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Insurance Claims /
Disputes
Cohen Battisti, Orlando
Insurance Dispute Lawyers / Attorneys


In
the absence of insurance, three possible
individuals bear the burden of an economic loss;
the individual suffering the loss; the
individual causing the loss via negligence or
unlawful conduct; or lastly, a particular party
who has been allocated the burden by the
legislature, such as employers under Workmen's
Compensation statutes.
While
types of insurance vary widely, their primary goal is to allocate
the risks of a loss from the individual to a great number of
people. Each individual pays a "premium" into a pool, from which
losses are paid out. Regardless of whether the particular
individual suffers the loss or not the premium is not returnable.
Thus, when a building burns down, the loss is spread to the people
contributing to the pool.
In
general, insurance companies are the safe keepers of the premiums.
Because of its importance in maintaining economic stability, the
government and the courts use a heavy hand in ensuring these
companies are regulated and fair to the consumer.
Up
until 1944, insurance was not considered "commerce" and not subject
to federal regulation. But in United States v. South-Eastern
Underwriters Association, the Supreme Court held that Congress could
regulate insurance transactions that were truly interstate. Congress
then enacted the McCarran-Ferguson Act (15 USCS § § 1011) which
provided that the laws of the several states should control the
insurance business, but that the Sherman Act, the Clayton Act, and
the Federal Trade Commission Act were applicable to the insurance
business to the extent that it was unregulated by state law.
The McCarran-Ferguson Act, broadly speaking, gives states the power
to regulate the insurance industry. While state insurance statutes
override most federal laws, some portions of federal law (like
federal tax laws) are always commanding. Therefore, when
researching whether a particular law governs, a good rule of thumb
is to ask whether the inquiry is related to the "business of
insurance" (where state law governs), or whether it is related to
peripherals of the industry (labor, tax, securities - where federal
law governs).
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