What happens and what to do when your insurance carrier denies your claims – Radio Guesting Oct 12, 2020

What happens and what to do when your insurance carrier denies your claims – Radio Guesting Oct 12, 2020

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The information and opinions you hear on this radio show are those of the guests and callers and do not necessarily reflect the opinions of KF & X, its affiliates management or advertisers. Networking Arizona is brought to you by hypnotic one, you can visit them on the web at hypnoticone.com. That’s hypnotic, the number one.com. The show is also brought to you by flash forward sights. The proof is in your numbers. Learn more at flashforwardsights.com. 


Welcome to networking Arizona with host Carol Blonder. You’ll hear interviews with businesses located throughout the valley. Networking, it makes a difference.  


Welcome to the show everyone happy week again now it’s what, the third week almost the second week of October. I can’t believe that we are here at this time doing this. We are having a lot of fun here, networking with people already while we’re on before we even get on the air. We are live on Facebook. So I want to say hi to everybody. Oh my God, we have a little bit of the wording showing now.Hi to everybody out there like us and follows. We are going to be showing, sharing the show in a little bit. My first guest has been on with me now several times, I have with me Troy Froman, he is one of the principals of FR Law Group. Thank you for being back with me. Tell everybody a little bit about yourself, what you do, and not about what you do on the weekends. But what you do. And you know, more than anything, what you want to talk about today. 


Thank you, Carol. Thank you for having us again. So Troy Froderman on behalf of FR Law Group, I’m a lawyer here in Phoenix. I’ve been licensed in Arizona for over 30 years. Personally, I have been practicing, some might say it’s sad, but I’ve been practicing in a, the Insurance Law arena for most of my career. Essentially, what that means is that our clients, which are principally business owners, when they have an insurance claim, they have some type of loss or liability. They come to us and we advise them on the best ways to approach the insurance company to try to cover the entirety of their loss. Again, I’ve been doing that for a long time. FR Law Group itself, we really have two specialties, as I’ve expressed to you in the past, the, when you and I were growing up lawyers were very much generalists, and did everything. That’s not the case anymore. Everybody has a specialty. So our two areas are insurance law, and construction. My law partner, Scott Ryan, before we formed FR Law Group was back actually a construction engineer in the field. And then when he went to law school, he was the general counsel for a large building company.


But what you did, if we talked before about this is that you brought your experience with working with corporate in the corporate world with big, huge, all sorts of lawyers that are how many you said that you had working with you. But you now brought that down to the smaller guys,


right? So for a long time, I was involved with large national and international law firms advising clients that had huge legal budgets. And so there was a lot of opportunities there to get a lot of experience that they could afford to pay for us to do that. And so after 27 years of traveling around the globe, and working a lot of hours and managing hundreds of lawyers, I decided that it might be a good opportunity to get together with my current law partner, form a small firm, and bring that expertise to companies that don’t have that large of a legal spend, certainly not in the types of that you’re dealing with General Motors or Exxon things of that sort. So we really have the great opportunity to advise smaller businesses with a lot of experience that they’re getting the good fortune to actually have and, and pay at a much much reduced fee schedule right. 


Now, you also said today that you wanted to talk about what happens if your insurance carrier denies your claim, what do we do? 


So when I try cases, and I’ve tried over 80 to a jury, one of the things that I like to do during the jury selection process is ask them how many of you have insurance whether it’s homeowners or others and you know, pretty much everybody raises their hands. How many of you have suffered a loss, everybody raises their hands? How many of you felt that the claims process was fair? No one raises their hands. So at that point, we have the jury in our hands as we’re representing the business that is being denied their claim by the insurance carrier. So everybody that has a policy and has a loss goes through this routinely. And as I’ve explained to you in the, in the past or shared with you, the insurance policy itself is nothing more and nothing less than a contract. Like you’re signing a contract for your car contract for a new house. An insurance policy is a written contract, it’s a written contract between you and the insurance company. The part of the policy that covers you for a loss is usually less than a page, the part that excludes you numerous pages, and businesses in particular, they have a lot of endorsements, they have a lot of binders, their policies typically can be tens of pages, if not hundreds of pages long. And again, the part that covers them, is usually a few paragraphs. So what happens is, is that if you have a loss, and you present it to your insurance company, a lot of businesses when they present their claims, they do it through their insurance agent, the entity that they bought the insurance from, right, that’s typically, and this is the wrong view. But that’s typically who they think their insurance is through, is through their agent, was not through their agent is through the company that actually issues the policy. So nonetheless, a lot of businesses will rely on their agents to tender the claim to the insurance carrier, what happens is that the insurance carrier will write an acknowledgement letter. But more often than not, that acknowledgement letter will come up with what’s referred to as a reservation of rights letter. And that’s not saying that you have rights under the policy that saying, we ABC insurance company, we’re reserving the right to deny the claim, should we find that there’s an exclusion that’s applicable to this particular law, which they 


probably find all the time?


