Homeowners insurance protects your financial interests if your home is damaged or destroyed by a covered peril. A peril is something that causes or may cause injury, loss, or destruction, such as a fire, tornado, or hurricane.
Although we have tried to give you a brief overview of the coverage found in your homeowners policy, insurance policies vary between insurers so you should always take the time to review the coverage included in your own policy to make sure you have the coverage you need. It’s too late to obtain additional coverage after a loss has occurred.
Types of Policies
There are many different types of homeowners insurance policies available. Normally, the type of policy coincides with the type of structure to be insured and how the structure is occupied. The type of policy also correlates to the coverage available as well.
Owner-Occupied: The main difference between policies which cover an owner-occupied, single family home is the perils covered. Basic or Broad Form policies (HO-1, HO-2) cover the structure for specified perils shown in the policy. Special form policies (HO-3) cover the structure for all perils except those specifically excluded in the policy.
Condo unit owners need a Condominium Unit-Owners Form (HO-6) which provides some coverage for the structure but primarily covers the personal property and liability of the insured. Condo unit owners policies normally cover named perils listed in the policy. However, a special endorsement can be purchased to broaden the policy to cover all perils except what is excluded in the contract.
The condo unit owners policy also provides Loss Assessment Coverage. It pays for your share of expenses for a covered loss to common property shared by all unit owners, up to the coverage limit. Policies must include at least $2,000 of loss assessment coverage with a deductible no greater than $250.
Renters: If you rent or lease your home, you need a renters policy (HO-4) to cover your personal property and liability.
Modified Coverage Form: Currently, in Florida, there are many insurers offering a Modified Coverage Form, (HO-8). The (HO-8) offers less coverage than the (HO-2). However, due to the company’s underwriting criteria, this may be the only coverage form offered by the insurer.
Dwelling Form: There are other property policies available for risks that may not qualify for a Homeowners policy. They are called Dwelling Forms. A Dwelling Form may be used instead of a Homeowner’s Form in the case of an older home, a home that is rented to others, or for other underwriting reasons.
Mobile Home: Many insurers have discontinued the sale of mobile home policies that duplicate Homeowners’ policies. Some insurers issue a dwelling form (discussed below) to cover a mobile home. .
Coverage
Homeowners insurance typically covers the dwelling including attached structures, certain unattached structures and your personal property. Additional Living Expense (ALE) and coverage for Liability is also normally included. All coverage is subject to the limits specified in the policy.
ALE provides indemnity for “additional” expenses of an insured that must live elsewhere due to a covered loss to the insured residence. ALE pays only reasonable ”excess” expenses until the property is habitable.
There are special limits on certain items such as jewelry, guns, furs, money, cameras, art or antiques, etc. You should review this list found in your policy and speak to your agent about additional coverage if needed.
Flood damage is not covered by your Homeowner's insurance policy. If you need flood coverage you must purchase a flood insurance policy.
Replacement Cost vs Actual Cash
Value
There is a very clear distinction between these terms. Actual cash value (ACV) refers to a policy that covers items for their value at the time they are lost or stolen. This means depreciation will be deducted from the current value. Replacement cost refers to the cost to replace the item, regardless of how old or outdated it may be.
Most replacement cost policies require you to carry limits to meet a certain percentage of the replacement value (normally 80%) at all times. If you fail to carry the correct amount of insurance coverage, you may be responsible for a percentage of a partial loss.
Both types of contracts are available in Florida. You should refer to your own contract to determine how your loss may be settled.
Inflation Guard
Many insurance companies include a provision known as inflation guard in homeowners insurance policies so values increase on a yearly basis. However, this does not guarantee the values
increase sufficiently to keep up with the cost of construction. This provision helps prevent problems of homes being underinsured. It is still the responsibility of the insured to evaluate their coverage each year to determine if the amount on the policy is sufficient. If an insured has concerns about the amount of coverage, they should speak with their agent about completing a new replacement cost estimate for their home.
