Guide to American Integrity Claim Denials in Pembroke Pines, FL

Estimated reading time: 13 min read

Introduction: Why Pembroke Pines Homeowners Need This Guide

Nothing is more frustrating than paying premiums for years only to have your insurer deny a legitimate claim when you need help the most. American Integrity Insurance Company of Florida (often simply called “American Integrity”) is a major player in the state’s homeowners market—including right here in Pembroke Pines. With tropical storms, heavy summer rains, and even the occasional hurricane brushing Broward County, local homeowners file thousands of property claims each year. Unfortunately, claim denials and underpayments are not uncommon.

This comprehensive legal guide—written for Pembroke Pines residents—explains why American Integrity may deny a claim, what your rights are under Florida insurance law, and how to challenge an adverse decision. While we favor protecting homeowners, the information below is factual, supported by state statutes, court precedents, and authoritative resources. If American Integrity has denied, delayed, or underpaid your claim, read on—then call Louis Law Group at 833-657-4812 for a free case evaluation.

Legal Disclaimer: This article is for educational purposes only and does not create an attorney-client relationship. Consult a licensed Florida attorney for advice about your specific situation. Louis Law Group practices statewide and is licensed in Florida.

Understanding Your Rights as a Florida Policyholder

Key Florida Statutes You Should Know

• Florida Statute § 624.155 – Civil Remedy for Insurer Bad Faith: Gives policyholders a cause of action if an insurer fails to settle claims in good faith. A civil remedy notice (CRN) must be filed with the Florida Department of Financial Services before suing.

• Florida Statute § 627.70131 – Prompt Payment of Claims: Requires insurers to acknowledge and respond to communications within 14 days and either pay or deny covered claims within 90 days after receiving notice.

• Florida Statute § 95.11(2)(e) – Statute of Limitations for Contract Actions: You generally have five years from the date of breach (often the denial date) to sue for breach of an insurance contract in Florida.

Your Leverage Points Against American Integrity

• The Duty of Good Faith: American Integrity must handle your claim fairly and honestly. If it doesn’t, you may pursue a bad-faith action after following the CRN procedure.

Regulatory Oversight: The Florida Office of Insurance Regulation (OIR) licenses and disciplines insurers that violate state rules. Complaints to OIR can trigger market-conduct examinations.

• Attorney’s Fees & Costs: Under certain Florida statutes—most notably § 627.428 (for older policies) and § 627.70152 (for policies issued after July 1, 2021)—prevailing policyholders may recover attorney’s fees from insurers. The applicable fee statute depends on your policy’s effective date.

• Appraisal & Mediation Programs: Florida law allows either party to demand appraisal (a binding form of alternative dispute resolution) and provides the DFS-managed Residential Property Mediation Program—often free for homeowners.

Bad Faith: What It Means in Florida

Florida’s bad-faith framework focuses on whether the insurer acted “fairly and honestly toward its insured and with due regard for her or his interests.” Courts look at factors like delay, inadequate investigation, and failure to explain coverage decisions. In Vest v. Travelers Ins. Co., 753 So. 2d 1270 (Fla. 2000), the Florida Supreme Court confirmed that an insurer’s failure to pay benefits due is actionable if the CRN procedure is followed.

Common Reasons American Integrity Denies Claims

1. Alleged Late Notice

American Integrity frequently argues that homeowners failed to give “prompt” notice. Yet Florida courts hold that late notice alone is not fatal unless the insurer proves actual prejudice. In Kroger v. State Farm, 189 So. 3d 1030 (Fla. 5th DCA 2016), notice six months after loss was excused because the insurer could not show prejudice.

2. Wear and Tear vs. Sudden Loss

Policies exclude maintenance and long-term deterioration. Disputes arise when American Integrity labels wind or water damage as “wear and tear.” A licensed public adjuster or engineer can provide evidence to rebut this.

3. Water Damage Exclusions & Caps

Since 2018, Florida insurers have imposed $10,000 sub-limits for non-weather water damage unless the homeowner opts to pay higher premiums. Denials often hinge on whether water originated from a sudden burst pipe (usually covered) or seepage over time (generally excluded).

4. Alleged Material Misrepresentation

If American Integrity believes you exaggerated square footage or misrepresented prior losses, it may rescind the policy. Florida Statute § 627.409 allows voiding policies only if the misstatement is material and intentional. Courts interpret this narrowly to protect consumers.

5. Failure to Mitigate Damages

The policy obligates you to make reasonable, temporary repairs. Still, insurers sometimes over-use this clause to deny legitimate claims. Keep receipts for tarps, fans, and emergency services.

Florida Legal Protections & Regulations

State Regulatory Bodies

Florida Department of Financial Services (DFS) – Division of Consumer Services: Handles consumer complaints and manages mediation. File a complaint or request mediation at myfloridacfo.com.

