Insurance Coverage Disputes

Insurance coverage is one of the most financially important areas of law. In a major dispute, the difference between having your insurer pay defense costs and having to pay those costs out of the company’s legal budget can translate into millions of dollars for your bottom line. At Mitby Pacholder Johnson PLLC, we are well known for developing creative and powerful arguments for coverage that get results. In many cases, we have replaced large, national law firms and found coverage for legal fees where no previous lawyer had succeeded.

We have represented multiple energy companies in both defense and plaintiff matters, often with counterclaims. In numerous cases, we have successfully worked with insurance carriers to obtain coverage for legal fees, ensuring our clients are protected financially.

We also represent hospitals and medical practices in disputes with all major insurance carriers, including Blue Cross, United, Aetna, and Cigna, over claims reimbursements. Our efforts have resulted in the recovery of millions of dollars in unreimbursed claims for our clients. We employ a proven approach that leverages artificial intelligence to identify underpayments. Additionally, we are familiar with the insurance company tactics that involve manipulating codes in explanations of benefits and remittance advices to conceal underpayments.

Our ability to uncover and counteract insurance company tactics has led to millions of dollars in recoveries for our clients. Due to our extensive experience and track record of success, we are open to considering contingency fee arrangements in appropriate cases.

Comprehensive Insurance Claim Litigation

Our team has extensive experience litigating against the largest U.S. insurers, as well as major international insurers, including those in the Lloyd’s Market and other surplus lines or specialty insurers. We have successfully secured compensation for a wide range of policy benefits, including:

Property Damage: Costs to repair or replace damaged property.
Business Income/Interruption: Compensation for lost business income and additional expenses incurred during the interruption.
Loss Adjustment Expenses: Payment for costs associated with hiring professionals such as engineers and accountants to assess and manage the loss.
Extra-Expense, Mitigation, and Emergency Repairs: Coverage for additional expenses incurred to mitigate losses and perform emergency repairs.

Complex Insurance Litigation

MPJ frequently advises clients on how to handle Reservation of Rights or Claim Determination Letters issued by insurance companies. These letters can be daunting, especially for those not well-versed in insurance matters. Our attorneys provide guidance, responding to insurers to protect our clients' rights and countering claims of exclusions or other reasons for claim denial.

Defense Against Liability Claims

If you have liability insurance and are facing a lawsuit or the threat of one, it is crucial to notify your liability insurer immediately. Our firm assists clients in ensuring their liability insurers pay for defending against lawsuits or other claims. Insurers often initially resist covering defense costs by claiming the allegations fall outside policy coverage. However, the duty to defend is broadly interpreted, and our team has a strong track record of securing paid defenses from liability insurers after initial refusals.

Success in Court and Early Resolutions

We have achieved numerous jury and bench trial verdicts for policyholders whose claims were initially denied. When we win at trial, we recover the full amount the insurer should have paid under the policy, plus attorneys' fees and statutory interest for late payment. This can result in recoveries that double or even exceed the original claim amount. Our success in court often prompts insurers to settle early, providing our clients with the funds they need promptly after a loss.

Early Resolution Strategy

While we are fully prepared to take cases to trial when necessary, our primary goal is to resolve disputes as early as possible. Early resolution provides clients with the financial resources they need without the stress and time associated with prolonged litigation. Our firm’s reputation for successful trial outcomes often motivates insurers to settle claims sooner, offering a quicker path to recovery for our clients.

Navigating Insurance Policy Exclusions

Insurance policies often contain numerous exclusions that insurers use to deny or limit claims. At MPJ, we thoroughly analyze these exclusions and challenge them where appropriate. Our deep understanding of insurance law and policy language allows us to effectively counter insurer arguments and secure the coverage our clients deserve.

Proven Track Record of Success

MPJ has built a reputation for excellence in insurance coverage litigation. Our attorneys are known for their tenacity, expertise, and commitment to achieving the best possible outcomes for our clients. Whether through litigation or negotiation, we work tirelessly to ensure our clients receive the compensation they are entitled to under their insurance policies. Choosing MPJ means partnering with a firm that has a proven history of success in insurance coverage disputes. Our team’s extensive experience, strategic approach, and dedication to client satisfaction make us the ideal choice for anyone facing an insurance claim denial or undervaluation. We fight vigorously to protect our clients’ rights and secure the benefits they deserve.

Contact our experienced attorneys today to protect your rights and achieve favorable outcomes in your insurance matters.