Well, not all the time, but more often than you would like to think. So, you know, not to pick on any particular insurance company, but you know, the old adage, you know, good hands company, they’re good at finding an exclusion. Sure. So that they have hundreds and hundreds and thousands of employees whose job it is, is to know the policy terms and conditions, and then to review them in light of a tender claim. So the first thing to do is make certain that you’ve reviewed the policy that you’re tendering under. So if it’s a property claim, you’re not going to tender it to your auto policy, you’re going to tender it to the carrier that issued you property protection. So a lot of that can be done through the agent in terms of understanding what coverages are there. But you really, specifically if it’s if the losses are such that it’s gonna have a significant impact on your business, or even even have enough of an impact that it’s going to cause a problem. Make certain that whoever’s reviewing these policies and tendering the claims consults, either with somebody like FR  law group, or somebody who’s knowledgeable about the terms and conditions? Well, I 


think that they should definitely call you and we are talking about you right now. So I think that you do free consultations with people, we do. And what I want to say is there’s first of all the one time that that first, first and foremost, let’s say you are forming right now, your New Business, that’d be a great time for us beforehand to make sure that you’ve got it done right in the first place, right, that you’re covered,


right. So a lot of businesses would, you know, if you’re going to start a construction company, there are certain policies that you’re going to need in place, if you’re going to start a business where you’re doing some type of professional consultation, that’s a different lines of policies. So not all companies need the same types of policies. So it’s a very important, large company, they’re already going to have in place somebody who’s the risk manager or somebody responsible for what the lines of policies are that they need. Smaller startup businesses typically typically don’t.


like. But she got to make sure that you’re covered and the right way, correct. And you are the one that can, they can call and do that with a free consultation. They’re rated with the Better Business Bureau, you also work with people how far out all over all over the country, all over the country. 


So for example, with the pandemic, we have claims all across the country where people are suffering and have suffered business interruption losses, and those are covered, potentially under property policies. And so we’re advising businesses across the country in terms of how to present their claim to their insurance carrier on their business interruption Loss Coverage.


I think it’s important. Listen up people, this is information that is, it’s so important for people out there and that’s what I love about the show, this kind of information. You may not realize it but you have rights to you want to make sure that you’re covered correctly and have somebody who’s experienced to make sure that you are. If there’s a problem, especially something like that you want to make sure you’ve ever experienced an attorney rated with the Better Business Bureau. They do free consultations at 602-566-7425. Hang tight, we’ll be back in just a minute.


So welcome back, everyone. We’re talking with Troy Froderman, and he is the principal, one of the principals of FR Law Group. And I, whenever I’m talking with you, we, I love listening, because you always have great examples of the different stories that have happened, you had two that you wanted to share with us. And I want you to go ahead and kind of do that and give you as much time as I can so get too in it.


Okay, I’ll try to be brief. So there are, I have a client that had formed a, an entity, basically, kind of a division in Mexico with a plant that did operations and they were doing a lot of sewing and things of that sort and then importing them back into the country. Well, they had hired a manager for that particular plant. And as it turns out, the manager was embezzling payments that were being made to that plant. And so the client over the course of just a meeting on something else mentioned to me that they were going to have to write off this large loss down in Mexico. And I said what, I think you purchased a fidelity policy and a fidelity policy is kind of a unique policy. Among other things, it covers theft, as long as you know, it’s unknown. So we looked into that, tender the claim to the carrier, the carrier initially denied it. We then explained how the theft that occurred and then ended the story is that you know, sad turned to glad in terms of Hey, we now have reimbursements and that was in the hundreds of thousands of dollars. And that’s another instance where they had actually purchased the policy, but hadn’t read they had not read the policy.


If they use it didn’t even know they had it right


And so, you know, it worked out well for them. The second example here in Phoenix is a client has a building that was vacant at the time here in Phoenix. And there was some vandalism of the building. And essentially what happened was people had broken into the large warehouse, broke into it. The question was, did they break into it to steal copper wire? Or did they break into the vandalized? Or was it a mixture of both? So at the end of the day, you know, I said, well, you do have property coverage for vandalism. That particular wasn’t a fidelity policy. So this is just a property policy. That doesn’t cover theft, but it did cover vandalism. So the claim was tendered to the insurance carrier. I know that’s gonna sound like a broken record, but the insurance carrier denied the claim. And so I then took that particular loss to an arbitration, where we prevailed, where the arbitrator found in our favor and said that, well, while they did, obviously take some of the copper wire, a majority, that wire itself commercially was only worth like, $15,000. But the damage that they caused the building was over $300,000.


Did you ever clean about these things? 


No, they were very easy. Exactly. So another example, where you have a loss, you have to understand the coverages that you have in place, so that you’re in the best position to try to recoup your loss. 


Now, that’s what I think is the most important is that even now, it doesn’t matter. And I think I asked you this the last time you were here, and I don’t remember if I did it on or off. So I’m going to ask you now, um, let’s say someone’s listening to this and wants to be sure that they’re covered correctly. Or let’s say even well, we’ll do those separately, I’m gonna do you have their cup, they want to just talk to you about, you know, do you look at all the time policies, and just to make sure that they are covered correctly? 


