American Integrity Denial Guide | Miami, Florida

Introduction

American Integrity Insurance Company of Florida (often shortened to “American Integrity”) insures tens of thousands of homes across South Florida. Yet, every hurricane season and in many non-storm-related claims, Miami homeowners report frustration when the company issues a partial or total denial. A 2022 quarterly report filed with the Florida Office of Insurance Regulation shows that American Integrity received more than 2,000 consumer complaints statewide—ranking it among the most-complained-about property carriers. While statistics do not tell the whole story, they underline a reality: if you live in Miami-Dade County and your claim is denied, you are not alone. This guide explains what a denial letter really means, which Florida laws protect you, and what practical steps you can take—today—to turn things around.

Because Miami’s subtropical climate produces intense heat, torrential summer rains, and frequent hurricanes, local homeowners face unique risks: wind-driven water intrusion, roof damage, mold, and rising construction costs. These factors can lead to complex coverage disputes with American Integrity over exclusions, depreciation, and causation. Knowing your rights before you speak with another adjuster can make the difference between a closed claim and the funds you need to repair your home.

Read time: 11 min read

Understanding Your Rights in Florida

The Florida Homeowner Claims Bill of Rights

Section 627.7142, Florida Statutes, requires insurers—including American Integrity—to provide every policyholder with a one-page “Homeowner Claims Bill of Rights.” It promises:

• Acknowledgment of your claim within 14 days.

• A coverage decision within 90 days, unless factors outside the insurer’s control apply.

• Fair treatment under Florida’s Unfair Insurance Trade Practices Act.

If American Integrity fails to meet these deadlines, you may recover interest, attorneys’ fees, or statutory penalties.

Bad-Faith Protections

Florida recognizes a private cause of action for first-party bad faith under § 624.155. Before filing suit, you must provide the insurer with a 60-day Civil Remedy Notice through the Department of Financial Services (“DFS”). If American Integrity fails to cure within that window, it can be liable for extra-contractual damages that exceed policy limits. Courts have awarded bad-faith damages for similar conduct, including time-delay tactics, inadequate investigations, and misrepresentation of coverage.

Concurrent Cause Doctrine & Causation

The Florida Supreme Court’s ruling in Sebo v. American Home Assurance Co., 208 So.3d 694 (Fla. 2016), adopted the “concurrent cause doctrine,” holding that when two or more perils contribute to a loss—one covered and one excluded—the loss may still be covered if the covered peril is a concurrent cause. Miami homeowners facing denials based on water-versus-wind disputes should keep Sebo in mind when reading their American Integrity policies.

Common Reasons American Integrity Denies Claims

Wear and Tear / Maintenance Exclusions American Integrity often cites the policy’s “Constant or Repeated Seepage” or “Wear, Tear, Marring” exclusion. For example, if a slow plumbing leak damaged your cabinetry, the adjuster may classify the loss as gradual. However, under § 627.70132, policyholders have up to two years to report a claim after discovering it—meaning late-reported damage is not automatically excluded. Flood versus Wind-Driven Rain Distinctions After tropical storms, adjusters sometimes label interior water damage as “flood,” excluded under the National Flood Insurance Program. Yet, when wind damages the roof or windows first and allows rain to enter, the loss may be covered. Your own forensic engineer can help establish causation. Matching and Cosmetic Denials Florida’s “matching statute,” § 626.9744, requires carriers to make “reasonably comparable” repairs so finishes match in adjoining areas. American Integrity may offer to replace only a few shingles or tiles. That limited scope is often challengeable under the statute. Underpayment Through Over-Depreciation Instead of outright denying, American Integrity sometimes pays replacement cost benefits only after repairs are completed, leaving homeowners without funds. If your policy includes “RCV” coverage, you may contest excessive depreciation holdbacks. Alleged Misrepresentation or Fraud The company may void coverage claiming the insured misrepresented the date of loss or pre-existing damage. Florida law requires insurers to prove “intent to mislead” with clear and convincing evidence, not mere suspicion.

Florida Legal Protections & Regulations

Key Statutes Miami Homeowners Should Know

• § 627.70131 – Insurers must pay or deny within 90 days or face interest.

• § 627.428 – Courts may award attorneys’ fees when policyholders prevail.

• § 95.11(2)(e) – Statute of limitations: five years for a breach-of-contract lawsuit.

• § 626.9541 – Lists unfair claim settlement practices, including “failing to adopt and implement standards for proper investigation.”

Regulatory Oversight

The Florida Department of Financial Services (“DFS”) licenses all adjusters and administers consumer complaints. DFS publishes complaint ratios so you can compare American Integrity to other carriers. The Florida Office of Insurance Regulation (“OIR”) approves rates and enforces market conduct exams. If you suspect bad-faith tactics, file a complaint online with DFS’s Division of Consumer Services or call 1-877-693-5236.

Recent Florida Court Decisions Involving American Integrity

• American Integrity Ins. Co. v. Estrada, 276 So.3d 905 (Fla. 3d DCA 2019) – The Third DCA (which covers Miami-Dade) compelled appraisal and held that payment after appraisal did not moot the policyholder’s right to attorneys’ fees.

