Fraud Insurance Lawyer & Property Insurance – Riviera Beach, Florida

Introduction

Situated on the Atlantic coast in northern Palm Beach County, Riviera Beach, Florida is no stranger to hurricanes, wind-driven rain, and the occasional burst pipe that can soak drywall in minutes. For the nearly 38,000 residents who call this maritime community home, a valid homeowners or commercial property insurance policy is supposed to be a financial backstop when disaster strikes. Unfortunately, many Riviera Beach homeowners discover that getting an insurance carrier to issue fair payment is far more complicated than paying premiums on time. Delays, underpayments, or outright denials frequently follow legitimate claims. When that happens, policyholders often turn to a fraud insurance lawyer to enforce their rights under both the contract and Florida law.

This guide was created specifically for Riviera Beach homeowners and small-business property owners. It explains the legal framework that governs property insurance claims in Florida, outlines common denial tactics, and walks you through practical steps if your claim is being delayed or has been denied. Throughout, we place a slight but intentional emphasis on protecting the interests of policyholders—because the balance of power is already stacked in favor of multibillion-dollar insurance companies.

Understanding Your Property Insurance Rights in Florida

1. The policy is a contract—Florida contract law applies

Every property insurance policy sold in Florida is a contract. Under Chapter 627, Florida Statutes, insurers must clearly spell out coverages, exclusions, and duties after loss. If the carrier fails to comply, you can pursue a breach-of-contract action in civil court.### 2. The “Homeowner Claims Bill of Rights”

Section 627.7142, Florida Statutes, requires insurers to give residential policyholders a one-page “bill of rights.” Key take-aways:

• Free access to the Florida Department of Financial Services’ (DFS) consumer helpline.
• Written acknowledgment of your claim within 14 days.
• A coverage decision (pay, deny, or partially pay) within 60 days of receiving a sworn proof-of-loss, unless factors outside the insurer’s control apply.

3. Statute of limitations for lawsuits and notice of claim

Notice of claim: For losses on or after 1 January 2023, you have 1 year to give the insurer notice (§ 627.70132, Fla. Stat.). For older losses it is 2 years (or 3 years for named storms with dates of loss before 2021).Lawsuit: You generally have 5 years from the date of breach to file suit under § 95.11(2)(e), Fla. Stat.. The breach occurs when the carrier denies or underpays the claim.

4. Right to attorney’s fees

When policyholders prevail after filing a lawsuit, Florida Statutes once gave them the right to recover reasonable attorney’s fees (formerly § 627.428). For new policies issued or renewed after 1 January 2023, the Legislature amended the law. Now, fees are available only in limited circumstances under § 86.121 or where bad-faith is proven under § 624.155. A qualified Florida attorney can explain whether fee shifting still applies to your loss date and policy form.

Common Reasons Property Insurance Companies Deny Claims in Florida

1. Late notice

Carriers frequently deny claims by arguing the insured failed to give “prompt” notice. However, Florida courts hold that an insurer must show actual prejudice from the delay. If you promptly documented damage in Riviera Beach but didn’t realize your roof leak was covered until months later, an attorney can challenge a late-notice denial.

2. Wear and tear vs. sudden loss

Insurers often label roof damage as “age-related deterioration.” Under most policies, however, a sudden wind uplift or hail strike is covered—even on an older roof—unless the policy contains a valid cosmetic exclusion.

3. Allegations of fraud or misrepresentation

When the dollar amount is high, carriers may accuse policyholders of inflating estimates. In Florida, the insurer bears the burden of proving intentional misrepresentation by “clear and convincing” evidence. A seasoned fraud insurance lawyer can push back against these tactics.

4. Unlicensed contractor work

Policies sometimes exclude losses caused by unlicensed work. If your Riviera Beach handyman lacked a license, the carrier might disclaim coverage. Yet the exclusion applies only if the unlicensed work actually caused the damage—not simply because the contractor was unlicensed.

5. Water damage sub-limits and mold exclusions

Many policies cap non-hurricane water loss at $10,000 unless you purchased an endorsement. Insurers also invoke mold exclusions liberally. Florida law requires these limitations to be conspicuous; hidden sub-limits may be unenforceable.