Sure. So we often will meet with either existing clients or prospective clients, to review their operations and make certain that whatever their line of business in, they have the best possible coverage that they can afford, that’s tailored to their particular needs. And I think I’ve made, I’m sure I’ve mentioned this each time, one of the things that FR Law Group that we really pride ourselves in, is we know our clients, we know their business, that gives us the ability to, to advise them on the best coverage for their business. If we don’t, if we don’t understand the client’s business, we’re not going to understand the coverages that they need. 


So it starts with a conversation, yes, getting to know them. And you said, you have said it many times that you really get to know them, almost personally, because you need to know all the ins and outs of their businesses, right. 


We’re a small law firm. And unlike a large law firm, we can’t take every case that comes to us, because then obviously, we’re not doing a very good job of the clients that we have. So we get to know the client’s business, a lot of our clients I’ve known for over 30 years. And it’s their friends, their clients first, but they’re also friends, and we look after them and make certain again, that, hey, if, if they need our assistance in terms of Hey, you know, we’re gonna go on to this venture. Is there something here that we need in terms of coverage that we don’t have, we already have the ability to help. 


Make sure that you make it makes sense to call them and talk to them. They do a free consultation, they’re rated with the Better Business Bureau, you’re right here, located here. But you do help anyone in the, in the nationwide, right? 


We do. In fact, we have an interesting loss right now that occurred in Indiana, it was a different type of policy, and that, this example, it was dealing with contaminated food policy. So there are a plethora, yeah, there are a lot of policies out there. 


Yeah, and the main thing is, a lot of things happen. Good things happen, and bad things happen to good people. Let me say it that way. And here’s the other question that I want to ask you before I want to get your phone number out there again. So I can say a couple more times 6025667425, check them out. It’s ffrlawgroup.com. I want to ask you this to let’s say someone’s listening, and they’ve already started a claim. Right? Can they have, you do a second opinion? Is there also, are there statutes of limitations with some of this kind of stuff? Yeah. Am I asking good questions? 


You’re asking good questions. So let me answer that in the reverse order. There are statute of limitations. In Arizona, this is not every state but in Arizona. If you are denied a claim, and you want to pursue a breach of contract lawsuit, you have six years from the date of the denial. If you think that you’ve been treated very poorly to the, to the point where it rises to the level of what we call bad faith, conduct. Then you have a two year statute of limitations, because it’s a tort claim as opposed to a contract claim. Now, I’ve forgotten your first question. 


Do can’t, well, I guess a second opinion or 


So, absolutely. Just as you know, when you are seeking medical advice, and you’re being told you need surgery for this, that or the other, it’s obvious that you should get a second opinion, because, you know, what’s minor surgery to you is major surgery to me if it’s me, 


And plus, on top of that, having somebody else look at it, you just never know, you might find something there that somebody else just didn’t see. 


Well, it’s, well, and the fact usually is, is that, with, with what we do, because it’s specialized, and insurance and construction, a second opinion for us is really kind of a first opinion, because the first opinion that they received was from somebody that didn’t understand insurance or construction. 


I want to also please let them understand that when you, with you, it doesn’t, you don’t have to be in construction, you specialize in that area, but on your side, any business, right?


So typical businesses that you work with. 


We represent agricultural businesses, recreational businesses, entertainment, so it’s not just construction.


It doesn’t really matter. I mean, if you have, if you have, especially if you’ve got a partnership too, you know, you got to make sure that your contracts, right? 


Right, so about that contract, I’m not advising on probate law, I’m advising on insurance claims. After 30 years of doing it, Fr Law Group is probably the place to go. 


The number to call is area code 6025667425, they’ll do a free consultation, and they’re rated with the Better Business Bureau. They’re located right here, but they help people nationwide. What are your final words for everybody out there today? 


So to me, what is sad is if somebody just gives up on a claim, because they don’t understand their coverages. That’s so easy, because what we typically do at Fr Law Group, I, I’d say, a lot of the claims that come to me, I say you’re not covered. Not every claim is good, right? But also not every denial is right. 


A lot of people try and do it by themselves. 


They do and or they just like, you know, it’s just a cost of doing business. 


Exactly, exactly. I’ve said that – you know what guys, it’s not, and you need to make sure that you speak to somebody who is experienced, you have a ton of experience behind you. But I’ve, what – thank you for bringing us to the smaller, you know, the smaller businesses out there that are hurting, right. 


And it really brings us a lot of joy to help smaller businesses because, if without firms like FR Law Group, they’re gonna just get trampled.  


And you want to make sure that you get the, last time we were on we had several people that call them because they have questions. If you’ve got a question, ask it. There’s no bad question. 


No lawyers must have a bad reputation for not communicating well, because the callers I’ve received from the show you actually made sense. 


Well, you know what, and because you got to come on here and explain. 


Thanks. So thank you. It’s all about that. 


It’s explaining the situation and you can call directly. His phone number is area code 602-566-7425 rated with the Better Business Bureau. Check them out on their website. It is frlawgroup.com