Property Insurance Mold Claim Guide – DeFuniak Springs, FL

Introduction: Why Mold Claim Denials Matter in DeFuniak Springs

With its humid Gulf air, frequent summer thunderstorms, and proximity to the Choctawhatchee Bay watershed, DeFuniak Springs sits in a region of Florida where excess moisture and rapid mold growth are common after a leak, roof failure, or hurricane-driven rain. Because mold spreads quickly and causes hidden structural damage, DeFuniak Springs homeowners often file property insurance claims seeking coverage for remediation, repairs, and related living expenses. Unfortunately, insurers routinely deny or underpay mold claims, leaving policyholders to face costly remediation on their own.

This guide—grounded strictly in verified Florida statutes, regulations, and court opinions—explains how a DeFuniak Springs homeowner can respond when a property insurance carrier denies a mold damage claim. While the information slightly favors the policyholder, it remains evidence-based and professional, giving you the tools to protect your rights under Florida law.

Understanding Your Rights in Florida

The Insurance Policy Is a Contract

Your homeowner’s insurance policy is a written contract. Under Fla. Stat. § 95.11(2)(b), a policyholder generally has five years from the date of breach (i.e., the denial or underpayment) to bring a lawsuit for breach of that written contract. Knowing this limitation period is critical when deciding whether to litigate.

Prompt Handling & Payment Requirements

Florida’s “prompt payment” statute—Fla. Stat. § 627.70131(5)(a)—requires insurers to pay or deny a covered claim within 90 days after receiving notice, unless factors beyond their control prevent that. Failure to comply may expose the carrier to interest penalties on any later payment.

Protection Against Unfair Claim Practices

Fla. Stat. § 626.9541(1)(i) prohibits insurers from “not attempting in good faith to settle claims”, misrepresenting policy provisions, or compelling litigation by offering substantially less than amounts ultimately recovered. Evidence of such conduct can support a civil remedy notice (CRN) and potential bad-faith action.

Mediation Option

For most residential property claims—including mold—policyholders may request free or low-cost mediation through the Florida Department of Financial Services (DFS) under Fla. Stat. § 627.7015. The insurer must pay the mediation fee if it elects to participate.

Common Reasons Property Insurance Companies Deny Mold Claims in Florida

When reviewing mold damage claims across Walton County, insurers frequently assert one or more of these grounds for denial:

• Policy Exclusions for Long-Term Moisture: Many policies exclude losses from “repeated seepage or leakage” lasting 14 days or more. The carrier may argue the mold existed long before it was reported.

• Limited Mold Endorsements: Even when coverage exists, insurers often cap mold remediation at $10,000 or less via a special endorsement.

• Failure to Mitigate Damages: Under standard policy language and Fla. Stat. § 627.701(4)(a), homeowners must take reasonable steps—like drying out wet areas—to prevent further loss. Insurers may allege you waited too long.

• Late Notice: If you do not promptly report the claim, the insurer may claim prejudice under Fla. Stat. § 627.70132 (which imposes certain notice deadlines for specific perils).

• Pre-Existing Conditions: Adjusters might label the mold contamination as normal wear, construction defect, or maintenance issue, which policies typically exclude.

Being prepared to rebut these arguments with inspection reports, photographs, and expert opinions—especially from locally licensed mold assessors—can make the difference between payment and denial.

Florida Legal Protections & Regulations

Key Statutes and Administrative Rules

• Fla. Stat. § 627.70131 – Sets strict time limits for insurer acknowledgment, investigation, and payment.

• Fla. Stat. § 626.9541 – Outlines unfair claim settlement practices and authorizes civil remedy notices.

• Fla. Admin. Code R. 69B-220.201 – Establishes ethical standards for independent adjusters operating in Florida.

• Fla. Stat. § 627.7015 – Creates DFS mediation program for residential property disputes.

Impact of Recent Florida Court Decisions

Florida appellate courts have reinforced policyholder rights when insurers deny mold claims without sufficient investigation. For example, in Citizens Prop. Ins. Corp. v. Manny Gonzalez & Sons, Inc., 310 So. 3d 1052 (Fla. 3d DCA 2021), the court held the insurer could not rely solely on an exclusion without establishing the loss fell squarely within that exclusion. While every case is fact-specific, the decision underscores that carriers bear the burden of proving exclusions.

