Insurance Lawyer Property Insurance – Marathon, Florida

Introduction: Why Marathon, Florida Homeowners Need to Know Their Rights

Living in Marathon – the heart of the Middle Florida Keys – means breathtaking ocean views, boating, and year-round sunshine. It also means routinely preparing for hurricane season and the flood, wind, and storm surge risks that come with life on a barrier island. Because property insurance premiums in Monroe County are among the highest in the state, Marathon homeowners expect prompt, fair claim handling when disaster strikes. Unfortunately, many policyholders experience claim delays, lowball estimates, or outright denials. This guide explains what to do after a property insurance claim denial Marathon Florida, the consumer protections built into Florida insurance law, and when a Florida attorney focused on insurance disputes can help you recover what you are owed.

The information below is grounded in Florida Statutes, Florida Administrative Code rules, and published decisions from Florida courts. While the tips favor policyholders, they are accurate and balanced. Remember: every claim is fact-specific. If you need individualized advice, consult a licensed Florida lawyer.

Understanding Your Property Insurance Rights in Florida

1. The Florida Homeowner Claims Bill of Rights (F.S. §627.7142)

After you notify your insurer of a residential property loss, you are entitled to:

• Acknowledgment of your claim within 14 days.

• A copy of the Bill of Rights within that same period.

• A claim decision (payment or denial) within 90 days of your notice, unless circumstances beyond the insurer’s control apply.

• Fair prompt settlement of undisputed amounts.

• Written notice of your right to mediate through the Florida Department of Financial Services (DFS).

2. Statute of Limitations and Notice Deadlines

• Five-year statute of limitations: Under F.S. §95.11(2)(e), you generally have five years from the date of breach (the denial or underpayment) to sue for breach of a property insurance contract.

• Hurricane/flood notice: For Hurricane Ian and later storms, policyholders must provide initial notice of a claim within one year and supplemental/reopened claims within 18 months (F.S. §627.70132).

• Flood claims under the NFIP: The federal Standard Flood Insurance Policy requires signed proof of loss within 60 days, unless extended by FEMA.

3. Policyholder Right to Independent Representation

Florida law allows you to hire a public adjuster (regulated by F.S. §626.854) or an attorney (licensed by The Florida Bar) on a contingency-fee basis, subject to Rule 4-1.5, Rules Regulating The Florida Bar. You cannot be penalized by your carrier for exercising this right.

Common Reasons Property Insurance Companies Deny Claims in Florida

Insurers sometimes have legitimate reasons to deny or minimize a claim. Just as often, denials rely on narrow policy interpretations or incomplete investigations. Here are the most frequent explanations Marathon homeowners see:

Late Notice of Claim Carriers often cite F.S. §627.70132 or the 14-day/30-day “prompt notice” requirement in the policy. Whether notice is truly late depends on when you discovered or reasonably should have discovered the damage. Wear and Tear, Deterioration, or Maintenance Exclusion Most HO-3 policies exclude long-term deterioration. Insurers sometimes misclassify hurricane or wind damage as “age-related.” Flood vs. Wind Causation Disputes Because most private homeowner policies exclude flood, carriers may attribute damage to storm surge. Under the Concurrent Causation Doctrine and Florida’s Valued Policy Law (F.S. §627.702), portions of the loss caused solely by wind remain covered. Pre-Existing Damage Adjusters may allege your roof had pre-existing leaks. A recent inspection report or photos can refute this. Failure to Mitigate Policies require you to make reasonable emergency repairs. Insurers may deny if mold spreads, yet frequently delay approving dry-out invoices. Misrepresentation or Fraud A material misstatement on your application or claim documents can void coverage under F.S. §627.409, but the insurer bears the burden to prove it was intentional or increased their risk.

Florida Legal Protections & Insurance Regulations

1. Bad-Faith Statute (F.S. §624.155)

If a carrier fails to settle when it could and should have done so, policyholders may file a Civil Remedy Notice with DFS, giving the insurer 60 days to cure. If it does not, you may pursue a bad-faith action for the full value of damages plus interest and attorney’s fees.

2. Prompt Pay Statute (F.S. §627.70131)

Insurers must pay undisputed benefits within 90 days of receiving notice of the loss, or they owe interest.

