Bad Faith Attorney Guide: Property Insurance, Hialeah FL

Introduction: Why Hialeah Homeowners Need a Focused Guide

Hialeah, Florida sits in the heart of Miami-Dade County, only a few miles northwest of downtown Miami and less than 15 miles from the Atlantic shoreline. With more than 220,000 residents, it is one of the largest cities in the state. Hialeah homeowners experience the same storm-season anxieties as their coastal neighbors—hurricanes, tropical storms, torrential rain, and sometimes even the odd cold-weather burst that can damage aging roofs. When disaster strikes, property insurance is supposed to provide a financial safety net. Yet many policyholders discover that filing a claim is just the first step in what can become a lengthy dispute. Denials, partial payments, and delay tactics are commonplace, especially when insurers question the cause of loss or the scope of repairs.

This guide is written for Hialeah homeowners and condo owners who have faced—or fear they may soon face—a property insurance claim denial. We will cover your rights under Florida insurance law, how to navigate bad-faith conduct, and when to involve a Florida attorney. Throughout, we emphasize protective steps homeowners can take to level the playing field with insurers. All legal citations come directly from Florida Statutes, Florida Administrative Code, published Florida court decisions, and the Florida Department of Financial Services (DFS).

Understanding Your Property Insurance Rights in Florida

1. The Policy Is a Contract—And Florida Law Governs That Contract

Under Florida common law, an insurance policy is a contract between the insurer and the insured. When an insurer fails to timely pay a covered claim, the homeowner can sue for breach of contract. According to Florida Statute § 95.11(2)(e), the statute of limitations to bring a breach of property insurance contract action is five years from the date the insurer breaches the policy (usually by denying or underpaying the claim).

2. Prompt Communication and Decision Deadlines

Florida Statute § 627.70131(7)(a) requires property insurers to pay or deny a claim—or a portion of the claim—within 90 days after receiving notice, unless factors beyond the insurer’s control prevent a determination. If the insurer fails to meet the deadline, it may owe interest on the payment. Knowing this statutory timeframe helps homeowners spot unreasonable delays.

3. Fair Claims Handling Obligations

• § 626.9541(1)(i) – Unfair claim settlement practices. Examples include “misrepresenting pertinent facts,” “failing to acknowledge and act promptly upon communications,” and “not attempting in good faith to settle claims.”

• § 624.155 – Civil remedy for insurer’s bad faith. Policyholders may file a Civil Remedy Notice (CRN) with DFS if the insurer engages in unfair practices. The insurer then has 60 days to cure the violation.

4. Right to a Copy of Your Adjuster’s Estimate

Under Florida Administrative Code Rule 69O-166.024, an insurer must provide, upon request, a copy of any detailed estimate they used to decide the claim. This transparency lets you compare their scope of repairs with your own contractor’s assessment.

5. Right to Hire Your Own Professionals

Florida allows homeowners to hire licensed public adjusters, contractors, engineers, and attorneys. Insurers cannot prohibit you from obtaining independent opinions about damage and repair pricing.

Common Reasons Property Insurance Companies Deny Claims in Florida

Insurers employ various justifications for denying, delaying, or underpaying claims. Below are the most frequent reasons cited in South Florida, along with homeowner counter-strategies.

1. Alleged Late Notice

Insurers often argue that the homeowner failed to provide “prompt” notice. While most policies require notice “as soon as practicable,” Florida courts, such as American Integrity v. Estrada, have ruled that late notice alone is insufficient for denial unless the insurer proves it was prejudiced. Homeowners should document all attempts to contact the insurer and explain any delays (e.g., evacuation after Hurricane Irma).

2. Wear and Tear / Pre-Existing Damage

Carriers sometimes label roof leaks or plumbing failures as “long-term deterioration.” Photographs, maintenance records, and expert opinions can rebut these allegations. In Hialeah’s aging housing stock—much of which was built before the 1980s—these disputes are common.

3. Excluded Perils

• Water Damage: Sudden pipe bursts are covered, but slow leaks may be excluded.

• Wind vs. Flood: Homeowners insurance covers wind-driven rain; National Flood Insurance Program covers storm surge. Insurers may try to shift causation.

• Earth Movement: Sinkhole activity is separate from ground settlement. Florida Statute § 627.706 mandates sinkhole coverage, but carriers may deny if they classify the event improperly.

4. Failure to Protect Property from Further Damage

Policies require “reasonable emergency measures.” Insurers may deny claims if homeowners don’t tarp a roof or stop water flow. Keep receipts for mitigation expenses and pictures of the temporary repairs.

5. Alleged Fraud or Misrepresentation

Under § 627.409, material misrepresentation can void coverage. Always give accurate statements and avoid inflating repair estimates. However, honest mistakes generally do not amount to fraud.

