American Integrity Denial Guide – Pembroke Pines, Florida

12 min read

Introduction: Why This Guide Matters to Pembroke Pines Homeowners

Few events are more stressful for a Pembroke Pines homeowner than discovering hurricane, wind, or water damage and then receiving a claim denial letter from American Integrity Insurance. Although the carrier markets itself as “Florida-focused,” data published by the Florida Office of Insurance Regulation (OIR) shows a significant number of consumer complaints arising from delayed payments and coverage disputes. Because Pembroke Pines sits in hurricane-prone Broward County and regularly experiences tropical storms, policyholders must understand both the claims process and their legal protections when an insurer refuses to pay. This guide—written by Florida insurance-law professionals—walks you through common denial reasons, state-specific statutes, and practical next steps to help you protect your biggest investment.

American Integrity’s claims phone number: 866-277-9871 (24/7).

Understanding Your Rights in Florida

Key Florida Statutes Every Homeowner Should Know

• Fla. Stat. §627.70131 – Requires insurers to acknowledge and pay or deny residential property claims within specified time frames (14 days to acknowledge, 90 days to decide).

• Fla. Stat. §624.155 – Creates a civil remedy for bad faith, allowing policyholders to sue insurers that fail to settle claims fairly and promptly.

• Fla. Stat. §626.9541 – Lists Unfair Insurance Trade Practices, including misrepresenting policy provisions and denying claims without reasonable investigation.

• Statute of Limitations: Generally five years to file a breach-of-contract lawsuit in Florida (Fla. Stat. §95.11(2)(b)), but shorter deadlines may apply to appraisal or proof-of-loss requirements.

What “Bad Faith” Looks Like

Under §624.155, an insurer acts in bad faith when it unreasonably delays, undervalues, or denies a valid claim after receiving clear evidence of coverage. Examples include ignoring engineering reports that favor the homeowner or offering pennies on the dollar for a roof replacement. If American Integrity acts in bad faith, you may seek extra-contractual damages—including attorneys’ fees and, in rare cases, punitive damages.

Leverage Points for Pembroke Pines Policyholders

• One-Way Attorney’s Fees (§627.428): When you win a lawsuit against an insurer, the court generally requires the insurer to pay your reasonable attorneys’ fees and costs.

• Mandatory Mediation: Florida allows residential property claimants to request free state-run mediation through the Department of Financial Services (DFS). This often pressures insurers to settle.

• Appraisal Clause: Most American Integrity policies include an appraisal process that can resolve disputes over amount of loss (but not coverage). Selecting a neutral appraiser is critical.

Common Reasons American Integrity Denies Claims

1. Excluded Perils

Wind-driven rain or water seepage may be excluded unless a covered opening (such as broken shingles) allowed entry. Disputes arise when American Integrity’s adjuster blames "wear and tear" instead of storm damage.

2. Late Notice

Policies generally require prompt notice. However, Florida courts (e.g., Himmel v. Avatar Prop. & Cas. Ins. Co., 257 So. 3d 488 (Fla. 4th DCA 2018)) place the burden on the insurer to prove prejudice from any delay.

3. Pre-Existing or Cosmetic Damage

Insurers sometimes claim roof shingles were already deteriorated. Independent inspections and weather data can rebut these assertions.

4. Failure to Mitigate

If you did not tarp or dry out the home, American Integrity may deny for additional damages. Keep receipts for any emergency repairs.

5. Alleged Material Misrepresentation

Providing inaccurate information on the application or claim form can trigger rescission. Florida’s materiality standard is strict; minor mistakes do not authorize voiding a policy.

Florida Legal Protections & Regulations

Role of the Florida Office of Insurance Regulation

The OIR licenses and oversees carriers, including American Integrity. You can file a complaint online via the OIR Consumer Services portal. The agency investigates patterns of unfair conduct and can impose fines or license restrictions.

Department of Financial Services Mediation Program

Under Rule 69J-166.031, homeowners can demand state-sponsored mediation before filing suit. The insurer must pay the mediator’s fee. Although non-binding, successful mediation often leads to settlements within 30 days.