Inspections
There are many types of property inspections. The most common are listed below. If the insurer requests a 4-point or specialized inspection and it is not provided, it can refuse to provide certain coverage or may refuse to insure the property at all.
Underwriting Inspection (Insurer Pays Cost): An insurer may require a visual inspection prior to writing a policy. This inspection is done to verify information given on the application about the home and property. The insurer may verify the construction of the home and whether there are potential hazards on the property such as unacceptable animals, pools, trampolines, unrepaired steps, steps without handrails, etc. The insurer may use the inspection to determine the presence of certain types of wiring or electrical panel boxes they believe increases the risk of a fire.
The inspection may also verify the maintenance of the home such as whether the property has any unrepaired damage. The insurer considers whether the home is properly maintained, such as, overgrown grass and weeds, trees with dead limbs near the home, non-operating vehicles on the property, etc. The insurer decides what risks to assume or avoid. If the insurer finds any of the risks listed above (this is not an all inclusive list), they may refuse coverage.
Insurers hire their own inspectors or inspection firms to inspect the condition of a property prior to the original issuance or renewal of a policy. This is part of the underwriting process. These inspectors are hired and paid by the insurance company so they decide who to use and what qualifications they must meet. Florida law does not address who an insurance company can hire for their underwriting process. The Department of Financial Services would not have authority to intercede on an inspector’s behalf if they were denied employment/contracts with an insurer.
4-Point Inspection: If you are insuring an older home, the insurer may require an inspection of the following items: The roof (to determine its life expectancy), the plumbing, electrical wiring, or heating and air. The insured/applicant pays for this inspection.
Specialized Inspection: Sometimes, an insurer may request an inspection of only one item, such as the roof. The determination of the life expectancy of a roof is one of the most common inspections requested today. Another common inspection requested in certain areas is sinkholes. The insured/applicant pays for this inspection.
Mitigation Inspection: Policyholders may elect to have an inspection to determine what wind mitigation credits they are entitled to receive on their homeowner’s windstorm premium. These inspectors complete the OIR-B1-1802 inspection form for the insured to submit to their insurance company. Insurers have the right to reinspect your home to verify your entitlement to these credits. The consumer normally pays for this type of inspection. However, if the insurer elects to reinspect a property, the insurer pays for the inspection.
Premium Discounts for Hurricane Loss Mitigation
Available for Download in English
Are you aware that hurricanes can cause major damage to your home?
Hurricanes have caused tens of billions of dollars in insured damages and predictions of more catastrophic hurricanes making landfall in Florida have triggered increases in insurance premiums in an effort to cover potential future losses.
Are you aware that there are steps you can take to help protect your home and make your home more resistant to wind?
The state of Florida requires insurance companies to offer discounts for protecting your home and mitigating damage that may be caused by hurricane-force winds. There are specific mitigation steps that you can take to help protect your home and family during a hurricane. Securing your roof so it doesn’t blow off and protecting your windows from flying debris are the two most cost-effective measures you can take to safeguard your home and reduce your windstorm (hurricane) premium. You may also replace your garage door with a hurricane resistant garage door or reinforce your garage door with hurricane-resistant garage door bracing kits. By installing mitigation features, you may be eligible to receive a reduction in your windstorm premium, reduce your out of pocket expenses, such as your hurricane deductible, and minimize the damage to your home from a catastrophic event. These discounts apply only to the windstorm coverage of your policy.
Insurance companies are required to provide you with a copy of the Wind Mitigation Notice of Premium Discount Form with each new policy and at each renewal thereafter. This form advises you of the policy deductible options and provides an example of how much your premium can be reduced if you have wind mitigation features on your home. To view a copy of the Wind Mitigation Notice of Premium Discount Form, click here.
How can you take advantage of the discounts?
Homeowners will need a qualified inspector to properly document your home’s wind mitigation features. The inspector will itemize the specific features incorporated in your home’s construction on the Uniform Mitigation Verification Inspection Form. In addition, the inspector must document the mitigation features listed on the form with accompanying photographs. The Uniform Mitigation Verification Inspection Form was approved by the Office of Insurance Regulation in order to specify the features in the construction of your home which may result in a discount, and to provide a uniform method of documentation for all insurance companies to use.
