You don’t pay us until we recover your benefits.
- The amount you pay us depends on the size of your claim and the amount of work required.
- Here is our Contingent Fee Agreement. As this fee agreement sets forth:
- If you choose not to proceed past this point, you owe us nothing.
3. Business Interruption Insurance Claim Submission
- Our claim submission goal is to force the insurance company to timely identify all of its reasons for denying your claim.
- Even though you may have already submitted your business interruption claim to your insurance company, chances are we’ll still want to submit a claim to your company.
- Insurance companies often respond differently on a claim decision when it is properly submitted by a reputable law firm.
- The insurance company response to our claim submission allows us to establish the battle lines.
- The insurer’s written response to our claim submission can be invaluable evidence in your case.
- We will give the insurance company 30 days to respond to our claim submission.
- If we don’t receive a timely response, this can be helpful to the lawsuit we file.
The chances are very high that your business claim will still be denied at this point. But this claim submission to the insurance company will still be worthwhile. If they decide to pay the claim rather than face a lawsuit, your fee will be lower if a lawsuit can be avoided.
If the insurance company agrees to cover your claim, there’s still a good chance that it will not agree to pay the full amount your business is entitled to. If this occurs, we’ll try negotiating before we file a lawsuit. If your claim settles in this phase, your fee is lower and your business gets these benefits sooner.
4. Decision to File a Lawsuit against your Insurance Company
- In order to obtain the benefits our clients are due, we will be required to file a lawsuit in most of our cases.
- If your insurance company won’t offer to pay the full amount of your claim without being sued, we’ll promptly start your lawsuit. In most cases, a lawsuit is the only way to force the insurance company to pay these benefits.
- After we commence a lawsuit, each side will exchange information that the other side requests.
- We are often required to file motions with the court in order to force insurers to provide us with all of the information we are entitled to.
- Once we have the documents and information we require, depositions typically follow this exchange of information.
- At any point in this phase (known as the “discovery phase”) settlement negotiations often occur.
- We will continue to press our client’s cases forward unless and until negotiations lead to a fair settlement.
We always move aggressively through the discovery phase and prepare each case for a successful trial. This assures a timely trial and is the best way to facilitate a fair settlement. If a fair settlement isn’t achieved in this discovery phase, the best practice is to start trial as soon as possible.
If a fair settlement can be reached in the discovery phase, our client will pay a lower fee than the percentage we would be due once we start trial.
- “Actions speak louder than words.”
- In some cases, a trial verdict is still the only way to obtain the entire insurance benefit our client is entitled to.
- Our lawyers take cases to trial many times each year.
- Our track record of obtaining major verdicts over the past quarter-century will be factored into the insurance company’s settlement posture.
- Before we need to go to trial for most of our clients, our reputation as a skilled trial firm helps us to achieve strong settlements.
- We build our cases assuming each one will go to verdict.
- By being “trial ready,” good settlement results are more likely to be achieved.
- This is why we do not build our cases to settle. We build our cases to win them at trial. Once this is clear to the other side, they are more likely to come to the table and to be realistic once they do.
While some trial verdicts may be appealed, this is not the norm.
Our appellate team has not lost an appeal in many years. We’re poised to successfully handle appeals when they are filed.
While this additional delay isn’t what our clients prefer, significant post-judgment interest on a verdict that is upheld can be substantial.
Are My Pandemic-Related Business Losses Covered?
Beware: Insurance adjusters and attorneys often misquote or take policy language out of context in order to deny legitimate, covered Business Interruption benefit claims.
Virtually every business insurance policy covers losses due to business interruption. Insurance companies are routinely denying these claims during the pandemic, even when these losses are covered and should be paid.
If the language in your business insurance policy does not specifically (and properly) exclude business interruption losses due to “virus” or “pandemic,” these losses are covered and should be paid by your insurance company.
Your business insurance policy may also cover expenses related to the pandemic, such as costs for protective gear (“PPE”) such as masks, hand sanitizer, face shields, antiseptic wipes, or disposable gloves for your staff and customers. Expenses incurred to prepare your manufacturing plant or premises to operate again would also be included, such as costs for disinfecting your plant or costs incurred to check those entering your premises for COVID-19 symptoms.
Business insurance policies are notoriously long and complex. Many business owners don’t realize they are covered for these losses and simply accept their insurance company’s denial.
Our attorneys will carefully analyze your business insurance policy. Click here to have one of our attorneys complete an analysis of your insurance policy or call us at 888-222-6658. There is no fee for this analysis and consultation.
Our clients pay us a percentage of the Business Interruption insurance benefit payments we obtain for them. Click here to see our fee schedule.
Our attorneys have spent decades handling Unfair Insurance Practices cases and Bad Faith Insurance Claims from both sides of the table. While Ostroff Law only represents business owners in these disputes, Partner Rich Godshall and Associate Ryan Michaleski were each partners at law firms that defended insurance companies, including cases involving coverage disputes. This first-hand, “behind-the-scenes” knowledge of unfair insurance practices is invaluable to our clients.
What Can I Do To Protect Myself?
If you believe that your business has sustained losses that may be covered by your commercial/business insurance policy, take these steps to protect your claim.
1. Locate your documentation
Find your entire business insurance policy, including all addendums and endorsements. If you don’t have all of these documents, request them from your insurance agent. The best practice is to carefully compare your entire insurance policy with your insurance company’s reasons for denial.
Remember: Insurance adjusters and attorneys often misquote, or take policy language out of context, in order to support baseless denials. Get a second, unbiased legal opinion.
2. Document your losses
Maintain an active business loss log. Keep track of your business interruption losses as they arise. For example, if you were forced to close your restaurant or production line for 3 weeks, document this in your log at that time. Collect and copy all items that support and document each loss.
If you have a CFO, accountant and/or Operations Manager, let them know the importance of retaining copies of all payroll documentation, cancelled orders (to and from your business), as well as emails or memos that document these losses.
Real time documentation is more reliable and it’s the best evidence to support your loss.
3. Submit your claim (if you’re nervous about getting it right, we can help you)
When you believe you are ready to submit your claim, be sure to identify all of your business interruption losses (there may be more than you realize).
Two claim submission objectives:
- Clearly outline, identify and request all of the Business Interruption Benefits that your business is entitled to. Make sure your claim submission is well organized and covers all of your losses. Don’t give your insurance company an “easy out” to delay, reject or deny these benefits.
- Ask your insurance company to provide a written basis for denial or reduction of benefits. If you request your insurance company to document all of their reasons for denial or reduction, you or your attorney can act sooner to verify and challenge your insurance company’s decision. Our attorneys will analyze your policy and the insurer’s denial for you at no cost.
Consider including this language at the end of your claim submission correspondence:
“If _________Insurance Company does not intend to pay all of the benefits requested in this claim submission, please set forth all of the reasons for this decision within 30 days of the date of this correspondence. Clearly identify the section and location of all policy, addendum or endorsement language in our insurance policy that supports your denial or reduction of the benefits requested herein.”