South Florida residents will likely remember Aaron Hirschhorn, the successful Miami entrepreneur who launched a dog-sitting service then won a big investment for a stem-cell therapy for dogs when he appeared on the “Shark Tank” TV show in 2019.

Hirschorn died in 2021 when a 38-foot Chris Craft boat collided with the hoverboard watercraft he was riding in Biscayne Bay. His widow was awarded $66 million in arbitration, from the boat owner and operator.

Four years later, that case and its insurance impact continue to reverberate through the federal court system in two states. Hirschhorn’s widow’s Florida lawsuit against Clear Blue Specialty Insurance and against Yachtinsure Services, a managing general agent and claims-management firm, is still pending. It demands that the insurance firms pay at least the $500,000 policy limit on the covered boat involved in the accident. Widow Karen Nissim also named Aspen Insurance, which wrote a similar policy on one of the boat owners.

In the latest development, Clear Blue Insurance this week won a judgment of its own, requiring Yachtinsure Services to comply with the terms of its contract agreement and to finish adjusting other high-dollar claims while the underlying litigation continues. Yachtinsure had essentially refused to handle any more big claims for Clear Blue after the Hirschhorn fatality, according to Clear Blue’s complaint.

“The public has an interest in the insurance industry functioning effectively and reliably, which requires the prompt adjustment of claims. Furthermore, this is at bottom a contract issue, and the public has a significant interest in ensuring that valid contracts are enforced,” U.S. District Judge Max Cogburn, in federal court in North Carolina, wrote in the June 2 order.

Yachtinsure has disputed Clear Blue’s assertions and its lawyer said the firm has only one claim remaining.

The litigation highlights Florida’s law that forbids insurers from denying claims based on “technicalities” that have no real bearing on the outcome of an event. Coverage for the Hirschhorn accident was denied, on Yachtinsure’s letterhead, due to an “unapproved operator” at the helm of the boat that fateful day, according to Hirschhorn widow Karen Nissim’s amended complaint. But the insurance declaration page clearly lists the Chris Craft boat owner, by name, as an operator, the lawsuit contends.

The argument is similar to that in a 2023 Florida technicality case, in which Travelers was required to pay $2 million to the owner of a 92-foot yacht sunk by Hurricane Irma in Florida.

The Hirschhorn and related suits also give some insight into the world of high-end boat insurance and the unusual role that Yachtinsure Services provides – serving as both MGA and third-party adjusting firm. Clear Blue Insurance Group, owned by Clear Blue Financial Holdings, is a fronting specialist insurer that operates in all 50 U.S. states, the company noted. It has offices in North Carolina and in Texas and is governed by Texas laws and regulations.

Clear Blue said in its North Carolina lawsuit complaint that it had contracted with Yachtinsure to handle almost everything, from underwriting to claims. The agreement authorizes Yachtinsure, part of International Risk Solutions, to settle claims up to $150,000 in value. It could also seek authority to settle claims above that level but is required to fully adjust all claims, regardless of dollar amount.

The agreement also requires the MGA/TPA to defend Clear Blue in litigation that may be related “in any way” to the contract or if Yachtinsure fails to comply with Florida laws, the Clear Blue complaint argues. The agreement further requires that disputes between the insurer and the MGA to be heard only in federal court in Charlotte, North Carolina, where Clear Blue has an office.

After the Hirschhorn crash, the claims denial and the award, and after Hirschhorn’s widow sued, Clear Blue sent a letter to Yachtinsure, demanding that it defend and indemnify the insurance company. In emails, Yachtinsure officials rejected the demands, refused to defend the carrier and has refused to complete adjustments of claims, the lawsuit contends. Mediation did not resolve the impasse.

“In its refusal to fully adjust claims to completion, Yachtinsure is likely irreparably harming Clear Blue and its policyholders, including actively jeopardizing the proper adjustment, administration, and timely payment of insurance claims under the Program—critical functions to the operation of insurance for both the policyholders, the general public, and those in the insurance industry charged with its orderly operation,” Clear Blue attorneys wrote.

Unlike some property insurance companies that employe staff field adjusters and desk adjusters, Clear Blue relies completely on the third-party adjusting firm to handle claims, it and the judge noted.

Yachtinsure’s attorney Robert Killeen Jr., of Houston, told Insurance Journal that Clear Blue had supplied the court with only part of Yachtinsure’s emails about its claims handling.

“To clarify, Yachtinsure currently has only one remaining claim in run-off and has never breached its contractual obligations with Clear Blue,” Killeen said in an email. “…A preliminary injunction compelling Yachtinsure to continue doing what it already has been doing, adjusting claims, was unnecessary for any litigation.”

Yachtinsure, with offices in London and Fort Lauderdale, plans to file a post-trial brief on the issue in due course, he noted.

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Florida
Legislation
Claims