Lawyers for Insurance: Property Insurance Guide – St. Augustine, Florida

Introduction: Coastal Risks in the Nation’s Oldest City

St. Augustine, Florida is known for its centuries-old Spanish architecture, vibrant tourism, and, unfortunately, its exposure to Atlantic hurricanes and nor’easters. From Vilano Beach to the historic downtown district, homeowners confront wind-driven rain, flooding, and storm surge every season. After a damaging event, many residents quickly discover that securing fair payment from their insurer can be just as stressful as boarding up windows before a storm. If you have experienced a property insurance claim denial St. Augustine Florida, understanding the rules that govern insurance companies—and the rights that protect you—can make the difference between rebuilding and financial ruin.

This comprehensive guide focuses on Florida-specific statutes, Department of Financial Services (DFS) regulations, and local considerations for St. Augustine homeowners. It is written with a pro-policyholder perspective, emphasizing the remedies available when insurers delay or deny payment. Throughout, we cite only authoritative sources—including the Florida Statutes, the Florida Administrative Code, and published opinions from Florida courts—so you can be confident the guidance is accurate and up to date.

Why St. Augustine? Besides its coastal location, St. Johns County’s rapid growth and historic building stock create unique insurance challenges: older roofs, moisture-prone masonry, and code-upgrade costs after storms. These issues regularly appear in claim disputes litigated in the Seventh Judicial Circuit, which covers St. Augustine. Because many carriers have narrowed coverage or increased deductibles in the past decade, it is more important than ever for property owners to know their rights.

Understanding Your Property Insurance Rights in Florida

1. The Right to a Copy of Your Policy

Under Florida Administrative Code Rule 69O-166.024, insurers must provide policyholders with a complete copy of their policy and declarations page upon request. Keep an updated digital copy off-site or in cloud storage before hurricane season begins.

2. The Right to Prompt Acknowledgment and Investigation

Florida Statute §626.9541(1)(i) makes it an unfair claims practice for insurers to fail to acknowledge and act promptly upon communications regarding claims. DFS interprets “prompt” as within 14 calendar days of receiving notice.

3. The Right to Accept or Deny in 90 Days

Per §627.70131(7)(a), insurers must pay or deny a claim (in whole or in part) within 90 days of receiving notice. If the carrier misses the deadline without good cause, interest accrues automatically.

4. The Right to Mediation and Appraisal

Florida offers a free, state-sponsored mediation program for residential property disputes under §627.7015. Even if mediation fails, it can push the insurer to negotiate. Many policies also include an appraisal provision allowing each side to hire an appraiser to value the loss.

5. The Right to Hire a Public Adjuster or Attorney

Florida law permits policyholders to engage licensed public adjusters (§626.854) and Florida attorneys to handle claims. Insurers may not prohibit you from seeking professional help.

6. Statute of Limitations

• Notice of claim: Two years from date of loss (§627.70132). • Supplemental claims: Three years from date of loss. • Contract lawsuit: Five years from date of breach (usually the denial date) under §95.11(2)(e). Missing these deadlines can permanently bar recovery, so act quickly after receiving a denial.

Common Reasons Property Insurance Companies Deny Claims in Florida

1. Late Notice

Carriers frequently assert that you failed to report the loss “promptly,” violating policy conditions. However, Florida appellate courts (see Hunt v. State Farm, 145 So. 3d 210, Fla. 2d DCA 2014) require the insurer to prove it was actually prejudiced by the delay. Do not accept a late-notice denial without challenging the prejudice element.

2. Wear and Tear vs. Sudden Event

Policies cover sudden, accidental damage—not gradual deterioration. Roof claims are often denied as “long-term wear.” A qualified engineer or public adjuster can help show that wind uplift during Hurricane Ian, for example, caused the immediate loss.

3. Pre-Existing Damage

Insurers may allege the damage existed before the policy period or a prior storm. Reviewing past inspection reports or real estate disclosures can rebut this.

4. Policy Exclusions and Endorsements

• Water damage 14-day rule: Many Florida policies exclude water damage if it occurs over more than 14 days. • Flood exclusion: Standard homeowner policies do not cover storm surge; National Flood Insurance Program (NFIP) provides separate coverage. • Concurrent cause: Some insurers argue if excluded and covered perils both contributed, the entire loss is excluded. Florida’s efficient proximate cause doctrine (see Sebastian v. State Farm, 46 So. 3d 940) often favors coverage when the initiating cause is covered.

5. Alleged Material Misrepresentation

If you inadvertently state an incorrect repair date or square footage, a carrier could rescind coverage. Florida Statute §627.409 allows rescission only if the misstatement was intentional or material to the risk. This is a high bar for insurers.