Qualified inspectors include licensed general, building, or residential contractors, licensed professional engineers, a licensed professional architect, or a certified building code inspector. The inspectors will complete a Uniform Mitigation Verification Inspection Form, based on the features of your home. This form should then be provided to your insurance company for review, and the implementation of the applicable discounts to the windstorm coverage of your premium. You may contact your insurance agent or insurance company to obtain a listing of individuals and/or inspection companies that meet these qualifications. To view a copy of the Uniform Mitigation Verification Inspection Form, click here.
What
features may result in a discount?
For homes built prior to the 2001 Building Codes, the discounts are based on the following:
Roof Covering - Roof coverings such as asphalt/fiberglass shingles, concrete/clay tiles, metal panels, other types of roof covering, which meet the current Florida Building Code standards or a reinforced concrete roof deck will qualify for wind mitigation discounts.
Roof Deck Attachment - The use of specific sized nails, with specific spacing between the nails which comply with the requirements of the current Florida Building Code qualify for wind mitigation discounts.
Roof to Wall Connections - These connections are accomplished using one of three different connection types such as:
“Clips” nailed into the side of the rafter/truss and into the side of the top plate or wall stud;
“Single Wraps/Straps” that are attached to the side and/or bottom of the top plate and are nailed to the rafter/truss; or
“Double Straps” that are attached to the side and/or bottom of the top plate and are nailed to the rafter/truss.
Roof Shape – A HIP roof which is shaped like a pyramid, is the most wind resistant roof shape, and qualifies for a wind mitigation discount.
Secondary Water Resistance (Barrier) - A layer of protection between the shingles and the plywood roof deck that helps to protect the building from water penetration if the roof covering material is blown off qualifies for wind mitigation discounts.
Shutters:
Intermediate Type – Shutters that are strong enough to meet half the Pre-2001 Florida Building Code standards for South Florida.
Hurricane Protection Type – Shutters that are strong enough to meet the Post-2001 Florida Building Code standards for South Florida.
For homes built in compliance with the 2001 building code or later, the discounts are based on the following:
Roof Shape – A HIP roof which is shaped like a pyramid qualifies for a wind mitigation discount.
Shutters:
Intermediate Type – shutters that are strong enough to meet half the Pre-2001 Florida Building Code standards for South Florida.Hurricane Protection Type – shutters that are strong enough to meet the Post-2001 Florida Building Code standards for South Florida.
current Miami-Dade building code standards.
Homes built in compliance with the 2001 Florida Building Code or later edition, including the 1994 South Florida Building Code for homes in Miami-Dade and Broward Counties, are automatically eligible for a minimum 68% discount on the windstorm coverage of the premium due to the upgraded requirements which include a roof covering, roof attachment and roof to wall connection. You may be eligible for a greater discount if other mitigation features are installed on your home.
Important Points to Remember
The amount of the discount will vary based on the wind mitigation features incorporated into your home. Your insurance agent and/or insurance company should be able to inform you how much of a discount you may expect if certain wind mitigation features are installed and/or upgraded.
The costs of wind mitigation improvements vary. Homeowners should contact a licensed contractor for an estimate. You can find a Licensed Contractor in your area by visiting the Florida Department of Business and Professional Regulation online at www.MyFloridaLicense.com.
Regardless of the year of construction, if your home meets the minimum wind mitigation requirements of the 2001 Florida Building Code, not only are you eligible to receive the premium discounts, you may also have the option to reduce your hurricane deductible.
Rates
Property Insurance Premium Base Rates are developed using several factors
The location of the property: The city, county, zip code can be used to establish the territory.
The amount of coverage on the dwelling.
The fire protection class: The rating of the fire department in that territory. The ratings range from 1-10 established by the Insurance Services Office. A rating of Class 1 represents exemplary fire protection, and Class 10 indicates that the area’s fire-suppression program does not meet minimum criteria.
