How Long Does An Insurance Company Have to Pay a Claim in Florida?

Dealing with insurance claims can be a complex process, especially when you’re unsure about the timeline. In Florida, insurance companies don’t have a specific deadline to pay out claims. Instead, state law requires insurers to settle claims “within a reasonable time.”

While there’s no fixed payment deadline, insurance companies in Florida must acknowledge your claim within 14 days of receiving it. This acknowledgment starts the clock on the investigation and settlement process. Once a settlement is reached, insurers have 20 days to pay it out.

You should be aware that different types of claims may have varying timelines. For example, Personal Injury Protection (PIP) claims must be submitted within 14 days of the incident, and insurance companies then have 30 days to investigate and make a settlement offer. If you’re facing delays or issues with your claim, you have options to seek resolution, including filing complaints with the Florida Department of Financial Services.

Understanding Florida’s Claim Settlement Regulations

Florida has specific laws and regulations governing insurance claim settlements. These rules outline the timelines for filing claims, how quickly insurers must respond, and when payments are required.

Florida Statutes Governing Insurance Claims

Florida Statute 627.70131 is the primary law regulating insurance claim settlements. It sets strict deadlines for insurers to acknowledge, investigate, and pay claims.

Insurers must acknowledge receipt of claims within 14 days. They have 30 days to decide whether to pay, deny, or request more information about a claim.

If an insurer needs more time, they must notify you in writing every 45 days about the claim’s status.

Timeframe for Filing a Claim

You have limited time to file an insurance claim in Florida. For most property damage claims, you must file within 1 year of the date the damage occurred.

Personal injury protection (PIP) claims have a much shorter window. You must file PIP claims within 14 days of an accident.

It’s crucial to file your claim as soon as possible. Delays can complicate the process and potentially lead to claim denial.

Commencement of the Payment Period

The payment period begins once you’ve submitted all required documentation for your claim. Insurers then have 90 days to pay or deny the claim, unless factors beyond their control prevent payment.

If your claim is approved, the insurer must pay within 20 days of reaching a settlement agreement. Failure to pay on time can result in penalties, including 12% annual interest on the unpaid amount.

You can help expedite this process by promptly providing any additional information requested by your insurer.

The Insurance Claims Payment Process in Florida

Florida law outlines specific timelines and procedures for insurance companies to follow when processing claims. These regulations aim to ensure policyholders receive timely responses and fair treatment throughout the claims process.

Initial Response by Insurance Company

When you file an insurance claim in Florida, the company must acknowledge receipt within 14 days. This initial response typically includes information about your policy coverage and any additional documentation needed to process your claim.

Insurance providers may contact you by phone, email, or mail to confirm they’ve received your claim. They should also provide you with a claim number and the contact information for the assigned claims adjuster.

During this initial phase, it’s crucial to keep detailed records of all communications with your insurance company. Save emails, letters, and make notes of phone conversations, including dates and names of representatives you speak with.

Claim Investigation Timeline

After acknowledging your claim, Florida law requires insurance companies to begin their investigation within 15 days. 

The investigation process involves:

• Reviewing your policy details
• Assessing the reported damages or losses
• Potentially sending an adjuster to inspect the property
• Gathering additional information or documentation

The duration of the investigation can vary depending on the complexity of your claim. However, insurance companies must complete their investigation and make a decision within 90 days of receiving your claim.

During this period, be prepared to provide any requested information promptly to avoid delays. Keep copies of all documents you submit to the insurance company.

Obligations for Timely Payments

Once the investigation is complete, Florida law mandates that insurance companies either pay or deny your claim within 90 days of receipt. If your claim is approved, the insurer should issue payment promptly.

For certain types of claims, such as Personal Injury Protection (PIP), insurers have 30 days to pay benefits after receiving written notice of a covered loss. Failure to pay within this timeframe can result in penalties.

If only part of your claim is in dispute, the insurance company must pay the undisputed portion within the 90-day period. This ensures you receive at least partial compensation while any contested amounts are resolved.

Consequences of Delays in Payments

Insurance companies that fail to meet Florida’s claims processing deadlines may face consequences. These can include:

1. Interest penalties on overdue payments
2. Bad faith lawsuits filed by policyholders
3. Regulatory actions by the Florida Department of Financial Services

If your insurer unreasonably delays payment, you have the right to file a complaint with the Florida Division of Consumer Services. This department can investigate your case and may take action against the insurance company.