Attorney’s Fees and Interest

Under Fla. Stat. § 627.428, when a policyholder prevails in a coverage lawsuit, the court must award reasonable attorney’s fees. Additionally, Fla. Stat. § 627.70131(5)(a) imposes interest if the insurer fails to timely pay undisputed amounts.

Licensing Rules for Florida Attorneys

Only attorneys admitted to The Florida Bar may provide legal advice or represent you in court. Be cautious of unlicensed public adjusters or contractors offering “legal” opinions—they can face penalties under Fla. Stat. § 454.23 for the unlicensed practice of law.

Steps to Take After a Denial in Florida

1. Review the Denial Letter Thoroughly

Florida law requires insurers to state specific policy provisions supporting denial. Compare those citations to your policy’s declarations, endorsements, and exclusions. Look for ambiguous language; under Florida jurisprudence, ambiguous provisions are construed in favor of coverage.

2. Gather Evidence

Immediately collect:

• Moisture readings from a certified Florida mold assessor

• Photos/video documenting damage progression

• Repair estimates from licensed DeFuniak Springs contractors experienced with mold remediation and the Florida Building Code

• Any correspondence with the insurance adjuster

3. File a Supplemental or Reopened Claim

Under Fla. Stat. § 627.70132(2), you must generally file a supplemental property claim within three years of the date of loss. Provide new documentation and cite additional damages or costs you discover.

4. Submit a Civil Remedy Notice (CRN) if Bad Faith Is Suspected

Per Fla. Stat. § 624.155, filing a CRN with DFS puts the insurer on 60-day notice to cure unfair conduct. Failing to cure can create grounds for a separate bad-faith damages action after a favorable verdict on coverage.

5. Request DFS Mediation

The Florida Department of Financial Services offers a no-cost or low-cost mediation program. To participate:

• Complete the online request on the DFS website.

• Provide your claim number, policy number, and a brief dispute summary.

• The insurer has 21 days to respond. Once scheduled, mediation is held via videoconference or at a regional DFS office.

Mediation success rates hover around 50% statewide; even if settlement fails, you gain insight into the insurer’s position.

6. Consider Appraisal

Many Florida policies include an appraisal clause. Each side hires an appraiser; the two select a neutral umpire. Appraisal decides amount of loss, not liability. Check whether your policy’s appraisal language is mandatory or permissive, and review deadlines.

When to Seek Legal Help in Florida

Red Flags That Warrant a Florida Attorney

• Denial citing wear-and-tear or “long-term” water damage you believe was sudden.

• Carrier invokes an anti-concurrent causation (ACC) clause to exclude mold stemming from a covered peril.

• Evidence that the insurer’s retained engineers or hygienists used outdated sampling methods, conflicting with ANSI/IICRC S520 mold standards.

• Multiple “reinspections” without a coverage decision beyond the 90-day statutory deadline.

Benefits of Hiring Counsel

A licensed Florida property insurance attorney can:

• Issue subpoenas for carrier documents and adjuster field notes.

• Depose the adjuster and carrier experts under Florida Rules of Civil Procedure.

• Pursue statutory attorney’s fees under Fla. Stat. § 627.428.

Because attorney’s fees shift to the insurer upon a favorable judgment, many lawyers accept valid mold denial cases on contingency—no fee unless you recover.

Local Resources & Next Steps for DeFuniak Springs Homeowners

Walton County Building Department

Before beginning mold remediation, obtain any required permits through the Walton County Building Department to ensure work complies with the Florida Building Code’s ventilation and moisture-control standards.

Certified Mold Assessors & Remediators

Always hire professionals licensed under Fla. Stat. § 468.8419. A local directory is available from the Florida Department of Business and Professional Regulation.

Disaster Assistance

After a federally declared disaster—such as Hurricane Michael (2018)—residents may qualify for FEMA Individual Assistance. Document denied insurance claims; FEMA can sometimes bridge coverage gaps related to mold remediation.

Useful Government Links

Florida Department of Financial Services Consumer Services Florida Statutes, Chapter 627 Florida Office of Insurance Regulation Florida Administrative Code

Legal Disclaimer

This article provides general information for DeFuniak Springs policyholders and is not legal advice. Laws change, and every claim is unique. Consult a licensed Florida attorney for advice regarding your 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.