Mitigation Credits given for certain items that help reduce hurricane/windstorm losses.
The construction of the dwelling such as wood frame, concrete block, brick, etc. Companies charge different premiums based on the fire resistance of the construction material.
Some insurance companies charge a higher premium according to the age of the home.
Some insurance companies charge a higher premium if you didn’t consistently maintain prior homeowners coverage.
After the base rate is determined, other rating factors are applied to determine individual surcharges and credits. Also, assessments currently due are added to the base rate to determine the final rate.
In most instances, an insurer must charge the rates filed with the Office of Insurance Regulation. However, with written consent of the insured signed prior to the policy inception date, the insurance company
may use a rate in excess of the otherwise applicable filed rate on any specific risk. This is also referred to as A Rating or Excess Rates. An insurance company may not use a consent to rate form for more than 5 percent of its personal lines policies written or renewed in each calendar.
Underwriting
Underwriting guidelines vary between insurers. However, below are a few of the most common things an insurer reviews when determining whether to insure a new property or how much to charge. They also use this same underwriting to determine whether or not to offer a renewal policy.
The insurer may consider the age of the home, roof, plumbing, electrical wiring or the heat and air. They consider the condition and location of the home and who occupies it. They may refuse to insure an individual that owns certain animals. Most insurers believe the presence of certain animals on the premises increases liability risk. The credit and loss history of the applicant is also considered. If the insurer does make an underwriting decision based on adverse information contained on a credit report, they must furnish the insured with a copy of the report or provide the name, address, and telephone number of the reporting agency.
If an insurer refuses to insure an applicant or if it decides to non-renew or cancel an existing homeowners policy, it must provide advance notice to the insured and provide the specific reason for their decision. This is discussed further in the nonrenewal – cancellation information.
Cancellation
Cancellation means the termination of an insurance policy before its normal expiration date (in other words, mid-term). If the company sent you a non-renewal notice, the requirements are discussed under the Nonrenewal Tab.
Insurers must provide a specific reason for cancellation in their notice to the insured. Depending on the situation, the following advance notices must be provided to the insured:
Binders, 5 days unless it was issued for more than 60 day period;
During the first 90 days of contract, insurers must provide 20-day advance notice with certain exceptions;
A 10-day advance notice if the premium is not paid;
After the first 90 days of contract, the insurer may only cancel for misrepresentation, non-payment of premium, failure to comply with underwriting requirements, a substantial change in the risk, or if all policies in a given class of insureds are being cancelled.
Exception: Insurers may cancel policies with 45-days advance notice if the Office of Insurance Regulation (OIR) determines that the early cancellation of the policies is necessary to protect the best interests of the public or policyholders. The OIR must also approve the insurer’s plan for early cancellation or nonrenewal.
Cancellation Limitations
Act of God Claims: Only under certain circumstances is it permissible for claims on property insurance policies that are the result of an "Act of God", to be cited as the reason for cancellation. The insurer must demonstrate, by claims frequency or otherwise, that the insured has failed to take action reasonably necessary, as requested by the insurer, to prevent recurrence of damage to the insured property. However, the insurer may raise a deductible at renewal.
Daycare on Premises: With exceptions, Florida law prevents an insurer from canceling a homeowners' insurance policy solely on the basis of operating a daycare business at the residence. The insurer can cancel a policy if one or more of the following conditions exist:
The insured does not carry a separate liability policy or endorsement at all times that provides liability coverage for the daycare home operations;
The insured fails to comply with the daycare licensure and registration requirement; or
The insurer discovers any willful or grossly negligent acts or omissions, or any violations of state laws or regulations establishing safety standards for daycare homes by the insured, or by his/her representatives which materially increase any of the risks insured.
The insured cares for more children than allowed by law;
During a Hurricane: If a cancellation is scheduled to take place during a hurricane, the insurer is required to extend coverage until the end of the duration of the hurricane. However, the insurer may charge the “current” premium rate (the rate then in effect) for the extended coverage.