• Office of Insurance Regulation (OIR): Approves rates and investigates insurer misconduct.

• Broward County Consumer Protection Division: Provides additional local resources and complaint avenues.

Recent Court Precedents Involving American Integrity

• American Integrity v. Reavis, 340 So. 3d 410 (Fla. 5th DCA 2022) – Appraisal award confirmed insurer must timely pay or face interest penalties.

• American Integrity v. Estrada, 276 So. 3d 905 (Fla. 3d DCA 2019) – Court ruled policy’s “concurrent causation” clause ambiguous, favoring coverage for wind-driven rain.

• American Integrity v. Correa, 364 So. 3d 70 (Fla. 3d DCA 2023) – Insurer’s late denial deemed evidence of potential bad faith in subsequent litigation.

Climate & Weather Risks Unique to Pembroke Pines

Pembroke Pines sits roughly 10 miles inland but is still highly susceptible to hurricane-force winds and heavy rainfall. According to the National Hurricane Center, Broward County has experienced 27 tropical cyclones since 2000. Localized flooding along the C-11 canal and South Florida Water Management District zones can cause water intrusion claims—often disputed by insurers.

Practical Steps After an American Integrity Denial

1. Review the Denial Letter Thoroughly

American Integrity’s letter must cite policy provisions and explain why coverage was denied. Match each cited exclusion or limitation against your policy declarations and endorsements.

2. Gather & Preserve Evidence

• Inspection reports, photographs, and videos of all damage.

• Receipts for emergency repairs and additional living expenses (ALE).

• Correspondence logs: dates/times of calls, emails, and adjuster visits.

3. Request a Certified Copy of Your Policy

Florida law requires insurers to provide policy documents upon request. Verify that the language matches what was in force on the date of loss.

4. Consider an Independent Inspection

Hiring a licensed public adjuster or engineer (costs are often contingency-based or flat fee) can strengthen your argument, particularly when causation is disputed.

5. Demand Appraisal or Mediation

• Appraisal: Check if your policy contains an appraisal clause. Either party can invoke it when there’s a dispute about amount of loss, not coverage.

• DFS Residential Property Mediation: Free or low-cost; insurer pays the mediator’s fee. Contact DFS within 60 days of a denial to request.

6. File a Civil Remedy Notice (CRN) if Bad Faith Is Suspected

Use DFS Form DFS-10-363. The insurer has 60 days to cure (usually by paying the claim) once you file the CRN. Failure to cure opens the door to a bad-faith lawsuit.

7. Mind the Deadlines

• Notice of Claim: Many policies require notice “as soon as practicable,” but at least within one year for hurricane losses per § 627.70132.

• Mediation Request: 60 days from denial.

• Suit Limitation: Up to five years under § 95.11, unless the policy shortens the period (courts often strike down periods shorter than one year as unreasonable).

When to Seek Legal Help

Although Florida statutes allow you to dispute claims on your own, insurers have extensive legal resources and seasoned adjusters who know policy language inside out. Consider hiring a lawyer when:

• The denial cites ambiguous exclusions or “concurrent causation.”

• American Integrity delays payment beyond 90 days without valid reason.

• You suspect claim undervaluation—especially for roof, mold, or ALE benefits exceeding $25,000.

• A structural engineer’s report conflicts with American Integrity’s findings.

• You receive a Reservation of Rights letter threatening rescission or fraud allegations.

Why Louis Law Group? Our attorneys have handled thousands of property claims across Florida, recovering millions for homeowners. We work on a contingency-fee basis: no fees unless we win. Call 833-657-4812 today for a free case evaluation and policy review.

Local Resources & Next Steps

Helpful Agencies and Organizations

DFS – Division of Consumer Services: File complaints, request mediation, track CRNs. Broward County Consumer Protection Division: Local assistance with deceptive trade practices. Florida Bar Lawyer Referral Service: Verify attorney licensing and find additional counsel.

Checklist Before You Call an Attorney

• Secure a complete copy of your policy, endorsements, and denial letter.

• Collect all photos, videos, estimates, and receipts.

• Prepare a timeline of all communications with American Integrity.

• List any prior claims and repairs to the property.

• Have names and contact information for contractors or experts you’ve hired.

Final Thoughts

Pembroke Pines homeowners face unique weather-related risks. When you purchase homeowners insurance from American Integrity, you expect prompt, fair claim handling. If that promise is broken, Florida law gives you powerful tools—statutory deadlines, bad-faith remedies, and the right to legal counsel. Use them.

Take Action Now: If American Integrity denied your claim—whether for roof damage, water intrusion, or hurricane loss—call Louis Law Group at 833-657-4812 for a free case evaluation and policy review. Don’t let an insurer’s denial jeopardize your biggest investment: your home.