• American Integrity Ins. Co. v. Reale, 291 So.3d 616 (Fla. 2d DCA 2020) – Court clarified that insurer’s right to repair must be unequivocally exercised; otherwise, the homeowner may pursue cash benefits.

• American Integrity Ins. Co. v. Garcia, 2020 WL 5645388 (Fla. 4th DCA) – Reversed summary judgment where genuine issues existed as to cause of loss.

Steps to Take After an American Integrity Denial

1. Read the Denial Letter Line-by-Line

Florida law requires insurers to cite specific policy language. Highlight every exclusion referenced. Note any missing explanations—an omission can support a bad-faith theory.

2. Gather and Preserve Evidence

• Photograph all affected areas before, during, and after mitigation.

• Keep receipts for tarps, dehumidifiers, and plumbing repairs.

• Request a copy of the adjuster’s photos and estimate from American Integrity.

3. Order an Independent Inspection

Hire a licensed Florida public adjuster or structural engineer experienced with Miami’s high-velocity hurricane zone (“HVHZ”) building code. Independent reports frequently contradict carrier scopes.

4. Review Your Policy Declarations

Verify coverage limits, deductibles, and endorsements such as:

• Screened Enclosure Exclusion – Often eliminates pool-cage repairs.

• Water Back-Up – Endorsement may broaden coverage.

• Ordinance or Law (“O&L”) – Pays code-upgrade costs that are substantial in Miami-Dade’s HVHZ.

5. Submit a Written Reconsideration Package

Cite statutory deadlines and attach your expert’s findings. Under § 627.70131(5)(a), the insurer must respond within 10 business days to any “communication that reasonably suggests a claim.” Keep correspondence in writing; phone calls are hard to prove.

6. Utilize Florida’s Appraisal Clause (If Available)

Most American Integrity policies include appraisal for dispute resolution. Either side can invoke appraisal in writing. Select a competent, neutral umpire knowledgeable about Miami construction costs. Remember: appraisal decides value, not coverage. If American Integrity denies the entire claim for lack of coverage, you may still need litigation.

7. File a Complaint or Civil Remedy Notice

When delays continue, submit a formal complaint through DFS’s website and consider a Civil Remedy Notice under § 624.155. The notice must describe the facts and cite specific statutes the insurer violated. Many carriers cure by paying the claim; if not, you can sue for bad-faith damages after the 60-day window.

8. Litigate if Necessary

Miami-Dade Circuit Court is the proper venue for property disputes exceeding $30,000. Effective July 2021, § 627.70152 requires pre-suit notice at least 10 business days before filing. Your attorney will draft the notice and comply with the evidence-exchange requirements.

When to Seek Legal Help in Florida

While some straightforward claims can be resolved through direct communication or appraisal, several red flags suggest you need immediate legal representation:

• Your home is uninhabitable, and American Integrity refuses to advance additional living expenses (“ALE”).

• The carrier requests an Examination Under Oath (EUO) while threatening to void the policy.

• You receive conflicting engineer reports, or the insurer switches experts mid-investigation.

• American Integrity alleges fraud or misrepresentation.

• The 90-day decision deadline has passed with no payment.

Florida attorneys who handle first-party property claims work on a contingency fee basis under § 627.428, so you typically pay nothing up front. Make sure the lawyer is licensed in Florida and experienced with Miami building codes and jury pools. An attorney can:

• Issue subpoenas for underwriting and claim file documents.

• Depose American Integrity adjusters and engineers.

• File motions to compel appraisal or enforce settlement.

• Pursue statutory bad-faith damages beyond policy limits.

If American Integrity denied your claim—or if you sense a low-ball offer—call Louis Law Group today at 833-657-4812 for a free case evaluation and policy review.

Local Resources & Next Steps

Key Contacts for Miami Homeowners

Florida Department of Financial Services – Division of Consumer Services Phone: 1-877-693-5236 Website: DFS Consumer Division Florida Office of Insurance Regulation Phone: 850-413-3140 Website: OIR Consumer Portal Miami-Dade Building Department – HVHZ Code Enforcement Phone: 786-315-2000 Website: Miami-Dade Permitting National Weather Service Miami For storm data useful in proving date-of-loss weather events. Website: NWS Miami

Checklist Before You Call an Attorney

• Locate your American Integrity policy and all endorsements.

• Organize photos, videos, and repair receipts.

• Secure any correspondence (emails, text messages) from the adjuster.

• Make a timeline of every phone call and inspection.

• Prepare your questions: coverage limits, deadlines, needed repairs.

Legal Disclaimer: The information in this guide is provided for educational purposes only and does not constitute legal advice. Reading this article does not create an attorney-client relationship between you and Louis Law Group or any of its attorneys. Laws and regulations change, and individual facts matter—consult a qualified Florida attorney for advice regarding your specific situation.

Next Step: Hurricanes, plumbing leaks, and South Florida’s relentless humidity will not wait for the insurance company’s bureaucracy. If American Integrity has delayed, underpaid, or denied your claim, act now. Call Louis Law Group at 833-657-4812 for a free, no-obligation policy review. You pay nothing unless we recover funds for you.

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