Insurance Attorney: Property Insurance - Marathon, Florida

Introduction: Why Property Insurance Matters to Marathon Homeowners

Marathon, Florida sits midway along the Overseas Highway, surrounded by the Atlantic Ocean to the south and the Gulf of Mexico to the north. That postcard-worthy location comes with serious risk: tropical storms, category-strength hurricanes, salt-air corrosion, and occasional fires caused by power surges or lightning. For most Marathon homeowners, a property insurance policy is the only financial shield standing between a catastrophic event and an unaffordable repair bill. Yet every year Monroe County residents report windstorm, water, and fire losses only to receive a lowball offer—or worse, a flat property insurance claim denial.

This guide is written with a bias toward protecting policyholders. Using only verified Florida authorities—Florida Statutes, Florida Administrative Code, and bulletins issued by the Florida Department of Financial Services (DFS)—we explain what rights you have, why insurers often deny claims, and how to push back effectively. Whether you live in Coco Plum, Sombrero Beach, or on one of Marathon’s many live-aboard vessels converted to homesteads, the law discussed here applies statewide, but examples highlight our unique Middle Keys realities.

Understanding Your Property Insurance Rights in Florida

1. The Right to a Copy of Your Policy

Under Florida Administrative Code Rule 69O-166.031, an insurer must provide a complete certified copy of the policy within 30 days of your written request. This is critical after a loss because exclusions and endorsements sometimes hide in supplemental forms.

2. The Right to Prompt Communication

Florida’s Unfair Insurance Trade Practices Act, Fla. Stat. §626.9541(1)(i), prohibits an insurer from failing to acknowledge communications regarding a claim within 14 calendar days. If your adjuster has gone silent, that may constitute an unfair claim settlement practice.

3. The Right to Fair Claims Handling

Fla. Stat. §624.155 allows policyholders to file a Civil Remedy Notice (CRN) when an insurer does not attempt "in good faith" to settle claims. Submitting a CRN opens the door to statutory bad-faith damages if the carrier still refuses to act fairly after 60 days.

4. The Right to Mediation and Appraisal

The DFS operates a free property insurance Mediation Program authorized by Fla. Stat. §627.7015. You may invoke mediation within 90 days after receiving the insurer's notice of rights. Many Marathon residents use mediation to resolve disputed roof and dock repairs without filing suit.

5. The Right to Sue Within the Statute of Limitations

• Five years from the date the insurer breaches the policy for general property insurance lawsuits (Fla. Stat. §95.11(2)(e)).

• Three years from the date of landfall to file or reopen hurricane and windstorm claims (Fla. Stat. §627.70132).

Missing these deadlines almost always ends your claim permanently, so track them carefully.

Common Reasons Property Insurance Companies Deny Claims in Florida

Understanding the carrier’s playbook helps you prepare your response. Below are denial rationales policyholders in Marathon most frequently encounter:

• Wear and Tear Exclusions – Carriers often argue that a leaky roof or rusted seawall failed due to age, not a covered peril. Florida courts, such as Citizens Prop. Ins. Corp. v. Hamilton, 43 So.3d 746 (Fla. 1st DCA 2010), have held that insurers bear the burden of proving an exclusion applies.

• Late Notice – Insurers cite policy language requiring "prompt notice" and claim your delay prejudiced their investigation. However, under Bankers Ins. Co. v. Macias, 475 So.2d 1216 (Fla. 1985), the burden shifts to the insurer to show actual prejudice.

• Water Damage Cap – Post-2016 policies may cap non-weather water damage at $10,000 unless you purchased an endorsement. Always check Section I – Perils Insured Against.

• Flood vs. Wind – With Marathon’s low elevation, carriers frequently label storm surge damage as "flood," a peril excluded under standard homeowner (HO-3) policies. However, if wind created an opening that allowed water to enter, wind coverage may still apply.

• Misrepresentation – An insurer can void a policy for material misstatements (Fla. Stat. §627.409). Simple mistakes—like miscounting shutters—rarely qualify, but intentional misstatements can be fatal.

Florida Legal Protections & Insurance Regulations

Key Statutes Every Marathon Homeowner Should Know

• Fla. Stat. §627.428 – Allows recovery of attorney’s fees when a policyholder prevails in court against an insurer.

• Fla. Stat. §627.70152 – Requires pre-suit notice in residential property insurance cases filed after July 1, 2021.

• Fla. Stat. §627.7142 – Outlines the Homeowner Claims Bill of Rights that must be delivered within 14 days after a claim is reported.

