Guide to Property Insurance Claims in Miami Springs, FL

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

Miami Springs is no stranger to moisture. Nestled near Biscayne Bay and surrounded by canals, the city’s historic stucco homes and lush landscaping create the perfect environment for hidden mold colonies. When heavy summer rains or a passing hurricane push moisture into walls and attics, mold can take hold quickly. Unfortunately, insurers often treat mold-related claims with skepticism, denying or underpaying even legitimate losses.

This guide focuses on property insurance claim denial in Miami Springs, Florida. It is written for homeowners who have already filed a claim—often for mold resulting from roof leaks, plumbing failures, or hurricane damage—and received a denial letter. We explain your rights under Florida law, common reasons for denial, steps to dispute the decision, and when to involve a licensed Florida attorney. Every statement below is supported by publicly available statutes, regulations, or Florida court opinions.

Understanding Your Rights in Florida

Key Statutes Protecting Policyholders

• Florida Statute § 627.70131(5)(a)—Requires insurers to pay or deny a claim within 90 days after receiving notice, unless factors beyond the company’s control prevent a decision.

• Florida Statute § 627.428—Authorizes an award of reasonable attorney’s fees to policyholders who prevail in court against an insurer that wrongfully denies or underpays a claim.

• Florida Statute § 627.70152—Mandates a pre-suit notice and a 10-day “safe harbor” period before filing a residential property insurance lawsuit, giving insurers one last chance to resolve the dispute.

• Florida Administrative Code 69O-166.024—Lists unfair claims settlement practices, such as failing to adopt reasonable standards for prompt investigation or misrepresenting policy provisions.

Statute of Limitations

Under Florida Statute § 95.11(2)(b), you generally have five years from the date of breach to sue on a property insurance contract. However, windstorm and hurricane claims must be reported within three years of the date of loss under § 627.70132. Missing these deadlines can extinguish your rights, so mark your calendar and act promptly.

Notice Requirements

The 2023 amendments to § 627.70152 require homeowners to send a presuit notice to the insurer at least 10 business days before filing suit. The notice must include an estimate of damages, the disputed amount, and supporting documentation.

Common Reasons Property Insurance Companies Deny Claims in Florida

• Policy Exclusions for Mold – Many standard policies exclude or limit mold coverage unless the mold results from a covered peril, such as a burst pipe or hurricane-caused roof damage.

• Failure to Mitigate – Insurers may argue you allowed mold to spread by not acting promptly. Under most policies, the homeowner must take reasonable steps to prevent further damage.

• Late Notice – Reporting the loss months after discovery can trigger a denial under the policy’s prompt notice requirement and § 627.70132 for hurricane claims.

• Pre-Existing or Gradual Damage – Carriers frequently point to long-term leaks or age-related deterioration to avoid paying for repairs.

• Insufficient Proof of Loss – If the sworn proof of loss form, photos, or contractor estimates are incomplete or contradictory, the insurer may refuse payment.

While some denials are legitimate, Florida courts have repeatedly reprimanded insurers that rely on boilerplate exclusions without adequate investigation. In Johnson v. Omega Insurance Co., 200 So. 3d 1207 (Fla. 2016), the Florida Supreme Court held that an insurer cannot avoid appraisal simply by labeling a claim “coverage dispute.”

Florida Legal Protections & Regulations

Prompt, Fair Claims Handling

Florida’s “Homeowner Claims Bill of Rights,” codified in § 627.7142, outlines the carrier’s duty to acknowledge a claim within 14 days, to begin investigation within 14 days of proof-of-loss submission, and to pay undisputed amounts within 90 days. Violations can trigger administrative penalties by the Florida Office of Insurance Regulation (OIR).

Unfair Claims Settlement Practices

Florida Administrative Code 69O-166.024 prohibits insurers from:

• Misrepresenting policy provisions.

• Failing to promptly investigate claims.

• Requiring burdensome documentation irrelevant to the claim.

Attorney’s Fees and Bad Faith

Under § 627.428, a court must award reasonable attorney’s fees to a policyholder who obtains a judgment against an insurer. For more egregious conduct—such as knowingly undervaluing a mold remediation—§ 624.155 allows a bad-faith lawsuit, but only after a Civil Remedy Notice is filed with the Florida Department of Financial Services (DFS), providing the insurer 60 days to cure.

Steps to Take After a Denial in Florida

1. Review the Denial Letter

Florida insurance regulations require the denial letter to cite specific policy language. Compare those excerpts to your full policy to verify accuracy.

2. Gather Documentation

• Initial notice of loss (date, time, and method sent).

• Sworn Proof of Loss form and supporting estimates.

• Mold inspection reports and lab results.

• Photos/video of water intrusion and mold growth.

• Correspondence with the insurer or independent adjuster.

3. Obtain an Independent Inspection

Florida building codes (Florida Building Code 8th Edition, adopted statewide) impose strict moisture-barrier requirements on roofs and stucco. A licensed mold assessor can trace the source of mold and confirm whether the damage resulted from a covered peril.

4. File a Complaint with the Florida DFS

The Florida Department of Financial Services Division of Consumer Services offers free mediation under § 627.7015 for property insurance disputes. File online or call 1-877-693-5236. The DFS will contact the insurer within three business days, and mediation is typically scheduled within 30 days.

5. Submit a Presuit Notice

As required by § 627.70152, send a detailed presuit notice at least 10 business days before suing. Attach your expert reports and a demand for the disputed amount.

6. Consider Appraisal

If your policy includes an appraisal clause, either party can invoke it to resolve valuation disputes. Appraisal is binding but cannot decide coverage issues. Florida courts generally compel appraisal once a disagreement on price arises.

7. File Suit if Necessary

Should the insurer refuse to negotiate, your attorney can file a complaint in Miami-Dade County Circuit Court. Provide proof of presuit notice and attach the policy. Under § 627.428, you may recover attorney’s fees if successful.

When to Seek Legal Help in Florida

While some disputes resolve through DFS mediation or appraisal, complex mold cases often hinge on technical exclusions and policy endorsements. Seek a Florida attorney if:

• The insurer alleges your mold arose from “maintenance neglect.”

• Your claim involves concurrent perils (e.g., hurricane wind plus long-term leakage).

• A mortgage lender or HOA is pressuring for quick repairs without confirmation of coverage.

Florida Supreme Court rules require attorneys to hold an active Florida Bar license to practice law in-state. Verify licensure at The Florida Bar’s official site.

Local Resources & Next Steps

Miami-Dade County Building Department

Obtain past permits or inspection records that may prove your roof or plumbing was up to code before the mold incident. Phone: 305-375-2901.

City of Miami Springs Floodplain Management

If the mold stems from floodwater, the office can provide FEMA flood zone maps and Elevation Certificates, useful in demonstrating compliance with NFIP requirements.

Florida DFS Mediation

Free, non-binding mediation is available for residential property claims under $500,000. More information: DFS Consumer Services.

Authoritative Links

Florida Department of Financial Services Consumer Assistance Florida Statute § 627.70131 (Claim Handling) Florida Statute § 627.428 (Attorney’s Fees) Florida Supreme Court Opinions

Legal Disclaimer

This article provides general information only and is not legal advice. Laws and regulations change. For advice about your specific situation, consult a licensed Florida attorney.

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