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As you know, insurance companies are obligated to pay the fair and objective price for your services rendered, NOT the lowest price possible.

And yet, carriers routinely deny or underpay claims without cause. They leave underdog mitigation, restoration, and remediation vendors to advocate for themselves. Do not sit by idly and allow the insurance company to trample your rights!

You should know that carriers are relying upon the Florida AOB reform guidelines in Florida Statute 627.7152 to deny more claims than ever before! It is critical that you comply with the statute’s new requirements to ensure that you are not wrongfully denied, and to protect your right to payment.

The necessary requirements are outlined for your reference below:

NOTICE OF INTENT TO LITIGATE PURSUANT TO FLA. STAT. 627.7152
You must deliver a copy of the executed assignment agreement within three (3) business days after work has begun or the assignment was executed, whichever is earlier. Should you wish to file a lawsuit against the insurance company, you must provide a Notice of Intent to Litigate ten (10) business days before filing suit. This letter may only be served following the insurance company’s coverage determination and must include the following:

  1. Specific damages in dispute, the amount claimed, and a pre-suit settlement demand.
  2. The named insured, insurer, and assignor;
  3. A detailed written invoice or estimate of services,
  4. Proof that the work has been performed in accordance with accepted industry standards.

Upon receipt of the Notice of Intent to Litigate, the provider has 10 days to respond with either a pre-suit offer or an alternative dispute resolution. If they fail to do so, litigation is appropriate.

ASSIGNMENT AGREEMENT VALIDITY
A valid assignment of benefits must:

  1. Be in writing and executed by and between the assignor and the assignee;
  2. Contain a provision requiring the assignee to provide a copy of the executed assignment agreement to the insurer within 3 business days after the date on which the assignment agreement is executed or the date on which work begins, whichever is earlier;
  3. Contain a written, itemized, per-unit cost estimate of the services to be performed by the assignee;
  4. Relate only to work to be performed by the assignee for services to protect, repair, restore, or replace a dwelling or structure or to mitigate against further damage to such property;
  5. Contain the following notice in 18-point uppercase and boldfaced type: YOU ARE AGREEING TO GIVE UP CERTAIN RIGHTS YOU HAVE UNDER YOUR INSURANCE POLICY TO A THIRD PARTY, WHICH MAY RESULT IN LITIGATION AGAINST YOUR INSURER. PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING IT. YOU HAVE THE RIGHT TO CANCEL THIS AGREEMENT WITHOUT PENALTY WITHIN 14 DAYS AFTER THE DATE THIS AGREEMENT IS EXECUTED, AT LEAST 30 DAYS AFTER THE DATE WORK ON THE PROPERTY IS SCHEDULED TO COMMENCE IF THE ASSIGNEE HAS NOT SUBSTANTIALLY PERFORMED, OR AT LEAST 30 DAYS AFTER THE EXECUTION OF THE AGREEMENT IF THE AGREEMENT DOES NOT CONTAIN A COMMENCEMENT DATE AND THE ASSIGNEE HAS NOT BEGUN SUBSTANTIAL WORK ON THE PROPERTY. HOWEVER, YOU ARE OBLIGATED FOR PAYMENT OF ANY CONTRACTED WORK PERFORMED BEFORE THE AGREEMENT IS RESCINDED. THIS AGREEMENT DOES NOT CHANGE YOUR OBLIGATION TO PERFORM THE DUTIES REQUIRED UNDER YOUR PROPERTY INSURANCE POLICY.
  6. Contain a provision that allows the assignor to rescind the assignment agreement without a penalty or fee by submitting a written notice of recession signed by the assignor to the assignee within 14 days after the execution of the agreement, at least 30 days after the date work on the property is scheduled to commence if the assignee has not substantially performed, or at least 30 days after the execution of the agreement if the agreement does not contain a commencement date and the assignee has not begun substantial work on the property;
  7. Contain a provision requiring the assignee to indemnify and hold harmless the assignor from all liabilities, damages, losses, and costs, including, but not limited to, attorney fees, should the policy subject to the assignment agreement prohibit, in whole or in part, the assignment of benefits.

A valid assignment of benefits must NOT contain:

  1. A penalty or fee for rescission under subparagraph;
  2. A check or mortgage processing fee;
  3. A penalty or fee for cancellation of the agreement; or
  4. An administrative fee.

    If you need assistance complying with these requirements, or otherwise seek guidance in pursuing your outstanding AOB invoice, please contact us for a free evaluation. We can advise you on the most effective approach to obtaining prompt and fair payment!

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