Few property insurance companies provide for a contractual appeal of any decision made regarding an insurance claim. Some do, but these are subject to internal reviews by the company, many of which are not likely to result in a decision different from that made by the claims adjuster. There are, however, independent, statutory appeals processes that can be utilized when an insured believes the decision made is in error.
Who Can Help Me Appeal My Denied Insurance Claim?
The Office of Insurance Regulation and the Department of Financial Services (DFS) govern all insurance companies in Florida, which are executive agencies under the Governor’s office in Tallahassee. For most property insurance claims, the DFS provides non-binding mediation procedures to permit an insured to challenge a claims decision. See Section 627.7015, Florida Statutes.
Insurance companies are obligated to notify insureds of their right to participate in this process; the failure to do so acts as a waiver of other rights the insurance company has in the policy. For certain claims, such as sinkhole losses, there are specialized processes to permit an insured to challenge a company's findings. The state of Florida created a process called Neutral Evaluation for sinkhole losses, which is managed by the DFS. The impact of this process is debatable but there is no doubt many disputes between insurance companies and their insureds in sinkhole claims have been resolved using the Neutral Evaluation process.
For other insurance claim denials, where specialized appeals are ineffective, an insured may be left to his or her own devices, short of retaining legal counsel. Some counties have created ombudsmen to assist homeowners with their insurance claim denial by resolving disputes with their insurance companies.
To learn more about how to appeal a denied claim from an insurance company, please contact Corless Associates law firm at 813-498-1623 or, toll free: 877-517-5595.
