Insurance Claim Denied in Florida: What to Do

The Seven Steps After a Florida Denial

Work them in order — in Florida the deadline check comes before everything else, because a strong claim noticed late is still a barred claim.

1. 1

   Read the denial letter — and the policy provisions it cites

   Match every exclusion or condition the letter cites against your actual policy: the declarations page, the policy form, and every endorsement. Florida denials often turn on a specific factual assertion — wear and tear, pre-existing damage, late notice, or the roof rules — that can be tested against evidence. A denial letter is the insurer’s coverage position, not a final legal ruling.

2. 2

   Check the §627.70132 deadlines immediately

   Florida sets hard statutory filing windows measured from the date of loss: for losses after the December 2022 reforms, notice of an initial or reopened claim generally must be given within 1 year, and notice of a supplemental claim within 18 months. The clock runs from the date of loss — not from discovery or the insurer’s first payment — and a claim noticed outside the window can be barred regardless of merit. Older losses may be governed by the statute version in effect on the date of loss.

3. 3

   Gather and re-document the evidence

   Assemble dated photos and video taken before temporary repairs, a room-by-room inventory of damaged contents, receipts for mitigation and additional living expenses, independent repair estimates, and a dated log of every carrier contact. Keep the insurer’s estimate and the denial letter in the file — the gap between the carrier’s scope and the documented loss is where a re-presented claim is built.

4. 4

   Re-present or supplement the claim — a licensed public adjuster can do this

   Denials and underpayments are frequently revisited when new documentation, an independent line-item estimate, or professional representation addresses the stated reason. A licensed Florida public adjuster inspects the loss, prepares a detailed estimate, and negotiates with the carrier on a contingency fee capped at 20% of the claim payment — 10% for declared-emergency claims made within one year (Fla. Stat. §626.854(11)); the fee cannot be based on the deductible or on amounts already paid. Florida’s matching statute (§626.9744) and, for total losses, the Valued Policy Law (§627.702) can also shape what a correct settlement looks like.

5. 5

   Apply the §627.70131 prompt-pay framework

   After the 2022 reforms, Florida insurers generally must acknowledge claim communications within about 7 days and pay or deny a residential property claim — in whole or in part — within 60 days after receiving notice (reduced from the prior 90 days), subject to limited exceptions such as factors beyond the insurer’s control. Amounts paid late accrue statutory interest. These timeframes apply to supplemental and reopened claims as well, so the 60-day clock restarts when the insurer receives notice of a supplement. Document every date.

6. 6

   Use DFS mediation or the appraisal clause for the right dispute

   Florida offers a mediation program through the Department of Financial Services (§627.7015) as a lower-cost step before appraisal or litigation on certain residential property disputes. Separately, most policies contain an appraisal clause: when coverage is agreed but the dollar amount is disputed, each side names an independent appraiser, the two select an umpire, and an award signed by any two binds the amount of the loss. Appraisal decides value — not coverage — and a public adjuster can serve as your appraiser or prepare the documentation going in.

7. 7

   Know when the dispute belongs to an attorney

   If the disagreement is whether the loss is covered at all, or whether the insurer acted in bad faith, that is a legal matter. Florida bad-faith claims proceed through the Civil Remedy Notice process under §624.155, and a pre-suit notice under §627.70152 is generally required before suing on a property claim — both attorney work, not public adjusting. The 2022 reforms (SB 2-D, SB 2-A) also changed the litigation landscape, including attorney-fee rules, so consult a licensed Florida attorney on any lawsuit question.

The right professional depends on what is actually in dispute. Only one of these paths is a public adjuster’s lane.

Frequently Asked Questions