Recent Court Precedents Involving American Integrity

• American Integrity Ins. Co. v. Estrada, 276 So. 3d 905 (Fla. 3d DCA 2019) – Court upheld appraisal award despite insurer’s argument that damage was pre-existing, reinforcing the importance of the appraisal process.

• American Integrity Ins. Co. v. Campbell, 43 Fla. L. Weekly D1330 (Fla. 2d DCA 2018) – Addressed scope of neutral evaluation in sinkhole claims; illustrates carrier’s obligation to comply with statutory timelines.

Penalties for Unfair Claim Handling

Violations of §626.9541 can result in administrative fines up to $200,000 per act and mandatory restitution to policyholders. Repeated offenses may trigger market conduct exams and rate-filing restrictions.

Steps to Take After an American Integrity Denial

• Read the Denial Letter Carefully Identify each reason cited. Compare language to your policy’s declarations and endorsements.

Gather and Preserve Evidence

- Photographs/videos of interior and exterior damage

- Weather reports (National Hurricane Center archives)

- Receipts for repairs or temporary housing

• Request the Claim File Florida law allows policyholders to demand the complete claim file, including adjuster notes and third-party reports. Send a written request via certified mail.

• Obtain an Independent Inspection A licensed public adjuster or structural engineer can refute American Integrity’s findings. Ensure your expert is experienced with Florida Building Code wind uplift standards.

• File a Notice of Intent (NOI) to Litigate As of 2023, §627.70152 requires policyholders to serve an NOI at least 10 business days before filing suit. The insurer must respond with a settlement offer or demand for appraisal within 10 days.

• Consider State-Run Mediation Submit a request through the DFS website. Bring your documentation and repair estimates.

• Track Deadlines Rigorously Mark the 90-day decision deadline and the five-year statute of limitations on your calendar.

When to Seek Legal Help in Florida

You may handle small disputes alone, but certain red flags signal the need for experienced legal counsel:

• Coverage denial based on alleged misrepresentation or fraud

• Significant underpayment relative to contractor estimates

• Complex policy endorsements (e.g., Ordinance & Law, mold sublimits)

• Expiration of deadlines or delays nearing 90 days

Louis Law Group’s attorneys are licensed in Florida and focus exclusively on homeowner insurance disputes. Thanks to Florida’s one-way fee statute, hiring counsel often costs nothing up front; the insurer may pay your fees if you prevail.

Bad Faith & Extra-Contractual Damages

If American Integrity’s misconduct goes beyond a reasonable dispute, a §624.155 bad-faith action can recover consequential losses—like lost rental income—and potentially punitive damages. Your attorney must first file a 60-day Civil Remedy Notice (CRN) with the DFS.

Local Resources & Next Steps

Pembroke Pines & Broward County Contacts

• Pembroke Pines Building Department: (954) 435-6502 – Permits and post-storm inspections

• Broward County Emergency Management: (954) 831-3900 – Disaster assistance

Broward County Bar Association Lawyer Referral: Find local counsel

State Agencies

• Florida Department of Financial Services Consumer Helpline: 1-877-693-5236

DFS Mediation Request Portal: Submit online Office of Insurance Regulation Market Conduct Reports: OIR website

Weather & Climate Data

Keep an eye on hurricane advisories and historical storm tracks via the National Hurricane Center. Document wind speeds and rainfall totals relevant to your loss date.

Next Steps Checklist

• Secure the property; mitigate additional damage.

• Request American Integrity's claim file within 14 days.

• Schedule an independent roof and water-intrusion inspection.

• File an NOI if the claim remains unresolved at 90 days.

• Consult Louis Law Group for a policy review and litigation strategy.

Disclaimer: This guide provides general information about Florida insurance law and is not legal advice. Every claim is fact-specific. Consult a licensed attorney for advice regarding your particular situation. Reading or using this content does not create an attorney-client relationship.

Take Action Today

If American Integrity denied or underpaid your homeowner’s claim in Pembroke Pines, you do not have to accept the decision. Call Louis Law Group at 833-657-4812 for a free case evaluation and policy review. Our Florida insurance attorneys are ready to pursue the full benefits you deserve.