Practice Areas & Industries: Carlton Fields, P.A.

Practice/Industry Group Overview

The insurance industry is truly America's safety net, providing our citizens, cities, and businesses with billions of dollars a year in compensation for what would otherwise be irretrievable losses. But in order to protect others, insurance companies must also protect themselves, litigating and defending in matters with millions of dollars at stake, where the legitimate interests of the company must be protected, and making the case to insurance regulators for adequate rates, flexible products and forms, fair market entry and retrenchment rules, and reasonable tax structures.

The attorneys in the Insurance Practice Group understand the risks and benefits of litigation. We understand the value of employing dialogue with regulators and using administrative law procedures to affect policy decisions at the outset to avoid or limit the risks of future litigation. Our goal is always to advance your interests with a cost-effective, successful outcome -- in court, in administrative law venues where regulators' policy decisions may be informed through dialogue or through formal administrative proceedings, and through alternative dispute resolution.

We make it a point to listen to our clients as well as counsel them.

Our experience includes:

• Litigating and defending health, life, and disability claims under group and individual policies and defending ERISA claims
• Investigating and defending comprehensive general liability, builder's risk, environmental, director and officer errors and omissions, attorney, accountant, and appraiser malpractice liability claims
• Defending life and health insurers, and property and casualty insurers, in claims, coverage, and market conduct individual suits and class actions
• Counseling insurers in form and rate filings, market conduct examinations, and financial examinations
• Representing insurers in regulators' financial examinations and market conduct investigations
• Representing insurers in regulatory rule development proceedings, rule challenge proceedings, regulatory disciplinary matters, and other regulatory litigation matters
• Assisting with insurance tax assessments and other state and local tax assessments affecting insurers and litigating tax issues
• Analyzing and defending construction, fidelity, and financial institution bond claims
• Representing surety insurers concerning all types of contractor defaults, payment bond claims and subrogation issues as well as financial, brokers, and commercial crime bond claims for fidelity insurers
• Representing life and health insurers in ERISA claims litigation involving disputed ERISA governed group health, group disability, and group life insurance throughout Florida .
• Providing advice concerning the appropriate standard of review in fully insured and self insured ERISA benefit plans, ERISA preemption, ERISA plan establishment and administration, weight to be given to treating physicians' opinions and reviewing physicians' opinions, the appropriate scope of the insurer's administrative review record.
• Representing insurers in extra contractual litigation, which includes bad faith claims and other matters outside claims for coverage under an insurance contract, such as defamation, tortious interference, fraud, deceptive trade practices, and breach of fiduciary duty
• Consulting with clients on how to avoid, as well as defending against, bad faith actions
• Representing insurers in commercial litigation
• Providing counsel in regard to formation, acquisition, and divestiture of insurers and insurer assets

REPRESENTATIVE MATTERS

Among the many high profile and high-stakes matters we have recently handled:

• Successfully resolved a multi-million dollar class action mold claim involving 20 years of insurance coverage, four different carriers and numerous policy forms.
• Successfully defended insurance subsidiary against a claim under the Florida False Claims Act alleging underpayment of state taxes.
• Successfully defended in the federal court trial and appeal of a financial institution bond claim, that resulted in a reported decision by the 11th Circuit Court of Appeals, containing a most favorable definition of "discovery" under the current version of the financial institution bond.
• Successfully defended in a class action mass tort suit alleging market practice misconduct and unfair coverage denials combined with parallel investigations and disciplinary proceedings by regulators.
• Successfully defended a workers compensation carrier in a multi-million dollar contract dispute with a policyholder over claims administration and risk rating.
• Gained dismissal of a class action challenging pricing and service arrangements between title insurers and their agents statewide.
• Gained reversal of a $78.5 million verdict for bad faith denial of benefits.