Florida Legal Protections & Insurance Regulations

1. The Bad Faith Framework

§ 624.155 enables first-party bad faith lawsuits for unfair claim handling. Before filing suit, homeowners must:

Submit a CRN through the Florida Department of Financial Services CRN Portal.

• Identify the specific statutory violations and facts.

• Give the insurer 60 days to cure (pay the claim, correct errors, or otherwise fix the violation).

If the insurer fails to cure, the homeowner may sue and seek extra-contractual damages such as emotional distress or lost rental income.

2. Appraisal and Mediation

Many Florida policies include an appraisal clause—a binding dispute-resolution process to determine the amount of loss. The Florida DFS also offers state-sponsored mediation under Rule 69J-166.031. Participation is voluntary for the policyholder but mandatory for the insurer when the homeowner elects mediation. This option can provide a relatively quick resolution without litigation.

3. Assignment of Benefits (AOB) Restrictions

Recent reforms (Chapter 2019-57, Laws of Florida) limit AOBs to curb alleged abuses. Homeowners signing an AOB with contractors should ensure the contract complies with notice and cancellation requirements. Non-compliant AOBs may jeopardize coverage.

4. Attorney’s Fees and Penalties

Florida encourages insurers to settle meritorious claims by allowing prevailing homeowners to recover attorney’s fees under § 627.428 (for policies issued before 12/16/22) and § 626.9373 for surplus-lines carriers. Even after 2022 reforms, fee-shifting still applies to older losses and certain situations, making litigation financially feasible for consumers.

Steps to Take After a Property Insurance Claim Denial in Florida

Step 1: Review the Denial Letter

Florida law (Rule 69O-166.024) requires insurers to state specific policy provisions they rely on. Match each reason with the exact section in your policy.

Step 2: Gather and Preserve Evidence

• Photos & Videos – Date-stamped images of damage, both wide-angle and close-ups.

• Repair Invoices – Emergency mitigation, tarping, plumbing work, etc.

• Communication Log – Calls, emails, certified mail receipts with the insurer.

• Expert Reports – Licensed contractor or engineer opinions contradicting the insurer’s cause-of-loss analysis.

Step 3: Request the Claim File

You are entitled to many parts of the claim file once litigation is reasonably anticipated. Even before suit, you may request estimates, photographs, and engineer reports used to deny the claim.

Step 4: Consider State-Sponsored Mediation

File a mediation request through DFS online or by calling 1-877-MY-FL-CFO. The insurer must pay the mediator’s fee, and sessions are scheduled locally—often at a Miami-Dade conference center within driving distance of Hialeah.

Step 5: Send a Civil Remedy Notice (If Bad Faith Suspected)

Cite the precise statutes violated (§ 626.9541, § 624.155) and demand payment of a specific amount. The 60-day cure period can encourage insurers to settle.

Step 6: File Suit Within the Five-Year Limitation Period

Do not let the clock run out. Because hurricanes often affect thousands of properties, insurers sometimes send denials months after the event—leaving homeowners confused about their deadline. The safe approach is to mark the breach date (denial letter date) and count five years forward.

When to Seek Legal Help in Florida

While some homeowners resolve disputes through appraisal or mediation, many situations justify hiring a Florida attorney early:

• Complex Causation: Wind vs. flood vs. faulty construction.

• Suspected Bad Faith: Pattern of ignored communications, low-ball offers, or contradictory engineer reports.

• Large-Loss Claims: Fire losses, total roof replacement, extensive interior water damage.

• Prior Litigation Experience: Repeated issues with the same insurer.

Only attorneys admitted to the Florida Bar may provide legal advice or represent you in court. Check an attorney’s license status and disciplinary history on the Bar’s website. Under Florida Bar rules, attorneys may charge contingency fees—usually a percentage of the recovery—making representation affordable without upfront costs.

Local Resources & Next Steps for Hialeah Homeowners

1. Miami-Dade Consumer Protection Division

If you suspect contractor fraud or adjuster misconduct, file a complaint with the County’s consumer bureau. They often coordinate with state officials on insurance-related scams following hurricanes.

2. Hialeah Building Department

Permit records can help prove the age and condition of your roof or plumbing, countering insurer claims of pre-existing damage.

3. Florida Department of Financial Services Consumer Helpline

Call 1-877-693-5236 for claim-related questions, mediation requests, or to verify public adjuster licensing.

4. Document Translation Services

Hialeah’s large Spanish-speaking population may need certified translation of policy documents. Accurate translations prevent misunderstandings that lead to denial.

5. Community Organizations

Local groups such as Centro Campesino or Hialeah Housing Authority sometimes host post-storm clinics with volunteer attorneys and contractors. Attendance can provide free initial assessments.

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

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