In cases of significant delays or unfair claim denials, you might consider consulting with an attorney specializing in insurance law. They can advise you on your rights and potential legal actions to pursue fair compensation.

Exceptions and Special Considerations

Insurance claims in Florida can face unique circumstances that alter standard timelines and processes. These situations require special attention and may involve different procedures or extended deadlines.

Catastrophic Events and Mass Claims

When natural disasters like hurricanes strike Florida, insurance companies face an overwhelming volume of claims. In these cases, standard timelines may be extended. The Florida Office of Insurance Regulation often issues emergency orders allowing insurers more time to process claims.

You might experience longer wait times for adjusters to assess damage. Insurance companies may prioritize claims based on severity. Temporary housing and emergency repairs typically receive faster attention.

Document all damage thoroughly with photos and videos. Keep receipts for any emergency repairs or temporary living expenses. This documentation will be crucial for your claim.

Dispute Resolution and Mediation

If you disagree with your insurer’s decision or payout, you have options. Florida law provides a mediation program for property insurance disputes. You can request mediation within three years of the incident date.

Mediation is typically faster and less costly than litigation. A neutral third party facilitates discussions between you and your insurer. The process is non-binding, meaning you can still pursue legal action if unsatisfied.

You may also file a complaint with the Florida Department of Financial Services. They can investigate your case and help resolve issues with your insurer.

Supplementary Payments and Coverage

Some insurance policies offer additional living expense coverage. This helps with costs if you’re displaced from your home during repairs. Check your policy for specific limits and duration of this coverage.

You may receive multiple payments for a single claim. Initial payments often cover immediate needs or undisputed amounts. Supplementary payments can follow as additional damages are assessed or repairs progress.

Keep detailed records of all communications and payments received. This helps track the claim’s progress and ensures you receive full compensation for covered losses.

Legal Recourse for Claim Payment Delays

Florida law protects policyholders from unreasonable delays in claim payments. You have options to address prolonged insurance claim processes and seek resolution.

Filing a Complaint with Florida’s Division of Consumer Services

If your insurance company is delaying payment, you can file a complaint with Florida’s Division of Consumer Services. This state agency oversees insurance companies and investigates consumer complaints.

To file a complaint:

1. Visit the Division’s website or call their hotline
2. Provide details about your claim and the delay
3. Submit any supporting documentation

The Division will contact your insurer and attempt to mediate the dispute. They may also conduct an investigation if they suspect the company is violating state regulations.

This process is free and can often resolve issues without legal action.

Civil Remedies and Litigation

When other methods fail, you may need to pursue legal action against your insurance company. Florida law allows policyholders to sue insurers for unreasonable delays or denials of claims.

Key points about civil litigation:

• You can file a “bad faith” lawsuit if the insurer violates its duty to handle claims fairly
• Damages may include the claim amount plus interest, attorney fees, and additional compensation
• There are strict time limits for filing, so consult an attorney promptly

Before suing, send a formal demand letter to the insurer. This gives them one last chance to resolve the issue and strengthens your case if you go to court.

Consider hiring an experienced insurance attorney to navigate the complex legal process and improve your chances of a favorable outcome.

Contact Landau Law for Help with your Florida Property Damage Claim

Dealing with property damage claims in Florida can be challenging. If you’re struggling with the process, consider reaching out to the experienced attorneys at Landau Law Group.

With offices in Boca Raton and Bonita Springs, Landau Law serves clients throughout Florida. Their team specializes in property damage claims and personal injury cases.

The firm has handled over $10 million in property damage claims, including both residential and commercial cases. They assist:

• Homeowners
• Business owners
• HOA and Condo associations

To get started, call Landau Law at 866-703-4878 for a free, no-obligation consultation. Their attorneys can review your case and help you understand your options.

When you work with Landau Law, you’ll have knowledgeable advocates on your side. They can help you navigate the complex claims process and work to secure the maximum compensation you deserve.

Don’t let insurance companies take advantage of you. If your claim has been denied or underpaid, Landau Law can fight for your rights. Their experience with Florida property damage laws can be invaluable in resolving your claim effectively.

Remember, time is crucial in property damage cases. Contact Landau Law promptly to ensure you meet all necessary deadlines and protect your interests.