Guide to Property Insurance Claim Denials in Sunrise, Florida

Introduction: Mold Damage & Property Insurance Claim Denial in Sunrise, Florida

High humidity, torrential summer rain, and the lingering aftermath of hurricanes combine to make mold damage a constant threat for Sunrise homeowners. Unfortunately, insurers frequently deny or underpay mold-related claims, leaving families to shoulder expensive remediation bills. This comprehensive guide examines what to do if you receive a property insurance claim denial Sunrise Florida residents dread, and how Florida statutes protect you. All information is strictly sourced from Florida law, published court opinions, and the Florida Department of Financial Services (DFS). Slightly favoring policyholders while remaining evidence-based, our goal is to equip you to respond quickly and effectively.

Understanding Your Rights in Florida

The Policyholder Bill of Rights

Florida Statutes Chapter 627 contains specific safeguards. Under Fla. Stat. § 627.7142, insurers must:

• Provide a written acknowledgment of your claim within 14 days.

• Begin an investigation within a reasonable time.

• Pay or deny the claim within 90 days (unless factors outside the insurer’s control prevent a decision).

These deadlines apply equally to mold, wind, or water damage claims. If your insurer misses them without good cause, you may later request interest on overdue payments under Fla. Stat. § 627.70131(5)(a).

Statute of Limitations

Time matters. For a breach-of-contract lawsuit against your homeowner’s carrier, Fla. Stat. § 95.11(2)(e) provides a five-year statute of limitations. The clock usually starts on the date of breach—the day your insurer unequivocally denies or underpays the claim. Always confirm dates with a licensed Florida attorney.

Sunrise-Specific Mold Concerns

Broward County’s building code, which adopts the Florida Building Code with local amendments, requires moisture control barriers and proper ventilation. Homes built before the 2002 statewide mold-resistant changes are particularly vulnerable. As a result, insurers frequently argue “wear and tear” or “maintenance” exclusions. Knowing city requirements helps rebut these defenses.

Common Reasons Property Insurance Companies Deny Claims in Florida

Policy Exclusions for Mold & Fungi Many homeowner policies cap mold remediation at $10,000 unless a covered peril—like a sudden pipe burst—caused the mold. Carriers sometimes stretch this exclusion to deny legitimate claims. Late Notice Under Fla. Stat. § 627.70132, a claim must be reported within two years of the date of loss for hurricane-related damage and within one year for supplemental claims. Insurers may assert you waited too long to report mold. Failure to Mitigate Damages Policies require “reasonable measures” to stop ongoing damage. If you delayed removing wet drywall, your insurer might allege you amplified mold growth. Pre-Existing or Gradual Damage Florida courts, such as in Homeowners Choice Prop. & Cas. v. Maspons, 211 So.3d 1067 (Fla. 3d DCA 2017), uphold denials when damage results from long-term leaks. Documentation can refute this. Insufficient Proof of Loss Insurers may claim your mold inspection or remediation estimate lacks detail.

Florida Legal Protections & Regulations

Prompt Pay Statute

As noted, Fla. Stat. § 627.70131 compels insurers to pay undisputed amounts within 90 days. Failure triggers statutory interest.

Appraisal Clause

Most Florida policies include an appraisal provision. If you and the insurer disagree only on the amount of loss—not coverage—you can demand appraisal. The Florida Supreme Court in Johnson v. Nationwide, 828 So.2d 1021 (Fla. 2002), held appraisal cannot decide causation. This protects policyholders from being forced into premature appraisal before coverage is admitted.

Bad-Faith Remedies

After prevailing on a breach-of-contract claim, you may file a civil remedy notice (CRN) with DFS under Fla. Stat. § 624.155 to pursue extra-contractual damages for bad-faith claim handling. The insurer has 60 days to cure.

Florida Administrative Code 69O-166.024

This rule requires insurers to adopt claims handling manuals ensuring compliance with state law. DFS can fine carriers that violate these standards.

Steps to Take After a Denial in Florida

1. Read the Denial Letter Carefully

The insurer must cite specific policy provisions. Note every clause referenced.

2. Collect Evidence

• Date-stamped photos of mold, water stains, and prior repairs.

• Moisture meter readings.

• Invoices from emergency mitigation companies.

• Correspondence with the insurer.

3. Obtain an Independent Mold Assessment

Florida requires licensed mold assessors (Fla. Stat. § 468.84). An unbiased expert report can undermine the insurer’s position.

4. File a Re-opened or Supplemental Claim

If new damage is discovered, you have one year from the date you knew or should have known of the supplemental loss (Fla. Stat. § 627.70132).

5. Engage the Florida DFS Mediation Program

The DFS offers free, non-binding mediation for residential property disputes under Fla. Stat. § 627.7015. Submit form DFS-I0-C1 and the insurer must attend unless it timely rejects mediation for claims under $500. For Sunrise homeowners, sessions often occur virtually or in Broward County facilities.

6. Consider Appraisal

If the disagreement is purely over cost, appraisal can be quicker than litigation. Choose an appraiser with mold-specific experience.

7. Consult a Licensed Florida Attorney

Under Fla. Stat. § 627.428 (policies issued before 2023) or its successor fee-shifting statutes (§ 627.70152 for later policies), a court may order the insurer to pay your reasonable attorney’s fees if you win.

When to Seek Legal Help in Florida

Consider retaining counsel when:

• The insurer alleges fraud or misrepresentation.

• You receive a “reservation of rights” letter.

• Denial hinges on complex exclusions like “continuous seepage” or “microbial growth.”

• Your loss exceeds policy mold sub-limits.

Florida attorneys must be licensed by the Florida Bar and follow Rule 4-1.5 on fees. Many firms, including Louis Law Group, accept property cases on contingency, meaning no fees unless a recovery occurs.

Local Resources & Next Steps

Florida DFS Consumer Services – File complaints or request mediation. Florida Building Code – Verify mold-related construction standards. City of Sunrise Building Division – Obtain permits and inspection records. Florida Bar Lawyer Referral Service – Find a qualified Florida attorney.

Legal Disclaimer: This guide provides general information only and does not constitute legal advice. Laws change, and each claim is unique. Consult a licensed Florida attorney for advice 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.