FAQ #1: My claim is denied. What can I do?

This is when you should consider consulting an attorney. Many reputable attorneys will provide free initial consultation. Many attorneys provide advice on how to re-open an insurance claim or how to get it resolved without having to obtain legal help.

Sometimes, simply asking for a new adjuster or having an attorney send a factually accurate letter requesting reconsideration is all that is needed to get an insurance company to investigate and evaluate the claim from a different perspective. A consumer complaint to the Insurance Commissioner may help as well.

If all else fails, a policyholder should consult an experienced and reputable attorney regarding their policy rights. If the case has merit, many attorneys will represent a policyholder on a contingency fee basis and even advance the costs for litigation, which means it costs the policyholder nothing upfront. The attorney is only paid a percentage of the amount he recovers for the policyholder.

Finally, a wrongful denial causing you additional damages not covered under the insurance policy may be recoverable through a bad faith claim, and you will need an attorney’s help in that case.
 

FAQ #2: Can I afford to hire an attorney?

Fortunately, there are a number of reputable and experienced attorneys in Texas who will represent a policyholder with a valid claim on a contingency fee basis. The Merlin Law Group has proudly represented and advised all types of policyholders, including large Corporations, various sized businesses, Condominium Associations, Schools, and individuals— whether rich or poor.

We are in a position to advance costs for estimates and experts that will help prove your case. Yes, a policyholder with a valid claim can afford an attorney.

FAQ #3: How do I make a commercial claim for business losses?

Businesses run on money. Most commercial business policies have coverage benefits that allow businesses extraordinary allowances to maintain customers and keep in business even after being shut down following a hurricane. Commercial Claims are generally unique to each business and require specialized estimators, appraisers, salvers and accountants working as a team to develop loss claims that fully reimburse business owners. Obtaining an experienced team that understands the coverage is a key ingredient to any business claim.

Construction methodologies vary widely and have to be evaluated with detail because individual owner interests cannot be overlooked while repairing damaged property. Similar to Commercial policies, many Associations purchase coverage to help maintain revenue while the property is being repaired.

Our compensation is based on your returns and by speeding up recovery time. We minimize risk to shareholder value, profit loss and productivity. It is a new approach to commercial insurance recovery that is long overdue.

FAQ #4: What should I do if my insurance company hasn't made me an offer?

Follow up in writing and ask for immediate response. A consumer complaint to the Department of Insurance can be helpful. A refusal to adjust a claim is the same as a claim denial and should be treated that way if the insurance company ignores you.

FAQ #5: How does my residential policy coverage work?

A Home is usually a person’s most valuable investment. It also represents part of one’s way of life, a means of storing precious property obtained over a lifetime. Most modern residential policies recognize this and cover the House and Personal Property at Replacement Cost. Further, the policy covers the additional costs of maintaining that lifestyle while the property is being repaired or replaced. We at Merlin Law Group typically find that there are “many valuable benefits available under Residential Policies that often go unclaimed because people do not understand how the coverage works.”

FAQ #6: How is a Condo loss different from other commercial losses?

Condominium losses are different from other commercial losses because there are typically different documents other than just the policy that control how the loss is going to be adjusted. Condominium by-laws have to read in conjunction with the policy to ensure that everything required to be adjusted is considered.

Construction methodologies vary widely and have to be evaluated with detail because individual owner interests cannot be overlooked while repairing damaged property. Similar to Commercial policies, many Associations purchase coverage to help maintain revenue while the property is being repaired.
 

FAQ #7: What is Bad Faith?

Insurance companies have an ongoing duty to investigate coverage and evaluate damages so that their policyholders receive full policy benefits promptly. They should hire a sufficient number of competent adjusters and consultants that are motivated to explain the coverage available and get those benefits to the policyholder as quickly as possible. These duties are known as “good faith” obligations. When the insurance company fails to act in good faith, it can be liable for such conduct and those lawsuits are known as “Bad Faith Claims.” If the bad conduct is intentional or extreme, the insurance company can be held liable for punitive damages if the circumstances warrant such an award.

FAQ #8: Ike Relief: How you can help

A few places you can contribute to for relief efforts.  Please return to this page often to find out how you can help.

Feed the Children

The Red Cross Ike Relief Effort

United Way Houston

FAQ #9: For Adjusters

For over twenty years, Merlin Law Group has been representing both commercial and residential insurance policyholders. During that time we have routinely worked with Public Adjusters on a regular basis. We respect and appreciate the Public Adjusting community and recognize the importance of their work, protecting their fees when their clients retain our firm as counsel. Our firm prides itself on its reputation amongst Public Adjusters. We proudly support the National Association of Public Insurance Adjusters (NAPIA) and the Florida Association of Public Insurance Adjusters (FAPIA) by sponsoring, attending, and speaking at local and national events to assist Public Adjusters in their advocacy for insurance policyholders.