• Fla. Admin. Code 69B-220 – Regulates public adjusters, including fee caps (10% for hurricane events).

Recent Legislative Changes Impacting Keys Residents

In 2022 and 2023, the Florida Legislature enacted sweeping reforms (Senate Bills 2-A and 4-D) aimed at stabilizing the insurance market. While some provisions restrict assignments of benefits and shorten attorney fee multipliers, policyholder protections remain intact. For example, insurers must still acknowledge a claim within 7 days (down from 14) and start an investigation within 7 additional days after that acknowledgment.

Attorney Licensing & Ethical Duties in Florida

Only members in good standing of The Florida Bar may give legal advice on Florida insurance matters. Rule 4-1.1 of the Rules Regulating the Florida Bar imposes a competence duty; Rule 4-1.5 prohibits excessive fees. Contingency fees in property insurance cases must follow the written agreement requirements of Rule 4-1.5(f)(4)(B).

Steps to Take After a Property Insurance Claim Denial in Florida

1. Read the Denial Letter Carefully

The letter should cite the exact policy language relied upon. Highlight those provisions and compare them with your declarations page, endorsements, and Florida’s Homeowner Claims Bill of Rights.

2. Request a Certified Policy Copy

Send a written request under Fla. Admin. Code Rule 69O-166.031. Keep proof of mailing via certified mail or e-mail read receipt in case litigation becomes necessary.

3. Gather Independent Evidence

• Photographs and videos made immediately after the loss.

• Receipts for emergency mitigation—board-ups, tarps, water extraction.

• Professional reports (engineers, mold assessors, marine surveyors for dock damage).

4. Consider Hiring a Licensed Public Adjuster

A public adjuster can re-estimate your damage and negotiate directly with the insurer. In Monroe County, fee caps are generally 10% for hurricane claims and 20% for other perils, per Fla. Stat. §626.854(11).

5. Invoke the DFS Mediation Program

File the “Request for Mediation” form online with the DFS within 90 days of the denial. Many Marathon homeowners reach settlement here without the costs of litigation.

6. Send a Civil Remedy Notice (CRN)

If the carrier still refuses to act in good faith, file a CRN via the DFS portal. The insurer then has 60 days to cure the violation—often by paying the claim plus interest.

7. Preserve Your Litigation Rights

Track both the five-year general statute and the three-year hurricane deadline (see Fla. Stat. §627.70132). Filing a lawsuit requires a pre-suit notice at least 10 business days before suit and must include a detailed estimate and proof of loss (Fla. Stat. §627.70152).

When to Seek Legal Help in Florida

Indicators You Need a Florida Attorney

• The insurer alleges fraud or misrepresentation.

• Your damages exceed $50,000 and complex building code issues arise (e.g., Monroe County’s 180-mph wind-load requirements).

• The denial hinges on nuanced policy interpretation—concurrent causation, anti-concurrency clauses, or proximate cause.

• Bad-faith behavior: unexplained delays, repeated document requests, lowball offers unrelated to market labor rates in the Keys.

Retaining counsel early can preserve evidence, manage deadlines, and often shift attorney’s fees to the insurer when you prevail under Fla. Stat. §627.428.

Choosing the Right Lawyer

Look for a Florida attorney whose practice focuses on first-party property insurance. Verify disciplinary history through The Florida Bar’s public website and confirm experience litigating in the 16th Judicial Circuit (Monroe County).

Local Resources & Next Steps

• Monroe County Building Department – Obtain permits and post-loss inspection records: 2798 Overseas Hwy, Marathon, FL 33050.

• Florida Keys Area Legal Aid – Income-qualified residents can call (305) 292-3540 for free legal assistance.

• DFS Consumer Helpline – Speak to a state insurance specialist at 1-877-693-5236.

• Small Claims Court – For disputes under $8,000, you can represent yourself in Monroe County Court, 3117 Overseas Hwy.

Federal Flood Insurance (NFIP) – Many properties in Marathon fall within FEMA’s AE or VE zones. Separate deadlines apply; see FEMA Flood Insurance.

Action Plan for Marathon Policyholders

• Document everything immediately after a loss.

• Report the claim within policy deadlines.

• Set a calendar reminder 30 days after filing—if no adjustment progress, escalate.

• Use mediation or public adjusting as low-cost first steps.

• If denial persists, consult a licensed Florida attorney without delay.

Legal Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Homeowners should consult a licensed Florida attorney for advice regarding their 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."