American Integrity Claim Denial Guide for Orlando, Florida

11 min read

Introduction: Why American Integrity Denials Matter for Orlando Homeowners

American Integrity Insurance is one of the largest writers of homeowners policies in Florida, insuring thousands of properties across Orange County and greater Orlando. While the company markets itself as a responsive, Florida-focused carrier, claim denials are not uncommon—especially after costly wind, water, or hail events. If you live in Orlando, you already understand how Atlantic hurricanes funnel up the peninsula, often veering inland along the I-4 corridor. Hurricane Ian’s record rainfall in 2022 and Hurricane Irma’s destructive winds in 2017 both caused widespread roof, water, and mold damage far from the immediate coastline. When storms strike, policyholders count on their carriers to honor covered losses. Unfortunately, some Orlando homeowners receive a denial letter from American Integrity citing exclusions, wear and tear, or late notice. The following guide explains your legal rights under Florida insurance law, the most common reasons for American Integrity denials, and the concrete steps to fight back—so you can recover the funds you need to repair your home and safeguard your family.

1. Understanding Your Rights Under Florida Law

Key Florida Statutes Protecting Policyholders

• Florida Statute §624.155 – Civil Remedy for Insurer Bad Faith: Gives homeowners a direct action against insurers that fail to settle claims in good faith within 60 days of written notice.

• Florida Statute §626.9541 – Unfair Claim Settlement Practices: Prohibits carriers from denying claims without reasonable investigation or misrepresenting policy provisions.

• Florida Statute §627.70131 – Prompt Payment of Claims: Requires insurers to acknowledge and begin investigating a claim within 14 days and pay undisputed amounts within 90 days.

• Statute of Limitations: Under §95.11(2)(e), you typically have five years from the date of loss to sue for breach of a property insurance contract, though hurricane claims must now be filed within one year of the event (effective 2023).

Florida’s consumer-friendly insurance code places the burden on insurers—like American Integrity—to handle claims promptly, fairly, and in compliance with policy language. When an insurer violates these duties, it can face extra-contractual damages, penalties, and attorney’s fees.

The Florida Office of Insurance Regulation (OIR) and Department of Financial Services (DFS)

The Florida Office of Insurance Regulation approves policy forms and monitors solvency, while the Department of Financial Services investigates individual consumer complaints through its Division of Consumer Services. If American Integrity wrongfully delays or denies your claim, filing a DFS complaint can jump-start negotiations and create a documentary record of potential bad faith.

Bad Faith: Your Leverage Point

If American Integrity fails to conduct a reasonable inspection, issues a boilerplate denial without citing specific policy provisions, or intentionally underpays a covered loss, that behavior may constitute statutory bad faith. After serving a Civil Remedy Notice (CRN) through DFS, the insurer has 60 days to cure the violation by paying the claim. Failure to do so opens the door to additional damages—an important bargaining chip during settlement talks.

2. Common Reasons American Integrity Denies Claims

Reviewing hundreds of denial letters across Florida reveals recurring patterns:

• Wear and Tear vs. Sudden Loss: American Integrity often argues that roof leaks or pipe breaks were the result of gradual deterioration, excluded under the policy’s wear-and-tear limitation. However, Florida courts distinguish between long-term damage and sudden failures. A sudden rupture—even in an old roof—may still be covered.

• Late Reporting: The policy typically requires you to give “prompt notice.” American Integrity sometimes denies claims reported weeks or months after discovery. Yet, under §627.70132, the carrier must show it was prejudiced by the delay—not merely that notice was not immediate.

• Water Damage Below Deductible: Adjusters may estimate repairs below your hurricane or all-perils deductible. Independent contractor estimates and detailed photos often rebut lowball assessments.

• Policy Exclusions: Mold, earth movement, or sewer backup exclusions are frequently cited. However, ensuing loss provisions can reinstate coverage if the initial cause (e.g., wind) is covered.

• Misrepresentation or Fraud Allegations: In rare cases, American Integrity voids the policy, claiming the homeowner concealed prior damage or inflated invoices. These are serious accusations that require immediate legal counsel.

Case Example

In Capitol Preferred Ins. Co. v. Mesecher (Fla. 5th DCA 2021), an insurer denied water damage as wear-and-tear. The appellate court reversed, holding that sudden pipe ruptures were covered because the policy ambiguous language construed against the insurer. Orlando falls under the Fifth District Court of Appeal, making this precedent particularly persuasive.

3. Florida Legal Protections & Regulations

Regulatory Oversight

American Integrity must comply with the Florida Insurance Code, including mandatory participation in the Florida Insurance Guaranty Association (FIGA) to protect policyholders if the company becomes insolvent. DFS regularly audits carriers for claim-handling violations.

Recent Legislative Changes Affecting Orlando Homeowners

• Senate Bill 2-A (2022 Special Session): Shortened the time to report hurricane claims from three years to one year and reduced attorneys’ fee multipliers, making prompt legal action essential.

• Assignment of Benefits (AOB) Reform (2019): Places restrictions on contractors taking over insurance benefits, but still allows post-loss assignments with specific language.

