Insurance fraud costs insurance carriers billions of dollars each year and contributes to increased premiums, prolonged investigations, and unnecessary litigation. While most policyholders submit legitimate claims, a small percentage of claims involve intentional misrepresentations, exaggerated damages, or outright fabrication. For insurance companies, identifying and defending against fraudulent claims is essential to protecting policyholders, maintaining financial stability, and ensuring fairness throughout the claims process.
At HD Law Partners, our Tampa insurance defense attorneys represent insurance carriers in complex fraud investigations, coverage disputes, bad faith allegations, and insurance litigation matters throughout Florida. If your company is facing a suspected fraudulent claim, contact our experienced insurance defense team today by calling 813-253-5333 or visit our Contact Us page to schedule a consultation. HD Law Partners is recognized throughout Florida for insurance defense, coverage litigation, and bad faith defense representation.
In the beginning of 2025, the Fort Myers community was rocked by a shooting at a popular restaurant. The shooting was notable because the aggressor killed his own brother. However, the fact that a shooting had occurred at a restaurant was hardly surprising for local residents. Violence is fairly routine in not only restaurants, but also gas stations, hotels, bars, clubs, and malls across Fort Myers. All of these incidents can lead to “negligent security” lawsuits. How do you defend against these claims as an insurer? Could a Fort Myers insurance defense lawyer help?
The Basics of a Negligent Security Claim
A negligent security claim is a type of premises liability lawsuit. Like all premises liability claims, the concept of negligent security relies on a business owner’s “duty of care” to keep visitors safe. If someone ventures onto your property, you must take reasonable steps to protect them from harm.
Invalid auto accident claims are quite common throughout Florida, and many of these claims are completely fraudulent. Aside from filing claims for staged car accidents, many policyholders also attempt to pursue compensation for injuries that actually have nothing to do with auto collisions. Insurance companies should be aware of the limitations of their own policies, and it may be surprisingly easy to deny claims that are only peripherally connected to auto accidents. An experienced insurance defense attorney in Orlando might make it easier to fight these claims.
Road Rage Is Increasing in Orlando
Road rage incidents continue to increase in Orlando. Florida has the highest number of firearm-related road rage incidents in the entire nation, according to WFTV. Midway through 2025, Florida had seen almost 30 of these incidents. Other recent reports point to growing incidents involving tailgating, honking, brake checking, and other forms of aggressive behavior. Insurers should be aware that a significant portion of injuries on the road could be caused by violence and road rage – and not necessarily “accidents.”
Self-dealing is a very serious allegation in the insurance industry. If your organization has been accused of this misconduct, the first step is to gain a solid understanding of what “self-dealing” actually means. How might an insurance representative engage in this misconduct? What are the potential consequences, and can a Tampa insurance defense lawyer help you avoid these penalties?
In Florida, allegations involving self-dealing are relatively common across the insurance industry. In April of 2025, Insurance Business reported that the lack of transparency in this industry had become concerning. The report also cited numerous investigations that uncovered “widespread” self-dealing by insurers. Some say that this practice, which involves draining money out of insurance companies through affiliates, has caused premiums to increase.
Another report by Insurance Journal in May of 2025 highlighted an incident involving alleged self-dealing by a major insurance company’s CEP. The CEO is accused of charging $400,000 for questionable IT services, and paying her own company this sum. The report implies that this is an example of “self-dealing” in the insurance world.
The “option to repair” is a common clause in Florida property insurance policies, and it allows insurers to avoid paying out cash settlements in many cases. But are these clauses sometimes unenforceable? This is a common issue for insurers, as many homeowners prefer cash payouts. A recent case in Florida provides some degree of optimism for insurers, especially those who work with experienced insurance defense attorneys in Orlando.
Insurance Company Wins Appellate Victory Over “Option to Repair”
In May of 2025, Insurance Business reported that a major insurer in Florida had won an important appellate victory. This case revolved around the insurer’s “option to repair” roof damage – a common issue that all Florida insurers are undoubtedly familiar with. Although the specific wording of most policies describes this as an “option” to repair, insurers actually have the “right” to repair. This is something that the recent appellate decision clearly affirms.
Clear vision is incredibly important for drivers, and it is impossible to safely operate a vehicle without a functioning set of eyes. This is why the Florida Department of Highway Safety and Motor Vehicles takes vision tests so seriously when issuing driver’s licenses. From an insurance defense perspective, it may help to determine whether a driver was wearing their glasses at the time of a crash. Could an insurance defense attorney in Tampa help implement this type of defense strategy?
