Insurance Lawyers: Property Insurance in Tequesta, Florida

Introduction: Property Insurance Challenges in Tequesta

Nestled at the northern tip of Palm Beach County on the banks of the Loxahatchee River, Tequesta, Florida offers picturesque waterfront living only a few miles from the Atlantic Ocean. Yet the same subtropical climate that attracts new residents each year also exposes local properties to hurricanes, windstorms, torrential rain, and occasional flooding. According to the Florida Office of Insurance Regulation, Palm Beach County homeowners filed tens of thousands of storm-related claims after Hurricanes Irma (2017), Ian (2022) and Nicole (2022). Many Tequesta homeowners, condo owners, and small-business landlords discovered that their insurers delayed, underpaid, or outright denied valid claims.

If you are facing a property insurance claim denial in Tequesta, Florida, understanding your rights under Florida insurance law is critical. This guide, written with a slight bias toward protecting policyholders, walks you through every major step—from analyzing your policy to deciding when to hire a Florida attorney who focuses on insurance disputes. While no single article can replace personalized legal advice, the following sections provide Tequesta-specific context, Florida statutes, and practical tips you can use today.

Understanding Your Property Insurance Rights in Florida

1. Your Contractual Right to Coverage

Your homeowners or commercial property policy is a binding contract governed by Florida law. If you paid premiums and satisfied post-loss duties (like timely notice and reasonable temporary repairs), you have the contractual right to full payment for covered damages—minus deductibles and applicable policy limits. The insurer must interpret exclusions narrowly and resolve ambiguous language in favor of coverage, as repeatedly held by Florida appellate courts such as Fayad v. Clarendon Nat’l Ins. Co., 899 So.2d 1082 (Fla. 2005).

2. Homeowner Claims Bill of Rights

Section 627.7142, Florida Statutes, requires insurers to include a Homeowner Claims Bill of Rights with any residential claim acknowledgment letter. Among other things, it states that you are entitled to:

• Free access to the Florida Department of Financial Services (DFS) for questions or mediation.

• Prompt confirmation (within 14 days) that the insurer received your claim notice.

• A coverage decision or partial payment within 90 days after you submitted complete proof-of-loss documentation.

If the insurer misses these statutory deadlines without reasonable cause, you can cite the violation during negotiations or in court.

3. Statute of Limitations—New and Old Rules

Florida’s window for filing suit has changed:

• Prior to March 24, 2023: You had five years from the date of loss to sue for breach of a property insurance contract under § 95.11(2)(e), Fla. Stat.

• On or after March 24, 2023: House Bill 837 amended the limitations period, creating § 95.11(14). You now have one year to sue after the date of loss or date of denial, whichever is later, for most residential and commercial property policies in Florida. Because many Tequesta properties incurred hurricane damage in 2022 or earlier, your exact deadline depends on both the policy date and the loss date. Missing the limitations period almost always kills your claim, so diary it carefully.

4. Bad-Faith Protections

Under § 624.155, insurers must settle claims in good faith. If an insurer’s delay or underpayment is “not fairly debatable,” you may seek extra-contractual damages, including attorneys’ fees and, in rare cases, punitive damages after first filing a Civil Remedy Notice (CRN) with DFS.

Common Reasons Property Insurance Companies Deny Claims in Florida

1. Late Notice of Loss

Insurers often argue that notice provided months or years after a storm materially prejudices their ability to investigate. Florida courts apply a two-part test: (1) Was the notice untimely under the policy’s “prompt notice” clause? (2) Did the delay actually prejudice the insurer? If you supply photos, invoices for emergency repairs, and engineering reports, you can often defeat the prejudice argument, as seen in Bankers Ins. Co. v. Macias, 475 So.2d 1216 (Fla. 1985).

2. Alleged Pre-Existing or Wear-and-Tear Damage

Carriers routinely attribute cracked roof tiles or window leaks to age-related deterioration. Under Florida law, the insurer bears the burden of proving that an exclusion applies. If wind or water accelerated an existing defect, the ensuing loss may still be covered under the doctrine of concurrent causation unless the policy has anti-concurrent-cause language.

3. Flood vs. Wind Disputes

Standard homeowners policies exclude flood damage, while National Flood Insurance Program (NFIP) policies exclude wind. For Tequesta residents west of U.S.-1 along the Loxahatchee River, storm surge and wind usually coincide. Insurers sometimes deny wind claims by blaming floodwaters. A licensed public adjuster or structural engineer can document wind-borne openings—e.g., torn shingles or broken doors—that allowed water intrusion, preserving your claim.

4. Alleged Failure to Mitigate

Florida policies require “reasonable emergency measures” to protect the property. Carriers may refuse payment for mold, drywall collapse, or interior contents loss if you didn’t dry out the structure promptly. Keep receipts for tarps, water extraction, and temporary lodging to rebut mitigation denials.

5. Policy Exclusions and Endorsements

Hurricane deductibles, cosmetic damage exclusions, and anti-assignment clauses added after 2020 can significantly reduce payouts. Always compare renewal policies, especially if your carrier participated in the 2022 Florida legislative changes aimed at curbing litigation.

