The most important asset of a law firm is the confidence and trust of its clients. Trust and confidence is earned with years of dedicated service and successful results. We work relentlessly for the citizens of the state of Florida and the medical providers that devote their time and expertise to care for those individuals. Working relentlessly, we pursue insurance benefits for Florida policyholders and aggressively defend against the insurance companies' ruthless attacks on Florida's medical community. It is not just about money - it's about forcing the insurance companies to abide by their promises to you and allowing Florida policyholders to avoid the harassment and aggravation that is common in the claims process. At the Simoes Law Group we put the legal system to work for individual policyholders as well as medical providers who have been abused, harassed and threatened by powerful insurance companies.
Big Insurance - The Masters of Manipulation, Intimidation and Greed
The insurance industry has long reaching tentacles that affect every aspect of business. The manipulation and influence of big insurance reportedly reaches from political campaigns, judicial elections and multi-billion dollar claim denials. Occasionally an insurance company's conduct is so outrageous that it results in a criminal investigation of its claims' handling practices. Although the media does a good job of reporting big cases involving millions or billions of dollars, the disastrous effects of the insurance company's attack on smaller businesses or individuals is not so widely reported.
Insurance companies are often unscrupulous in their unrelenting quest to save money. Not only does the insurance industry deny policyholder's claims without any legitimate basis, but the insurance companies will also attack the doctor you have selected to treat your injuries. Insurance companies, in a superior position of economic power, will file unsupported lawsuits against medical providers containing slanderous and patently false allegations to avoid paying claims. The insurance company will then take the "wait and see" approach to see if the medical provider is willing or financially able to undertake the long and expensive process of litigation. In many of these cases, honest and caring doctors are forced to concede to the insurance company's demand merely due to the overwhelming financial burden of defending a lawsuit brought against a small medical facility by a multi-billion dollar insurance company. With many years' experience representing Florida policyholders and the medical community, we have never shied away from a battle with the biggest insurance companies. This is the area where we focus our practice. The Simoes Law Group represents unfairly targeted individuals or small business owners in the face of an onslaught by the insurance company. This is what we do day in and day out.
Our Recent Decisions
The United States District Court for the Southern District of Florida found against State Farm Mutual Automobile Insurance Company for systematically failing to correctly reimburse Florida medical providers for MRI services. The Court held that Florida's no-fault law did not allow reduction of reimbursements for MRI services under Medicare's special rule. All Family Clinic of Daytona Beach, Inc. on behalf of itself and all others similarly situated vs. State Farm Mutual Automobile Insurance Company, 2011 WL 4954171 (11th Cir. 2011)
The Fifth District Court of Appeals determined that Peachtree Casualty Insurance Company's "suspicion" that the policyholder had staged the motor vehicle accident was insufficient to justify the insurance carrier's nine month delay in failing to pay the policyholder's property damage claim. Barreau v. Peachtree Casualty Ins. Co., 2012 WL 162035 (5th DCA 2012)
The Fifth District Court of Appeals found that the trial court properly dismissed a defendant's counterclaim against the plaintiff's medical provider wherein the defendant sought to add the doctor as a co-defendant to the Plaintiff's personal injury lawsuit. Berrios v. Deuk Spine, et al., 2011 WL 5598323 (5th DCA 2012)
The Second District Court of Appeals held that Infinity Insurance Company had filed a lawsuit against a medical provider for civil theft which lacked substantial or legal support. The Court awarded attorney fees to the medical provider due to Infinity's baseless claim. Nodal v. Infinity Auto Ins. Co., 50 So. 3d 721 (Fla. 2d DCA 2010)
The Eleventh Circuit Court of Appeals found that State Farm violated Florida's No Fault Law on three policyholder claims when State Farm discontinued payment for the policyholders' medical care without first obtaining the required medical opinion. Earl Byers, et al. v. State Farm Mutual Automobile Ins. Co., No. 10-10816 (11th Cir. May 23, 2011)