Failing to Wear Glasses Can Be a Moving Violation in Florida
If someone is legally required to wear glasses while driving in Florida, they face serious consequences for forgetting them. This can become a moving violation and a second-degree misdemeanor. Technically speaking, this means that a driver could face up to 60 days in jail and a $500 fine for not wearing their glasses.
These penalties could be even more severe if a driver causes an accident that injures or kills other people. In the past, drivers have faced homicide charges for striking pedestrians after failing to wear their glasses.
While Florida is known for its sunny, warm days and beautiful beaches, it is also no stranger to storms and floods. The risk of flooding is a regular concern for Tampa homeowners and businesses alike. This is because the Tampa area does not have a lot of topographical relief when heavy rains and tropical storms hit. As a result, water doesn’t drain quickly, and there are tidal floods to be aware of as well.
A seasoned Tampa insurance attorney can provide you with legal advice and guidance if you have questions about flood insurance coverage and claims. And if you have already experienced flooding, a lawyer will help you file a claim, negotiate with your insurance company or other parties, and represent you in court if necessary.
There are legal professionals available to help you secure the recovery you need due to flood damage. Some situations when a flood attorney can help:
There are often many steps to strengthening a claim, such as an evaluation process, connecting with documentation, filing paperwork, and negotiating with others involved in the case. And there are additional considerations if a dispute goes to court.
When interpreting an insurance policy, the choice of law will often determine how a court will enforce that policy’s terms. In this context, choice of law refers to which state’s laws govern the policy. Or in some cases, whether federal law may also apply.
A recent decision from a federal judge here in Florida, Great Lakes Insurance SE v. Lassiter, provides a case in point. This insurance dispute involved both federal and state choice-of-law questions–specifically, what laws to apply to a boating accident.
A man named Lassiter leased a boat called Shmily from a corporate owner. Lassiter hired another named Russick to captain the boat. Russick, acting as Lassiter’s intermediary, applied for an insurance policy for the boat. In that application, Russick failed to disclose the fact Lassiter had a 15-year-old misdemeanor domestic violence conviction. This will become relevant later.
Insurance disputes often involve complex questions of law and contract interpretation. Yet many cases boil down to a single question: Does the insurance policy actually cover the claim at issue? Sometimes this question proves relatively easy to answer.
For example, there is this recent decision from a federal judge in Tampa, Ditech Financial LLC v. AIG Specialty Insurance Company. The plaintiff in this case was a mortgage loan servicing company. The plaintiff ran into trouble with regulators in 2014 over purported “deficiencies” in its business practices. As relevant to this case, the plaintiff had failed to conduct annual escrow analysis for borrowers involved in Chapter 13 bankruptcy cases.
Basically, Ditech was supposed to analyze any changes to a borrowers’ property tax and insurance payments while they were in bankruptcy. The failure to conduct this analysis meant that there were shortages in the borrowers’ escrow accounts, which they remained liable for under their mortgages. Ditech made up for these shortfalls and then tried to get its money back from the borrowers after they exited bankruptcy.
The longstanding standard of what constitutes bad faith in Florida was determined by the Florida Supreme Court almost 40 years ago. The Court determined that an insurer has a duty to use the same degree of care and diligence as someone “of ordinary care and prudence.” Insurers must investigate the facts, give fair consideration to settlement offers and–where a reasonably prudent person would–pay total recovery.
However, two recent appellate decisions have made some important changes to what constitutes a bad faith insurance claim in the context of third-party liability claims, as we discuss below.
Eleventh Circuit Decision
The first of those decisions—by the Eleventh Circuit—upheld a lower court decision finding that Geico deciding to offer settlement limits twenty days from the first notice of the claim was not done in good faith as a matter of law. The court ultimately upheld the jury verdict in favor of plaintiffs, finding that the jury was reasonable and had enough evidence to conclude that Geico had acted in bad faith.
In September, a lawsuit was filed against Tower Hill Insurance in Florida, alleging that the company engaged in fraud concerning a number of claims filed by Hurricane Irma victims, defrauding them of money that they are owed. The lawsuit specifically alleges that Tower conspired with two other companies—Humble and Ladder Now—to deny or underpay compensation on various insurance claims filed by the hurricane victims.
According to the complaint, Ladder Now is an “unlicensed independent adjusting firm” that effectively worked with Humble, a consulting and restoration firm, to doctor fake engineering reports that ultimately found little-to-no damage done as a result of the hurricane. As a result, the lawsuit not only accuses Tower Hill of fraud, but also of mail and wire fraud, theft, and the use of unlicensed adjusters and engineers to systematically rob policyholders of premiums. The complaint alleges not only past harms to these policyholders—but ongoing harm—as a result of Tower’s allegedly nefarious activities.