Mortgage Company failed to pay premium from escrow
: If funds were available in escrow and the mortgage company failed to pay the premium in a timely manner resulting in cancellation of the policy, the insurance company should reinstate coverage with no lapse if the premium is received within 90 days of the renewal date. The lender should reimburse the property owner for any penalty or fees imposed by the insurer and paid by the property owner for purposes of reinstating the policy
If the lender pays the premium more than 90 days after the effective date, and the insurer refuses to reinstate the insurance policy, the lender shall pay the difference between the cost of the previous insurance policy and a new, comparable insurance policy for a period of 2 years. However, this law is not included in the Insurance Code. Therefore, complaints regarding the lender should be referred to the Office of Financial Regulation (OFR) at (850) 487-9687.
Pending/Open Claim or Existing Damage: Currently, there are no laws that prohibit an insurer from cancelling a property policy if the insured has a pending claim except upon a declaration of an emergency and the filing of an order by the Commissioner of Insurance Regulation.
Premium Refund Timeframe: When a Property Policy is cancelled by the insurer or the insured, any unearned premium must be returned to the insured within 15 working days after the effective date of the cancellation. (Unless the policy is subject to an audit) If the premium is financed with a Premium Finance Company, the unearned premium must be returned to the Premium Finance Company.
Sinkhole Claim: Florida law states an insurer may not cancel any property policy on the basis of a claim for a partial loss caused by a sinkhole, as long as the total of the claim payments do not exceed the current policy limit and provided the insured has repaired the structure in accordance with the engineering recommendations. If the policy limits are paid, the policy can be non-renewed by the insurer.
Water Damage Claim: A single claim on a property insurance policy which is the result of water damage may not be used as the sole reason for cancellation unless the insurer can demonstrate that the insured failed to take action reasonably requested by the insurer to prevent a future similar occurrence of damage to the insured property.
Nonrenewal
A nonrenewal is the termination of an insurance policy at its normal expiration date.
Insurers must provide a specific reason in their notice to the insured if it nonrenews a policy. They must also provide advance notice to the first named insured listed on the policy as specified below.
Notice Required – Effective July 1, 2015:
Insurers must give the first named insured written notice of nonrenewal at least 120 days in advance with the following exceptions:
Other company assumes Citizens Policy or offer of coverage through the eligibility clearing house program: Citizens Property Insurance Corporation must give a 45-day advance written notice for policies being assumed by an authorized insurer. The 45-day notice requirement also applies when an insurer agrees to offer coverage through the eligibility clearing house program.
Home and motor vehicle policy combined: 90-days advance notice of nonrenewal for policies that cover both a home and motor vehicle. The policy can be nonrenewed for any reason applicable to either the property or motor vehicle insurance.
Notice Required – Prior to July 1, 2015:
Other company assumes Citizens Policy or offer of coverage through the eligibility clearing house program: Citizens Property Insurance Corporation must give a 45-day advance written notice for policies being assumed by an authorized insurer. The 45-day notice requirement also applies when an insurer agrees to offer coverage through the eligibility clearing house program.
Home and motor vehicle policy combined: 90-days advance notice of nonrenewal for policies that cover both a home and motor vehicle. The policy can be nonrenewed for any reason applicable to either the property or motor vehicle insurance.
Insured less than 5 years, not effective during hurricane season: 100-days advance notice (if not effective during hurricane season), if insured with the insurer less than 5 years. (Citizens’ has an exception located under 45-days advance notice above.)
Insured less than 5 years, effective during hurricane season: 100-days notice or by June 1st, whichever is earlier, if the nonrenewal is to be effective during hurricane season, if insured with the insurer less than 5 years. (The requirement for providing written notice by June 1 of a nonrenewal effective between June 1 and November 30 does not apply to a policy being nonrenewed due to a revision in the coverage for sinkhole losses and catastrophic ground cover collapse.) If the nonrenewal is scheduled to take place during a hurricane, the insurer is required to extend coverage until the end of the duration of the hurricane. However, the insurer may charge the “current” premium rate for the extended coverage.
