Denied Home Insurance Claim Review in Miami

You have a right to challenge the denial

Florida law requires the insurer to give you a reasonable written explanation of the basis for a denial or partial denial, tied to the policy and the facts. A denial is not always the end: notice of a reopened claim can be given within 1 year after the date of loss, and a supplemental claim within 18 months.

What are your options when a homeowners insurance claim is denied?

Depending on the policy and the facts, the path forward may include:

• Asking for a re-inspection and providing additional documentation
• Submitting a supplemental claim with a detailed estimate, within 18 months after the date of loss
• Invoking the policy’s appraisal clause, which decides the amount of the loss, not whether it is covered
• Requesting the residential property mediation program of the Florida Department of Financial Services, whose cost is paid by the insurer
• Calling the DFS Consumer Helpline at 1-877-693-5236 with questions or to file a complaint
• Consulting an attorney for legal advice; Florida requires a written pre-suit notice to the insurer before a lawsuit

Appraisal, mediation and legal proceedings are outside RicardoPA’s service agreement; if one of them makes sense, we tell you.

Your property claim was denied. What now?

How the appraisal clause works in a Florida property claim

Denial and policy review

A denied claim review starts with the letter and the documents you already have. We look at the reason given, the documented damage and the policy language, and explain the options in plain words. The review is free and does not promise a result.

What Florida homeowners need to know about denied roof claims

The roof is often the most disputed part of a Florida property claim. Before you respond to a roof denial, check the roof age and material the insurer assumed, whether a separate roof deductible was applied, which does not apply to hurricane roof losses, and whether the building code or matching rules affect the scope of the repair.

Roof Damage Claims

Roof claims in Florida: age, deductibles and the 25 percent rule

What is the 90 day rule for insurance claims in Florida?

Under the current Florida rule the period is 60 days: section 627.70131 requires the insurer to pay or deny a claim, in whole or in part, within 60 days after it receives notice, unless factors beyond its control prevent it. Payments made after that period generally accrue interest, and older losses may follow earlier rules.

How far back can you do an insurance claim?

In Florida, notice of a new or reopened property claim must be given to the insurer within 1 year after the date of loss, and notice of a supplemental claim within 18 months, under section 627.70132 of the Florida Statutes. For hurricanes and other weather events, the date of loss is the date of landfall or the date the event is verified by the National Oceanic and Atmospheric Administration. Older losses may follow earlier rules, and your policy may also require prompt notice.

How to file an insurance claim in Florida?

Report the loss to your insurer promptly, within 1 year after the date of loss, and write down the claim number and every date. Take reasonable steps to prevent further damage, keep every receipt and photograph the damage before repairs. The insurer must acknowledge your claim communications within 7 calendar days and pay or deny the claim within 60 days after receiving notice, unless factors beyond its control prevent it.

Why would you be denied homeowners insurance?

If the question is about a claim, denial letters tend to rely on a cause of loss the policy excludes, late notice, insufficient documentation or an estimate that falls below the deductible. If it is about getting a policy, Florida limits one reason: an insurer may not refuse to issue or renew a homeowners policy solely because the roof is less than 15 years old. A claim denial must be explained in writing, tied to the policy and the facts.

What are the main home insurance problems in Florida?

The roof is often the most disputed part of a Florida property claim, with rules on roof age and a possible separate roof deductible. Other common problems are disputes over the cause of a loss, such as a sudden leak versus long-term seepage or wind versus flood, and estimates that leave out hidden damage, matching or building code upgrades. Late notice and missing documentation can also lead to a denial.

What are the common reasons for home insurance claims being denied?

Denial letters tend to rely on a few reasons: a cause of loss the policy excludes, such as wear and tear, long-term seepage or flood; late notice; insufficient documentation; or an estimate that falls below the deductible. Many disputes also come from an incomplete scope, such as hidden damage, missing line items, matching or building code upgrades that were not considered.