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Last Update: 8/9/20

Know your insurance claim rights under Florida law.

Florida homeowners pumping water away from their homes after a Hurricane. Wikimedia Commons Public Domain Image.

 

Awhile back, Florida’s Chief Financial Officer, Jeff Atwater (the current CFO is Jimmy Patronis), appointed Robin Smith Westcott to be the Florida Insurance Consumer Advocate. At that time, Atwater explained that Westcott’s job was to be “… committed to holding insurance companies accountable and to ensuring consumers get exactly what they pay for and are protected from fraud and abuse.”

As part of that mandate as head of the Consumer Advocacy Office, a new Homeowners’ Policy & Claims Bill of Rights Working Group was created.

Consumer Advocates and Insurance Representatives Meet to Discuss Bill of Rights for Insurance Claimants and Policyholders in Florida

That Working Group brought together consumer-rights groups and insurance industry people to address issues that Westcott had learned from Floridians across the state during a series of consumer forum meetings where Florida homeowners came to tell their stories of the problems they had experienced in filing an insurance claim here in the State of Florida.

After hearing all these complaints about (1) filing insurance claims, (2) getting them to move through the process within the insurance company, and (3) to get paid (finally), the Working Group was formed. Explaining why she was forming this group, Westcott said, “Consumers should not be victimized by poor claims handling and unscrupulous business practices by those seeking to exploit homeowners when they are most vulnerable”.

Poor Claims Handling and Unscrupulous Insurance Company Practices Are Focus of Working Group

The Working Group of Consumer Advocates and Insurance Representatives were to address the following problems:

  • Adjusting & Investigating the Claim – Examinations Under Oath
  • Post-Claim Underwriting & Material Misrepresentation on the Application
  • Solicitation of Consumers within 48 – 72 Hours of a Loss and Policyholders’ Requirement to Mitigate Damages
  • Assignment of Claims and Unauthorized Adjusting of Claims
  • Insurers’ Right to Repair – Safeguards and Warranties for Consumers
  • Non-Renewal of Policies – Post-Claim but Prior to Repairs
  • Mortgage Company Withholding of Funds for Repairs for Loans in Arrears and Guarantee 100 Percent Replacement Cost
  • Mediation and Appraisal.

New Policy and Claims Bill of Rights Released

To educate the public on their rights as residential property policyholders, Florida’s Chief Financial Officer created an easy to read pamphlet which can be found here.

Read The Claims Law in Detail Here

The Homeowner Claims Bill of Rights (which is codified in Florida Statute 627.7142), states as follows:

Homeowner Claims Bill of Rights.An insurer issuing a personal lines residential property insurance policy in this state must provide a Homeowner Claims Bill of Rights to a policyholder within 14 days after receiving an initial communication with respect to a claim, unless the claim follows an event that is the subject of a declaration of a state of emergency by the Governor. The purpose of the bill of rights is to summarize, in simple, nontechnical terms, existing Florida law regarding the rights of a personal lines residential property insurance policyholder who files a claim of loss. The Homeowner Claims Bill of Rights is specific to the claims process and does not represent all of a policyholder’s rights under Florida law regarding the insurance policy. The Homeowner Claims Bill of Rights does not create a civil cause of action by any individual policyholder or class of policyholders against an insurer or insurers. The failure of an insurer to properly deliver the Homeowner Claims Bill of Rights is subject to administrative enforcement by the office but is not admissible as evidence in a civil action against an insurer. The Homeowner Claims Bill of Rights does not enlarge, modify, or contravene statutory requirements, including, but not limited to, ss. 626.854, 626.9541, 627.70131, 627.7015, and 627.7074, and does not prohibit an insurer from exercising its right to repair damaged property in compliance with the terms of an applicable policy or ss. 627.7011(5)(e) and 627.702(7). The Homeowner Claims Bill of Rights must state:

HOMEOWNER CLAIMS BILL OF RIGHTS

This Bill of Rights is specific to the claims process and does not represent all of your rights under Florida law regarding your policy. There are also exceptions to the stated timelines when conditions are beyond your insurance company’s control. This document does not create a civil cause of action by an individual policyholder, or a class of policyholders, against an insurer or insurers and does not prohibit an insurer from exercising its right to repair damaged property in compliance with the terms of an applicable policy.

YOU HAVE THE RIGHT TO:

1. Receive from your insurance company an acknowledgment of your reported claim within 14 days after the time you communicated the claim.

2. Upon written request, receive from your insurance company within 30 days after you have submitted a complete proof-of-loss statement to your insurance company, confirmation that your claim is covered in full, partially covered, or denied, or receive a written statement that your claim is being investigated.

3. Within 90 days, subject to any dual interest noted in the policy, receive full settlement payment for your claim or payment of the undisputed portion of your claim, or your insurance company’s denial of your claim.

4. Free mediation of your disputed claim by the Florida Department of Financial Services, Division of Consumer Services, under most circumstances and subject to certain restrictions.

5. Neutral evaluation of your disputed claim, if your claim is for damage caused by a sinkhole and is covered by your policy.

6. Contact the Florida Department of Financial Services, Division of Consumer Services’ toll-free helpline for assistance with any insurance claim or questions pertaining to the handling of your claim. You can reach the Helpline by phone at  (toll-free phone number)  , or you can seek assistance online at the Florida Department of Financial Services, Division of Consumer Services’ website at  (website address)  .

YOU ARE ADVISED TO:

1. Contact your insurance company before entering into any contract for repairs to confirm any managed repair policy provisions or optional preferred vendors.

2. Make and document emergency repairs that are necessary to prevent further damage. Keep the damaged property, if feasible, keep all receipts, and take photographs of damage before and after any repairs.

3. Carefully read any contract that requires you to pay out-of-pocket expenses or a fee that is based on a percentage of the insurance proceeds that you will receive for repairing or replacing your property.

4. Confirm that the contractor you choose is licensed to do business in Florida. You can verify a contractor’s license and check to see if there are any complaints against him or her by calling the Florida Department of Business and Professional Regulation. You should also ask the contractor for references from previous work.

5. Require all contractors to provide proof of insurance before beginning repairs.

6. Take precautions if the damage requires you to leave your home, including securing your property and turning off your gas, water, and electricity, and contacting your insurance company and provide a phone number where you can be reached.

What Should You Do Now About Your Unpaid Insurance Claim?

A good piece of advice if you are having problems with getting money from your insurance company, including your insurance adjuster avoiding your calls and emails, is to speak with an experienced lawyer to learn your rights. Most experienced lawyers, like Alan Sackrin, will offer a free initial consultation (over the phone or in-person) to answer your questions.

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Do you have questions or comments? Then please feel free to send Alan an email or call him now at (954) 458-8655.

 

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