According to a new study, Florida’s third-party bad-faith legal environment increases claim costs for every insured vehicle by an average of $106 per claim, or a total of more than $7 billion in additional claim costs over more than a decade. According to some experts, most of these costs can reportedly be attributed to the rapid growth of bodily injury liability claims, as well as Florida’s legal rules and standards when it comes to resolving bad-faith allegations.
Under Florida law, anyone can bring a civil action against an insurance company if they have been damaged by the company’s failure to attempt, “in good faith,” to settle claims when, under all circumstances, they could and should have done so, while acting fairly and honestly towards the insured, with due regard for the insured’s interests.
The report compared key bodily injury liability claims in Florida to similar trends in three other states that are all no-fault (like Florida); specifically, New Jersey, New York, and Pennsylvania. According to the results, these three states experienced relatively stable injury claims over the study period after taking primarily administrative approaches to investigating and resolving bad-faith allegations on behalf of car insurance companies. Conversely, Florida’s trends did not reflect this kind of stability.
When it comes to hurricane claims, the last thing that any Floridian wants to hear is that their claim has been denied. And yet that is the case for many in our state, especially when it comes to flood claims.
In fact, according to statements made by the Federal Emergency Management Agency (FEMA) in this recent Miami Herald coverage, regardless of what flood zone maps might be telling you regarding whether or not you need to purchase flood insurance, everyone in Florida needs flood insurance.
Irma Delivered Historic Flooding
When Hurricane Irma hit Florida in September, it rolled across the Lower Keys and pushed a storm surge across the islands, continuing to swamp the coastline as it moved along Southwest Florida. Many homes filled up with mud five feet deep, and water swamped the business district, washing out over the seawalls and out of the Miami River. In Jacksonville in particular, the high tide caused the St. Johns River to swell and lead to the worst flooding in a century.
Recently, the 11th Circuit Court of Appeals upheld a ruling in support of an insurance company, clarifying the importance of what evidence is required in order to prove that a claimant has suffered from a permanent injury.
The bad faith case filed in the Middle District of Florida involved an insurance claim originally filed against Geico in 2009 for allegedly failing to provide the claimant—Catherine Cadle—with the maximum payout/settlement under her motorist policy for injuries she was supposedly suffering from due to a 2007 car accident. Geico responded that Cadle had failed to provide sufficient evidence that she actually suffered from a permanent injury.
Permanent Injuries
In claims involving allegations of permanent injuries, an insurer is entitled to rely on the documents provided by the claimant’s attorney; however, reliance on these documents cannot amount to bad faith (in other words, a court will not hold that an insurance company acted in bad faith in only relying on the documents provided by the plaintiff and failing to do their own investigation).
According to a recent news investigation, a law designed to help give the disabled access in the state of Florida is potentially being used for abusive reasons. Specifically, one man in particular has allegedly filed more than 1,000 lawsuits against local Florida businesses for supposedly violating the Americans with Disabilities Act (ADA), without even first bringing his concerns to the business owners and asking that they make specific changes to their accommodations (or even being a patron of the business itself).
In fact, many business owners claim that there are “ADA testers” filing various costly lawsuits—many of them over violations that have been called trivial, such as the height of a toilet paper dispenser being—and in doing so, potentially abusing the system for a cash payout.
The ADA is designed to prevent employers from discriminating against hiring someone due to a disability, and mandates that businesses make reasonable accommodations such that the disabled have access to their facilities. Many have now pointed out that this second requirement is very difficult to comply with because of how specific it is currently worded in terms of the permissible heights of toilet paper dispensers and other amenities, for example. Because of this, they say, even advocates of the disabled have failed to find anything that is 100 percent compliant with the ADA.
A new survey conducted by PolicyGenius reveals that while many Americans may believe that they understand their insurance policies, in fact, they do not, resulting in the mistaken belief that they are often the victims of bad faith insurance decisions. Unfortunately, this mistake could end up costing policyholders a fortune: Not only did the survey find that only four percent of policyholders were able to correctly define the terms that correlate their co-pays, but most individuals did not understand the basics when it comes to co-pays, deductibles, and out-of-pocket maximums, even though they were overly-confident of their understanding.
Unfortunately, not only are consumers overconfident about their own out-of-pocket costs, many aren’t confident at all when it comes to selecting the right insurance plan for their needs. This results in policyholders not only being at risk of choosing the wrong insurance plan, but also misunderstanding their exposure to charges when they receive treatment.