Florida Legal Protections & Insurance Regulations

1. Prompt Pay Requirements

Section 627.70131 mandates that insurers must:

• Pay undisputed amounts within 90 days after receiving notice of the claim, and

• Pay or deny supplemental claims within 90 days of reopening.

Interest accrues automatically on overdue payments.

2. DFS Mediation & Neutral Evaluation

The Florida Department of Financial Services offers free or low-cost mediation for most residential property disputes under Rule 69J-166.031, Florida Administrative Code. For sinkhole claims—a rare but possible concern along the limestone substrate beneath Tequesta—DFS also offers neutral evaluation under § 627.7074.

3. Assignment of Benefits (AOB) Reforms

After several Palm Beach County roofing scams, Florida enacted § 627.7153 to limit contractor AOBs. Post-2023 AOBs must: (a) be in writing, (b) include a 10-day cancellation period, and (c) bar the assignee from recovering attorneys’ fees if the assignment violates the statute. Tequesta homeowners who signed broad AOBs after a storm should consult counsel immediately.

4. Attorneys’ Fees Shifts—Why They Still Matter

Although Senate Bill 2-A (2022) repealed one-way attorneys’ fees under § 627.428 for many new policies, fee shifting still applies to pre-2023 losses and to lawsuits filed under a prior policy form. A successful insured may also recover fees in a bad-faith action under § 624.155. This fee leverage can pressure carriers to settle.

Steps to Take After a Property Insurance Claim Denial in Florida

1. Read the Denial Letter Thoroughly

Florida insurers must cite specific policy provisions when denying. Highlight any vague language such as “not a covered peril.” Demand clarification in writing.

2. Collect and Preserve Evidence

• Photograph every damaged area from multiple angles.

• Save roof tarps, broken tiles, or water-stained drywall as physical evidence.

• Create a timeline: date of loss, notice to insurer, adjuster inspection, communications.

3. Order an Independent Expert Inspection

Hiring a licensed Florida engineer or public adjuster can cost $500–$2,000 but often pays off tenfold. Independent experts may detect hidden moisture or structural shifts insurers overlooked.

4. File a Supplemental or Re-Opened Claim

Under § 627.70132(2), you have 18 months after the date of loss to file a supplemental claim for the same event. Provide your new evidence and demand a new decision. The 90-day prompt-pay clock restarts.

5. Use the DFS Mediation Program

Submit Form DFS-I0-0014 online. Mediation conferences are typically scheduled at nearby facilities—often in West Palm Beach—within 30–45 days. Carriers must send a person with full settlement authority.

6. Send a Civil Remedy Notice (If Bad Faith Is Suspected)

Under § 624.155(3)(a), filing a CRN gives the insurer 60 days to cure the violation, often by paying the claim in full. Failure to cure can expose the carrier to extra-contractual damages.

7. File Suit Before the Statute Expires

Retain a Florida attorney admitted to the U.S. District Court for the Southern District of Florida (if diversity jurisdiction) and to the Fifteenth Judicial Circuit in Palm Beach County. Confirm the attorney’s Florida Bar license in good standing.

When to Seek Legal Help in Florida

While some claim denials resolve through self-advocacy, many Tequesta homeowners prefer counsel when:

• The denial cites complex exclusions like earth movement or anti-concurrent-cause clauses.

• The projected repair exceeds $15,000—typical for roof replacements on CBS construction homes prevalent in Tequesta’s Country Club and River Ridge neighborhoods.

• The insurer alleges fraud or material misrepresentation.

• You face the one-year statute-of-limitations deadline.

Florida Supreme Court Rule 4-1.5 permits contingency fees up to 30% before filing suit and 40% after answer is filed (for amounts up to $1 million). Verify the fee agreement complies with Florida Bar ethics opinions.

Local Resources & Next Steps

State and County Agencies

Florida Department of Financial Services Consumer Services – File complaints, request mediation, or call the DFS helpline at 1-877-693-5236. Palm Beach County Division of Emergency Management – Disaster recovery resources after hurricanes. Florida Bar Lawyer Referral Service – Verify attorney licenses and obtain referrals.

Neighborhood-Specific Tips

• Many Tequesta riverfront lots have higher flood exposure; keep separate NFIP policies.

• In older communities like Tequesta Pines, clay sewer lines may back up during heavy rain—consider a water-back-up endorsement.

• Coastal Construction Control Line rules apply east of County Road 707 (Beach Road on Jupiter Island); ensure compliance when rebuilding.

Action Plan Checklist

• Calendar your statute-of-limitations date (one year for losses after 3/24/23).

• Request a certified copy of your policy from the carrier.

• Document damages with photos, videos, and receipts.

• Consult an independent adjuster or engineer.

• Engage a licensed florida attorney if the claim remains unpaid.

Disclaimer: This guide is provided for informational purposes only and does not constitute legal advice. Laws change frequently, and their application varies based on specific facts. Always consult a licensed Florida attorney regarding your unique situation.

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