American Integrity Claim Denial Guide – Palm Bay, Florida

Introduction: Why Palm Bay Homeowners Read This Guide

Living on Florida’s Space Coast offers year-round sunshine, proximity to the Atlantic Ocean, and—unfortunately—a heightened exposure to wind, hail, and tropical-storm damage. According to the National Hurricane Center, Brevard County has experienced more than a dozen named storms since 2000, and Palm Bay’s location just south of Cape Canaveral places roofs and siding in the direct path of salt-laden winds and driving rain. That is why many Palm Bay residents insure their homes with Florida-based carriers such as American Integrity Insurance Company of Florida ("American Integrity").Yet even with prompt notice, photographs, and estimates, policyholders sometimes receive a Notice of Claim Denial or Partial Denial. If that letter arrived in your mailbox, you may feel overwhelmed, angry, and uncertain about your next move. This comprehensive guide—grounded strictly in Florida statutes, administrative rules, and court decisions—explains how homeowners can contest an American Integrity claim denial, the deadlines that apply, and when to involve a licensed Florida attorney. While the information slightly favors the consumer, every statement is carefully sourced and factual.

Read Time

13 min read

1. Understanding Your Rights as a Florida Policyholder

Florida’s Homeowner Bill of Rights

Florida Statutes recognize that an insurance contract is "vested with the public interest" (see Fla. Stat. § 627.311(5)(a)). The Florida Office of Insurance Regulation (OIR) and the Department of Financial Services (DFS) therefore require insurers to handle residential claims promptly and fairly. Among the most important protections:

• Prompt Communication – Under Fla. Stat. § 627.70131(1)(a), an insurer must acknowledge a claim communication within 14 calendar days.
• 90-Day Coverage Decision – Fla. Stat. § 627.70131(5)(a) mandates that carriers pay or deny a property claim within 90 days after receiving notice, unless factors beyond their control reasonably prevent them from doing so.
• Attorney’s Fees for Wrongful Denial – If a homeowner sues and "recovers judgment," the court shall award reasonable attorney’s fees under Fla. Stat. § 627.428. This fee-shifting provision aims to level the playing field between insureds and insurers.
• Bad-Faith Remedies – When an insurer does not attempt in good faith to settle claims, the insured may bring a civil remedy notice (CRN) and a subsequent bad-faith lawsuit pursuant to Fla. Stat. § 624.155.

Policy Conditions Still Matter

Florida law protects you, but you must still comply with policy duties such as timely notice, cooperation with inspection, proof-of-loss forms, and mitigation of further damage (often within 14 days of the event). Courts routinely cite failure to comply with conditions precedent when upholding denials (see, e.g., Currie v. State Farm, 255 So. 3d 357 (Fla. 1st DCA 2018)).

2. Common Reasons American Integrity Denies Claims

Louis Law Group’s review of publicly filed complaints and appellate decisions involving American Integrity highlights recurring denial rationales:

• Wear and Tear vs. Sudden Loss – If American Integrity’s adjuster attributes roof leaks to "age-related deterioration" rather than a covered peril, the carrier may deny.
• Late Notice – Reporting wind damage more than 30–60 days after an event often triggers a "prejudice" defense.
• Water Damage Limitations – Policies frequently cap non-storm water losses at $10,000 unless the insured obtains an endorsement.
• Exclusion for Pre-Existing Damage – Photos or inspection notes suggesting damage existed before the policy’s inception can justify a coverage denial.
• Fraud or Material Misrepresentation – Inaccurate statements about prior claims or the loss may void the policy under Fla. Stat. § 627.409.

Some denials are valid. Others stem from adjuster oversight, incorrect application of exclusions, or under-scoping repairs. The Florida Supreme Court has held that exclusions are construed narrowly and ambiguity resolved in favor of coverage (Washington Nat’l Ins. v. Ruderman, 117 So. 3d 943 (Fla. 2013)).

3. Florida Legal Protections & Regulations You Can Invoke

Key Statutes

• Fla. Stat. § 627.70131 – Sets deadlines for acknowledgement, investigation, and payment.
• Fla. Stat. § 627.428 – Authorizes insureds to collect attorney’s fees if judgment is entered in their favor.
• Fla. Stat. § 624.155 – Provides a civil cause of action for bad faith.
• Fla. Stat. § 95.11(2)(e) – Establishes a five-year statute of limitations for actions founded on a written insurance contract.

Administrative Rules

The Florida Administrative Code, Rule 69O-166.055, requires carriers to implement anti-fraud plans and maintain complaint response systems. DFS monitors compliance through market conduct exams.