Florida Legal Protections & Insurance Regulations

Bad-Faith Remedies

When an insurer violates §624.155 by not attempting to settle a claim in good faith, you may file a Civil Remedy Notice (CRN) with DFS. The insurer then has 60 days to cure the violation. If it fails, you can sue for extra-contractual damages, including attorney’s fees and, in some cases, punitive damages.

Attorney’s Fees for Policyholders

Florida historically awarded reasonable attorney’s fees to insureds who prevail (see §627.428). Recent reforms, including 2022’s SB 2-A, moved these fee provisions to §627.70152 for residential claims that enter litigation. While the new statute imposes presuit notice requirements, policyholders who comply can still recover fees if they obtain a judgment at least 50% of their presuit demand.

Assignment of Benefits (AOB)

Florida curtailed abusive AOBs in 2019 (HB 7065). Today, contractors must include cancellation rights, and the assignee may owe attorney’s fees if it loses. Homeowners retain the option to file suit directly instead of assigning rights.

Department of Financial Services Oversight

DFS’s Division of Consumer Services can open investigations and fine insurers up to $20,000 per violation under §626.9521. Filing a complaint often pressures carriers to re-evaluate a denial.

Building Code Upgrade Coverage

Section 627.7011(1) requires insurers to offer Ordinance & Law coverage of 25% or 50% of Dwelling A limits. In cities with historic preservation ordinances like St. Augustine, code upgrade costs can be substantial. Ensure you opted in.

Steps to Take After a Property Insurance Claim Denial in Florida

1. Request a Written Denial Letter

Florida Statute §626.9541(1)(i) obligates insurers to explain claim denials in writing. This letter becomes critical evidence if you litigate.

2. Collect and Preserve Evidence

• Photograph all damage from multiple angles.

• Retain repair receipts, hotel invoices, and mitigation costs.

• Keep damaged materials (e.g., roof shingles) when feasible.

3. Obtain an Independent Damage Estimate

Hire a licensed public adjuster or contractor familiar with St. Augustine building codes (e.g., the city’s Floodplain Management Plan). Independent estimates often reveal undervalued scopes in the insurer’s report.

4. File a Florida DFS Mediation Request

You can request mediation within 60 days of a denial or disputed payment. DFS will schedule a session—often via Zoom—for you and the insurer’s representative. Many disputes settle at or before mediation.

5. Send a Statutory Presuit Notice (If You Plan to Sue)

Under §627.70152, you must send notice at least 10 business days before filing suit. Include an itemized estimate, attorney’s fee statement, and the amount you demand.

6. Consider Filing a Civil Remedy Notice

If the insurer’s conduct appears in bad faith, file a CRN on the DFS website. The 60-day cure period gives the insurer one last chance to pay before facing bad-faith damages.

7. File Suit Within the Limitations Period

Coordinate with your Florida attorney to meet all deadlines. For many residential claims, the lawsuit must be filed within five years of the breach but earlier notice deadlines apply.

When to Seek Legal Help in Florida

Indicators You Need an Attorney

• The denial cites “fraud” or “misrepresentation,” threatening rescission.

• Your home is uninhabitable and temporary living expenses (ALE) are exhausted.

• The difference between your estimate and the insurer’s is more than $25,000.

• Mediation failed or the carrier refused to participate.

Choosing a Qualified Lawyer

• Verify the attorney is in good standing with The Florida Bar (Florida Bar Lawyer Directory). • Confirm experience in first-party property litigation in St. Johns County. • Ask whether the firm advances costs and only collects fees if they win (contingency fee).

Attorney Advertising and Fee Caps

Florida’s Rules Regulating The Florida Bar require contingency contracts to be in writing and signed by client and lawyer (Rule 4-1.5). The typical fee for property insurance cases ranges from 10% to 33⅓% depending on stage of litigation.

Local Resources & Next Steps

Government and Non-Profit Assistance

Florida Department of Financial Services – Consumer Services St. Johns County Emergency Management FEMA Individual Assistance Program

Preservation Societies and Historic District Grants

The City of St. Augustine’s Historic Preservation Division offers limited grants for qualifying repairs. These funds can supplement—but not replace—insurance proceeds.

Checklist for St. Augustine Homeowners

• Print and store this guide with your policy.

• Photograph your home (interior and exterior) each May before hurricane season.

• Save contacts for local public adjusters and roofing contractors familiar with clay tile and coquina walls prevalent in the city.

• Add DFS mediation and CRN deadlines to your calendar after any loss.

• Consult a lawyer at the first hint of lowballing or denial.

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. Laws change, and every claim is fact-specific. Consult a licensed Florida attorney before making decisions about your insurance claim.

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