Florida Legal Protections & Insurance Regulations

1. The Florida Department of Financial Services (DFS)

DFS licenses adjusters, handles consumer complaints, and administers the state-run mediation program. Riviera Beach residents can request free mediation once the insurer issues a coverage decision worth at least $500 (DFS Property Insurance Mediation).### 2. Civil Remedy Notices (CRNs)

Under § 624.155, you must file a CRN giving the insurer 60 days to cure bad-faith conduct before filing a bad-faith lawsuit. A CRN must state the specific statutory provisions violated and the facts giving rise to the violation.

3. Claims handling time frames

• Insurer acknowledges claim – 14 days (§ 627.70131(1)(a)).
• Carrier begins investigation – “Reasonable” time, usually within 10 business days.
• Insurer pays undisputed amounts – within 60 days after proof-of-loss, or interest accrues (§ 627.70131(5)(a)).

4. Appraisal and arbitration clauses

Many policies contain appraisal provisions allowing either party to demand appraisal to resolve valuation disputes. Under recent case law (State Farm v. Parrish, 312 So.3d 145, Fla. 2021), the courts favor enforcing appraisal unless coverage is wholly disputed.

5. Attorney licensing in Florida

Only members in good standing of The Florida Bar may give legal advice on property insurance disputes. Out-of-state lawyers must seek pro hac vice admission and associate with local counsel.## Steps to Take After a Property Insurance Claim Denial in Florida

Step 1: Review the denial letter carefully

The insurer must cite specific policy language. Compare those citations with the full policy—not just the declarations page.

Step 2: Obtain a certified copy of your policy

You are entitled to one free copy under § 627.4137. Request it in writing.

Step 3: Gather evidence

• Photographs and video of damage
• Weather reports for Riviera Beach (e.g., NOAA storm data)
• Invoices and receipts for repairs
• Correspondence with the carrier

Step 4: Request DFS mediation

File the online form and pay the nominal fee (currently waived for many residential claims). Mediation is non-binding but forces the insurer’s adjuster and a supervisor to appear.

Step 5: Consider invoking appraisal

If your dispute is only about the amount of loss, appraisal can be faster than litigation. Choose a neutral, experienced appraiser.

Step 6: Send a pre-suit notice

For policies issued after 2021, § 627.70152 requires a pre-suit notice at least 10 days before filing suit. The insurer then has 10 days to respond with a settlement offer.

Step 7: Consult a fraud insurance lawyer

An attorney can evaluate whether the denial violates Florida insurance law, prepare a Civil Remedy Notice, and file suit if necessary.

When to Seek Legal Help in Florida

You should seriously consider hiring counsel when:

• The carrier alleges fraud or misrepresentation.
• You face a lowball offer that cannot possibly repair the property to pre-loss condition.
• The insurer refuses to pay undisputed amounts within 60 days.
• The denial rests on complex exclusions such as “anti-concurrent causation.”
• You are nearing the one-year notice deadline or five-year litigation deadline.

A fraud insurance lawyer serving Riviera Beach can depose claims representatives, hire forensic meteorologists, and leverage Florida’s remaining fee-shifting statutes to level the playing field.

Local Resources & Next Steps

• Florida DFS Consumer Helpline: 1-877-693-5236 – file complaints and schedule mediation.
• Palm Beach County Clerk of Court – Delray Beach branch serves Riviera Beach: file breach-of-contract lawsuits and record notices of lis pendens.
• City of Riviera Beach Building Division: obtain permits and inspection reports that may corroborate your loss.
• American Red Cross South Florida Region: temporary housing and cleanup supplies after major storms.

Stay organized. Keep a claim diary noting every phone call, inspection, and promise made by the adjuster. If the process drags on, these contemporaneous notes strengthen your credibility.

Legal Disclaimer

This guide provides general information for Riviera Beach, Florida property owners. It is not legal advice and does not create an attorney-client relationship. Always consult a licensed Florida attorney about your specific circumstances.

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