Insured 5 or more years: 120-days advance notice if the policy has been in effect for at least 5 years with the insurer or its affiliate. (Citizens’ has an exception located under 45-days advance notice above.)
Nonrenewal Limitations
Act of God Claims: Only under certain circumstances is it permissible for claims on property insurance policies that are the result of an "Act of God", to be cited as the reason for nonrenewal. The insurer must demonstrate, by claims frequency or otherwise, that the insured has failed to take action reasonably necessary, as requested by the insurer, to prevent recurrence of damage to the insured property. However, the insurer may increase a deductible at renewal due to act of God claims.
Credit Report/Score: Insurers cannot non-renew a homeowners policy solely based on information from a credit report, for having no credit history, or for having an adverse credit history due to medical bills. Also, if the insurer refuses to insure or non-renews a policy due to adverse information contained on a credit report, they must furnish the insured with a copy of the report or provide the name, address, and telephone number of the reporting agency.
Daycare on Premises: With exceptions, Florida law prevents an insurer from nonrenewing a homeowners' insurance policy solely on the basis of operating a daycare business at the residence. The insurer can nonrenew a policy if one or more of the following conditions occur:
The insured cares for more children than allowed by law;
The insured does not carry a separate liability policy or endorsement at all times that provides liability coverage for the daycare home operations;
The insured fails to comply with the daycare licensure and registration requirements; or
The insurer discovers any willful or grossly negligent acts or omissions, or any violations of state laws or regulations establishing safety standards for daycare homes by the insured, or by his/her representatives which materially increase any of the risks insured.
During a Hurricane: If a nonrenewal is scheduled to take place during a hurricane, the insurer is required to extend coverage until the end of the duration of the hurricane. However, the insurer may charge the “current” premium rate (the rate then in effect) for the extended coverage.
Nonrenewal of more than 10,000 policies: An insurer planning to nonrenew more than 10,000 residential property insurance policies within a 12-month period must advise the Office of Insurance Regulation 90 days before the issuance of any notices of nonrenewal. The notice to OIR must disclose the reason for the nonrenewal, the effective dates, and any arrangements made for other insurers to offer coverage to affected policyholders. This requirement does not apply to the policies being nonrenewed to exclude Sinkhole coverage.
Pending/Open Claim or Existing Damage: Currently, there are no laws that prohibit an insurer from cancelling a property policy if the insured has a pending claim except upon a declaration of an emergency and the filing of an order by the Commissioner of Insurance Regulation.
Single Water Damage Claim: A single claim on a property insurance policy which is the result of water damage may not be used as the sole reason for non-renewal unless the insurer can demonstrate that the insured failed to take action reasonably requested by the insurer to prevent a future similar occurrence of damage to the insured property.
Sinkhole Claim: Florida law states an insurer may not non-renew any property policy on the basis of a claim for a partial loss caused by a sinkhole, as long as the total of the claim payments do not exceed the current policy limit and provided the insured has repaired the structure in accordance with the engineering recommendations. If the policy limits are paid, the policy can be non-renewed by the insurer. (The policyholder can also request cancellation of the policy once the policy limits are paid and should receive a refund of any unearned premium that may apply.)
Sinkhole Coverage Elimination: An insurer may non-renew a property policy that provides Sinkhole Coverage. However, the insurer must offer the policyholder a policy that provides coverage for Catastrophic Ground Cover Collapse instead. The policyholder must be notified the non-renewal is for the purpose of removing sinkhole coverage, and that the policyholder is being offered a policy that provides catastrophic ground cover collapse. Subject to the insurers approved underwriting and insurability guidelines, the insurer must provide the policyholder with the opportunity to purchase an endorsement which provides sinkhole coverage. The insurer may require an inspection of the property before issuing the endorsement.
Wind coverage elimination: If a residential structure is currently covered with a policy which includes wind, but the property is eligible for wind-only coverage with Citizens, the insurer may elect to offer a renewal policy with wind excluded. In some instances the insurer may discontinue the existing policy and issue a replacement without wind coverage.