3. Attorney’s Fee Shifting (F.S. §627.428 & §57.105)

When an insurer wrongly denies or underpays, and you secure a judgment (or payment after suit is filed), the court can require the insurer to pay your reasonable attorney’s fees. This is a critical deterrent against insurer stonewalling.

4. Neutral Evaluation & Mediation Programs

DFS administers mediation for property claims under F.A.C. 69J-166.031 and a separate neutral evaluation program for sinkhole disputes (F.S. §627.7074). Participation is voluntary for the policyholder but mandatory for the carrier once requested.

5. Florida Administrative Code 69O-166 & Market Conduct Exams

The Office of Insurance Regulation (OIR) monitors carriers for unfair claim practices. Recent market conduct exams have resulted in hefty fines for companies failing Monroe County policyholders after Hurricane Irma.

Steps to Take After a Property Insurance Claim Denial in Florida

1. Analyze the Denial Letter

The denial must reference specific policy provisions. Compare them to your declarations page and endorsements. Look for vague language such as “not covered per policy.” Florida courts require specificity.

2. Gather and Preserve Evidence

• Photograph and video all damaged areas.

• Save contractor estimates, moisture readings, and meteorological data (e.g., NOAA wind reports for Marathon on date of loss).

• Keep receipts for temporary repairs.

3. Request Your Complete Claim File

Under F.A.C. 69O-125.003, you can demand copies of adjustment reports, engineer findings, and any underwriting notes.

4. Consider a Re-Inspection or Appraisal

Many policies include an Appraisal Clause. Each side picks an appraiser, and they choose an umpire. Although recent statutory reforms limit attorney fee awards in some appraisal situations, the process can resolve scope and pricing disputes without litigation.

5. File a Complaint or Mediation Request with DFS

Use the DFS Consumer Services portal or call 1-877-MY-FL-CFO. DFS will open an inquiry that often prompts quicker carrier responses.

6. Consult a Qualified Insurance Lawyer

Early legal intervention can preserve evidence, stop improper examinations under oath (EUOs), and ensure compliance with pre-suit notice requirements imposed by F.S. §627.70152 (for claims filed after July 1, 2021).

When to Seek Legal Help in Florida

You should strongly consider hiring a lawyer when:

• The insurer alleges fraud or misrepresentation.

• Your damages exceed $50,000.

• You receive a Reservation of Rights letter.

• The carrier invokes appraisal but refuses to pay the award.

• The 90-day decision deadline passes with no payment.

• You face overlapping flood and wind damage disputes (common in Marathon’s AE and VE flood zones).

A licensed Florida attorney can:

• Issue subpoenas and depose carrier engineers.

• File a Civil Remedy Notice and bad-faith lawsuit.

• Negotiate settlements that include attorney’s fees and interest.

Because Florida’s one-way fee statute (F.S. §627.428) often shifts legal fees to the insurer, representation may cost you nothing out-of-pocket if your lawyer prevails.

Local Resources & Next Steps for Marathon Homeowners

1. Government & Non-Profit Contacts

• City of Marathon Building Department: 305-743-0033 – For permits and post-storm inspections.

• Monroe County Property Appraiser: 305-292-3420 – Obtain historical property records to counter pre-existing damage arguments.

• 16th Judicial Circuit Court (Marathon Branch): 3117 Overseas Hwy – Venue for lawsuits under $30,000 (county court) and higher-value circuit cases.

• Florida DFS Division of Consumer Services: 1-877-693-5236 – Mediation and complaints.

• United Way of Collier & the Keys: Disaster assistance grants for temporary housing or repairs.

2. Strategic Checklist

• Read the policy – especially exclusions, duties after loss, and suit limitation clauses.

• Document all communications in writing.

• Schedule a licensed contractor or engineer (not tied to your insurer) for an independent damage report.

• Track all deadlines: proof of loss (60 days for NFIP), pre-suit notice (60 days under F.S. §627.70152), and five-year statute of limitations.

• Consult legal counsel before giving an Examination Under Oath.

3. Authoritative References

Florida Department of Financial Services Consumer Resources Florida Homeowner Claims Bill of Rights – F.S. §627.7142 Florida Statute of Limitations – F.S. §95.11 Key Florida Appellate Decision on Bad Faith

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. Laws change frequently, and the application of law can vary based on specific facts. Marathon homeowners should consult a licensed Florida attorney before acting on any information herein.

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