Case Law Spotlight: Appraisal vs. Litigation

Many American Integrity policies include an appraisal clause—an alternative dispute mechanism. Florida courts enforce appraisal broadly (State Farm v. Cincinnati, 246 So. 3d 908 (Fla. 5th DCA 2018)). However, in American Integrity v. Estrada (276 So. 3d 905 (Fla. 5th DCA 2019)), the court required the insurer to pay undisputed amounts before invoking appraisal, reaffirming the consumer-oriented "prompt payment" principle of § 627.70131.

4. Steps to Take After Receiving an American Integrity Denial

Step 1 – Review the Denial Letter Line-by-Line

Identify every policy exclusion cited. Compare it to your declarations page and endorsements. Verify the date American Integrity says you reported the loss—the timeline determines statutory rights.

Step 2 – Collect Objective Evidence

• Independent contractor or licensed public adjuster estimate.
• Before-and-after photos (drone roof shots are admissible if authenticated). Weather data (National Weather Service) to tie wind speeds to the date of loss.

Step 3 – File a Notice of Dispute with American Integrity

Florida law does not mandate a "proof of loss" for every claim, but many policies do within 60 days. Submit certified mail or email with read receipt. Keep copies.

Step 4 – Utilize the Florida DFS Mediation Program

The Department of Financial Services offers free, non-binding mediation for residential property disputes under Fla. Stat. § 627.7015. To request mediation:

• Complete Form DFS-I0-623 and email it to [email protected].
• Pay the $100 administrative fee unless the insurer agrees to cover it.

Insurers must participate once DFS issues the Notice of Mediation. Although non-binding, settlements reached are enforceable.

Step 5 – File a Civil Remedy Notice (CRN) if Bad Faith Is Suspected

Before suing for bad faith, Fla. Stat. § 624.155(3)(a) requires the insured to file a CRN via the DFS portal and give the carrier 60 days to cure. Failure to cure may expose the insurer to extra-contractual damages.

5. Department of Insurance Complaint Process in Florida

Consumer Services Help Line

Palm Bay residents may contact the DFS Division of Consumer Services at 1-877-693-5236. A "Request for Assistance" form can also be submitted online (MyFloridaCFO).### What DFS Can and Cannot Do

• Can: Obtain a written response from American Integrity, ensure statutory deadlines are followed, and facilitate mediation.
• Cannot: Compel payment or award damages—that power lies with the courts or appraisal.

Escalation Timeline

DFS typically provides the insurer 20 days to respond. The division then reviews and issues findings. Keep all correspondence; courts recognize DFS filings as evidence of reasonable efforts prior to litigation.

6. When to Seek Legal Help in Florida

Indicators You Need a Florida Attorney

• The amount in dispute exceeds your deductible by at least $10,000.
• American Integrity alleges "misrepresentation" or "fraud." These allegations may void coverage and affect future insurability.
• You have received a "Request for Examination Under Oath (EUO)." Statements during an EUO are sworn testimony; counsel is recommended.
• The carrier refuses to engage in appraisal or denies after appraisal award.

Attorney Licensing Rules

Only attorneys licensed by the Florida Bar may provide legal advice or represent you in court. Always verify a lawyer’s status at The Florida Bar.### Costs and Fee Arrangements

Most homeowner insurance lawyers work on contingency—no fee unless they recover. Under Fla. Stat. § 627.428, if the insured obtains any judgment against the insurer, the court must order the insurer to pay reasonable attorney’s fees.

7. Local Resources & Next Steps for Palm Bay Residents

City and County Contacts

• Palm Bay Building Department – Permits and inspection records can prove the age of your roof (321-953-8924).
• Brevard County Property Appraiser – Obtain historical aerial imagery and property cards.

Disaster Assistance

If the governor declares a state of emergency, homeowners may apply for grants or temporary housing through FEMA’s Individual Assistance Program.### Trusted Contractors

Only hire contractors licensed by the Florida Department of Business & Professional Regulation (DBPR). Verify licenses at MyFloridaLicense.## Conclusion

An American Integrity claim denial is not the end of the road. Florida statutes—particularly §§ 627.70131, 627.428, and 624.155—give Palm Bay homeowners multiple tools to secure fair payment. Act quickly, document everything, and consult professionals when needed.

Legal Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Consult a licensed Florida attorney regarding your specific situation.

If American Integrity denied your claim, call Louis Law Group at 833-657-4812 for a free case evaluation and policy review.