"Policy Change" Notice of Requirements
Per Section 627.43141, Florida Statutes, a property and casualty contract renewal may contain a change in policy terms. If a renewal contains such a change, the insurer must give the named insured written notice of the change which may be included with the notice of renewal premium required by F.S. 627.4133 and F.S. 627.728 or sent separately within the specified timeframe. Some policies that fall within this category are: personal auto, commercial and residential property, worker’s compensation, employer’s liability, inland marine, personal liability and watercraft. The insurer must also provide a sample copy of the notice to the named insured’s insurance agent before or at the same time the notice is provided to the named insured. The notice must be entitled “Notice of Change in Policy Terms.”
A renewal policy, which includes the addition of optional coverage that increases the premium to a policyholder, may not use the “Notice of Change in Policy Terms” to add the optional coverage to the policy unless the policyholder affirmatively indicates to the insurer or agent that they approve the addition of the optional coverage. Optional coverage is defined as the addition of new insurance coverage that has not previously been requested or approved by the policyholder.
Although not required, proof of mailing or registered mailing through the US Postal Service of the “Notice of Change in Policy Terms” to the named insured at the address shown in the policy is sufficient proof of notice.
Receipt of the premium payment for the renewal policy by the insurer is deemed to be acceptance of the new policy terms by the named insured.
If an insurer fails to provide the required notice, the original terms remain in effect until the next renewal and the proper notice is given, or until the effective date of replacement coverage obtained by the named insured, whichever occurs first.
Please note: “Change in Policy Terms” means the modification, addition, or deletion of any term, coverage, duty, or condition from the previous policy. The correction of typographical or scrivener’s errors or the application of mandated legislative changes is not a change in policy terms.
The intent of this law is to allow an insurer to make a change in policy terms without nonrenewing policyholders they wish to continue insuring. In addition, it alleviates concern and confusion to the policyholder caused by the required policy nonrenewal if the insurer intends to renew the insurance policy, but the new policy contains a change in policy terms and encourages policyholders to discuss their coverage with their insurance agents.
Common Claim Concerns
Non-matching replacement materials: When a loss requires replacement of items and the replaced items do not match in quality, color or size, the insurer should make reasonable repairs or replace the items in adjoining areas. The insurer may take into consideration such things as the cost of repairing or replacing the items in the adjoining areas, the degree of uniformity that can be achieved without the cost, the remaining useful life of the undamaged portion, and other relevant factors.
Debris and Tree Removal: Most insurance policies cover debris & tree removal if the downed tree damaged insured property regardless of who owns the tree. However, there are usually limits that the company will pay. There is usually no debris removal coverage if the trees fell on the ground and did not damage covered property. Some policies provide debris & tree removal if the downed tree blocks the main entrance to the property. Since insurance policies vary between insurers, you should always refer to your own personal contract.
Insurer’s duty to acknowledge claim communications: An insurance company must respond to any communication with respect to a claim within 14 calendar days, unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the company’s control. A communication made by an agent or another employee of a company shall constitute communication to or by the company. The communication can be made in writing, verbally, or any other form.
Within 10 working days after the company receives proof of loss statements, the company must begin its investigation of a claim unless the failure to investigate is caused by factors beyond the control of the company.
Please note: “Beyond the control” was intended to include physical incapability caused by natural disasters. This could be very broad though including delays due to lack of adjusters or engineering firms needed to analyze damages. Whether a factor was beyond the control of the insurer will have to be determined on a case-by-case basis.
Insured’s duties after a loss: When a loss occurs, the insured should promptly notify their agent or insurance company, and review the Conditions, Duties after a Loss Section of their policy. There are separate conditions for Section 1 (Property Coverage) and Section 2 (Liability Coverage) of the contract. If more than one insurance policy covers the occurrence, all insurers should be notified.
The insured has a responsibility to mitigate damages to their property, or protect the property from further damage. The insured should make reasonable temporary repairs and keep accurate records and receipts of those repairs. It is always a good idea to take photos of the damage prior to making temporary repairs, if possible.