• Roof Deductible Endorsements (2022): American Integrity now offers policies with separate roof deductibles; homeowners must carefully read these endorsements to avoid surprise out-of-pocket costs.

Important Court Precedents

• Johnson v. Omega Ins. Co., 200 So.3d 1207 (Fla. 2016): Ambiguous policy language is interpreted in favor of the insured.

• Tower Hill Signature Ins. Co. v. Kushch, 333 So.3d 247 (Fla. 2d DCA 2022): Late notice defense requires insurer to prove actual prejudice.

• American Integrity Ins. Co. v. Estrada, 276 So.3d 905 (Fla. 3d DCA 2019): Clarifies appraisal process and insurer obligations once appraisal is demanded.

4. Steps to Take After an American Integrity Denial

Step 1: Review the Denial Letter Thoroughly

The letter must cite specific policy provisions. Highlight every exclusion or limitation referenced. Compare those clauses with the declarations page to verify endorsements or amendments.

Step 2: Request Your Full Claim File

Under §626.9541(1)(i)3, you can demand American Integrity provide all adjuster notes, photos, and estimates used in making the decision. Send a written request via certified mail or email to the claims department.

Step 3: Gather Independent Evidence

• Second Inspection: Hire a licensed Orlando public adjuster, roofer, or water-mitigation expert to assess damage and generate an independent estimate.

• Photos & Videos: Document damages from multiple angles, including attic, trusses, and exterior walls.

• Maintenance Records: Provide receipts for roof repairs, HVAC service, or plumbing maintenance to show you properly maintained your property.

Step 4: File a Reconsideration or Supplemental Claim

Submit your independent estimate, photos, and a letter rebutting each denial point. Florida law does not limit the number of supplemental claims you can file within the statute of limitations.

Step 5: Explore Appraisal

Most American Integrity policies include an appraisal clause. If the dispute is solely about the amount of loss—not coverage—you or the insurer can demand appraisal. Each side selects an appraiser, and the appraisers choose an umpire. The appraisal award is binding but does not affect coverage disputes.

Step 6: File a Civil Remedy Notice (CRN)

If American Integrity continues to deny or underpay, your attorney can file a CRN via the DFS portal. This statutory notice details the insurer’s violations and triggers the 60-day cure window. Failure to cure may expose the insurer to bad faith damages.

Step 7: Litigate—If Necessary

Breach-of-contract lawsuits are filed in Orange County Circuit Court. Florida’s one-way attorney’s fee statute (§627.428, now §627.4287 for policies issued before 12/16/22) previously required insurers to pay your fees if you prevailed. For newer policies, the fee statute has changed, but prevailing policyholders can still recover fees under certain circumstances—making professional legal advice essential.

5. When to Seek Legal Help in Florida

Red Flags Requiring Immediate Counsel

• The denial letter alleges misrepresentation or fraud.

• You face a statute of limitations deadline (one year for hurricane claims).

• American Integrity offers a settlement far below independent estimates.

• The insurer refuses to provide your claim file or delays communication beyond statutory deadlines.

A seasoned Florida insurance attorney can evaluate the strength of your claim, calculate potential bad faith damages, and handle CRN filings. Legal counsel also levels the playing field during appraisal or mediation.

Why Choose Louis Law Group

Louis Law Group has offices throughout Florida and focuses exclusively on property insurance disputes. Our attorneys are fully licensed in Florida courts and have resolved hundreds of American Integrity claims through negotiation, appraisal, and litigation. Our Orlando-based team understands local building codes, wind-mitigation credits, and the unique weather patterns that affect Central Florida roofs.

6. Local Resources & Next Steps

Florida Department of Financial Services – Consumer Services: 1-877-693-5236 or file a complaint online. Florida Office of Insurance Regulation – Rate & Form Filings: Review American Integrity’s approved policy forms on the OIR portal.

• Orange County Clerk of Courts: Search case dockets for American Integrity lawsuits to see how similar claims resolved.

• Legal Aid Society of the Orange County Bar Association: Provides limited pro bono assistance for low-income homeowners facing claim disputes.

Action Checklist for Orlando Homeowners

• Verify the date of loss and mark statutory deadlines on your calendar.

• Request the full claim file and policy certified copy from American Integrity.

• Document damage thoroughly and obtain at least two independent estimates.

• File a supplemental claim or reconsideration letter, attaching evidence.

• Consult an insurance attorney before signing any release or low settlement.

• Track every call, email, and letter in a claim diary—it can become evidence in court.

Remember: Time is of the essence, especially under Florida’s shortened hurricane claim window. If you act quickly and strategically, you can preserve critical evidence and maximize your recovery.

Legal Disclaimer

This guide is for general informational purposes only and does not constitute legal advice. Insurance policies differ in language and coverage. Consult a licensed Florida attorney to obtain advice tailored to your specific circumstances. Past results do not guarantee future outcomes.

Get a Free Case Evaluation Today

If American Integrity denied, delayed, or underpaid your Orlando homeowners claim, do not go it alone. Call Louis Law Group at 833-657-4812 for a free case evaluation and policy review. Our insurance attorneys will analyze your denial letter, inspect your home, and outline the fastest path to compensation—at no upfront cost to you.