The insured should also compile an inventory of all damaged personal property. The inventory should include the date of purchase, quantity, description, value, and the amount paid for each item. The insured may be asked to provide receipts, bills, and any other related documents to justify the amounts provided.
The insured must cooperate with the company in the investigation of the claim. The insured and/or others parties may be asked to provide a recorded statement or an examination under oath.
If the occurrence is related to a liability issue, the insured should forward all notices, demands, summons, or other process documents relating to the “occurrence” to the insurer immediately upon receipt.
Notice of Windstorm or Hurricane Claim: The time period an initial, supplemental or reopened claim can be presented to an insurer under a property insurance policy providing coverage for windstorm or hurricane is limited. Under current Florida law, these claims are barred unless notice was given to the insurer in accordance with the terms of the policy within 3 years after the hurricane first made landfall or the windstorm caused the covered damage.
Timeframe for Payment of Claim: Within 90 days after a company receives notice of a new, reopened or supplement property insurance claim, the company must pay or deny the claim. If the settlement amount is contested, the company should pay all uncontested amounts within the 90-day timeframe unless the failure to pay the claim or the uncontested amount is caused by factors beyond the control of the company. Any payment (portion or entire claim) paid more than 90 days after the company receives notice of the claim, or paid more than 15 days after there are no longer factors beyond the control of the company, whichever is later, will bear interest according to Section 55.03, Florida Statutes.
Please note: “Beyond the control” was meant to include physical incapability caused by natural disasters. This could be very broad though including delays due to lack of adjusters or engineering firms needed to analyze damages. Whether a factor was beyond the control of the insurer will have to be determined on a case-by-case basis.
Valued Policy Law: In the event of the total loss of any building, structure, or mobile home, the insurer’s liability under the policy for the loss is the face amount of the policy, if such loss was caused by a covered peril.
Homeowner Tips
Verify before you buy!!!! Contact us to verify the license of the agent and the insurance company before you sign the application for a policy.
Prepare a Home Inventory Checklist! A home inventory – along with photos and proof of ownership - will make it easier to file an accurate, detailed insurance claim in case your home is damaged or destroyed. When you have a loss, it is your responsibility to know what property you have, when it was purchased, how much you paid for it, and how much it will cost to replace it. You should also keep receipts for large purchases, or keep your credit card statements. You may be asked to prove that you ever owned the item in question. It is always a good idea to take pictures or videos of your property as well.
Homeowners' Insurance Toolkit! This toolkit provides more detailed information regarding homeowners insurance. It includes a sample policy and a home inventory that you may use.
Better Building Codes Mean Lower Rates! The Building Code Effectiveness Grading Schedule (BCEGS) assesses the building codes in effect in a particular community and how the community enforces its building codes, with special emphasis on mitigation of losses from natural hazards.
Make sure your home is insured properly! If you have a replacement cost policy and fail to maintain the proper amount of insurance, you may be penalized when filing a claim. Although most homeowner policies include an inflation guard endorsement to automatically increase your coverage annually, you should check with your insurance agent once a year to make sure you have adequate coverage.
Read your policy carefully! Insurance policies differ between insurance companies so you must review your own contract. Insurance policies do not cover everything, read the exclusions. Also, there are limitations on certain types of personal property, such as but not limited to antiques, firearms, jewelry, furs and electronics, including computers and their equipment. In most instances, additional coverage may be purchased. Talk to your agent about additional coverage.
Keep a copy of your important documents in another location! In the event your home is totally destroyed, you would have copies of all your important documents including receipts you may need to settle a claim with your insurance company.
Contact Us or File a Complaint
Should you need additional information, you may call our statewide toll-free helpline.
1-877-MY-FL-CFO (1-877-693-5236)
Monday - Friday
Insurance Assistance available 9:00 AM - 3:00 PM
Insurance Agent & Agency Licensing available 8:00 AM - 4:45 PM
Out of State Callers: (850) 413-3089
You can also contact us for assistance anytime by email at or file a complaint through our “Consumer Help Online” portal.