Insurance Claim & Bad Faith Lawyer in Miami

Insurance is a contract. You pay your premiums month after month with the expectation that, if a covered loss happens, your carrier will treat you fairly, investigate promptly, and pay what the policy requires. Florida law actually imposes that obligation as a matter of statute — but it is broken every day. If a Florida insurance company has denied, delayed, or underpaid your claim — auto, homeowner's, business, health, life, disability, or commercial — you may have rights well beyond simply suing for the unpaid benefits. Florida's bad-faith statute can expose carriers to damages above policy limits when they handle claims unreasonably.

Types of Insurance Claims We Handle

• Auto insurance disputes — UM/UIM claims, PIP disputes, denied bodily-injury claims, totaled-vehicle valuation disputes
• Homeowner's and condo claims — wind, hurricane, water, fire, theft, mold, sinkhole
• Commercial property claims — including business interruption
• Life insurance disputes — denied death claims, contested beneficiary designations, contestability-period denials
• Disability insurance disputes — short-term and long-term disability denials, "any occupation" vs. "own occupation" disputes
• Health insurance denials — denied pre-authorizations, post-treatment coverage disputes (ERISA and non-ERISA)
• Marine insurance claims — particularly important in South Florida for boat damage and sinkings
• Workers' compensation insurance denials
• Excess and umbrella coverage disputes

First-Party vs. Third-Party Bad Faith

Florida law recognizes two categories of insurance bad faith:

• First-party bad faith. The insured sues their own carrier for unreasonably denying, delaying, or underpaying a claim under the insured's own policy. First-party bad-faith claims in Florida are statutory under § 624.155 and require pre-suit filing of a Civil Remedy Notice (CRN).
• Third-party bad faith. When a liability carrier fails to settle a claim against its insured within policy limits, exposing the insured to a judgment in excess of those limits. The insured (or the judgment-creditor as assignee) can then sue the carrier for the full amount of the excess judgment. Third-party bad faith in Florida is recognized at common law and does not require a CRN.

The Civil Remedy Notice

For statutory bad-faith claims, Florida law requires the policyholder to serve a Civil Remedy Notice on the Department of Financial Services and on the carrier, identifying the specific statutory and policy violations and the amount needed to cure. The carrier then has 60 days to cure by paying the amount demanded. If the carrier does not cure within 60 days, suit may be filed. The CRN is a strict prerequisite — failure to file one (or filing a defective one) can be a complete defense to a statutory bad-faith claim.

What Makes Insurance Conduct "Bad Faith"

Florida courts have identified a wide range of carrier conduct that can support a bad-faith claim:

• Failing to investigate the claim promptly and thoroughly
• Failing to respond to communications
• Failing to provide a coverage decision within a reasonable time
• Refusing to pay clearly covered amounts pending investigation of disputed amounts
• Misinterpreting policy language unreasonably in the carrier's favor
• Demanding excessive documentation
• Forcing the insured into appraisal or litigation to recover what should have been paid voluntarily
• In third-party cases, refusing to settle within policy limits when liability is clear and damages exceed limits

Damages in Bad Faith Cases

The damages available in a Florida bad-faith case can substantially exceed the policy limits:

• The full amount of the claim that should have been paid
• In third-party cases, the full amount of any excess judgment against the insured
• Consequential damages caused by the carrier's bad faith — financial losses flowing from the carrier's failure to pay
• Mental distress damages, in some cases
• Attorney's fees, in cases where they remain available under Florida law
• Punitive damages in cases of intentional or grossly negligent conduct

Recent Florida Reform Affecting Insurance Litigation

Florida significantly amended its insurance litigation framework in 2022 (SB 76 and SB 2D) and again in 2023 (HB 837). Key changes include:

• Elimination of the one-way attorney's fee statute for most property insurance claims
• Shorter notice-of-claim deadlines (one year for initial property claims, 18 months for supplemental)
• Pre-suit notice requirements
• Limitations on assignment of benefits (AOB) claims
• New defenses available to carriers

These reforms have made Florida insurance litigation more difficult for policyholders in some respects, but the core remedies for genuinely bad-faith conduct remain available — and aggressive insurance companies that count on policyholders being unable or unwilling to fight back still face exposure when they handle claims unreasonably.

Statute of Limitations

Florida's statute of limitations on contract actions is generally five years for written contracts (which most insurance policies are), and four years for unwritten or implied contracts. Statutory bad-faith actions are subject to the five-year period from accrual. Claims-notice deadlines under recent reforms can be much shorter and may operate as a complete bar even when the underlying litigation deadline has not passed.

The Miami Insurance Landscape

South Florida is the most litigated insurance market in the country. After Hurricane Andrew in 1992 wiped out a generation of homeowners' carriers, the legislature created Citizens Property Insurance Corporation as the state-backed insurer of last resort. Citizens now insures hundreds of thousands of Miami-Dade and Broward properties, especially in the coastal zip codes that admitted carriers have refused. The rest of the market is dominated by Florida-only specialty carriers — Universal, Heritage, American Integrity, Kin, Tower Hill, Florida Peninsula, and similar — whose financial strength ratings, surplus, and claim-handling practices vary widely. National brand-name carriers have steadily withdrawn from Florida homeowners over the past decade. Understanding which carrier you are dealing with, what its reinsurance looks like, and what its rate-filing record shows is part of evaluating a property claim before suit.

The Adjuster's Recorded Statement and the EUO

Two early traps appear in nearly every claim. The first is the adjuster's request for a recorded statement. On a first-party claim under your own policy, the policy generally requires cooperation, but the carrier cannot use a recorded statement as a fishing expedition for coverage defenses. Statements are routinely transcribed and used months later to argue an inconsistency between the claim narrative and the medical or repair record. The second is the Examination Under Oath (EUO) — a sworn examination under a specific policy provision, conducted by carrier counsel with a court reporter. Failure to attend a properly noticed EUO can void coverage altogether. Both should be handled with counsel present, after the claim file and policy have been reviewed.

Appraisal vs. Litigation

Most Florida property policies include an appraisal clause — a quasi-arbitration process where each side picks an appraiser, the two appraisers pick a neutral umpire, and the panel decides the amount of loss. Appraisal is binding on the amount of damages but does not decide coverage. For straightforward scope disputes, appraisal is often faster and cheaper than litigation. For disputes involving causation, exclusions, or the carrier's claim-handling conduct, appraisal can be a trap that hands away leverage. The decision to invoke appraisal — or to fight a carrier's invocation of appraisal — is one of the most consequential calls in a first-party case.

What to Do When a Claim Is Denied or Delayed

1. Obtain a complete copy of the policy, including all endorsements, schedules, and prior renewal declarations.
2. Demand a written explanation of the denial or coverage position from the carrier, citing specific policy provisions.
3. Document everything in writing — confirm phone calls by email the same day.
4. Calendar the one-year and 18-month property notice deadlines, the 10-business-day pre-suit notice under § 627.70152, and any policy-specific suit-limitation provisions.
5. Preserve damaged property until it has been inspected by your own expert.
6. Keep contemporaneous receipts for additional living expenses, alternate transportation, mitigation costs, and any out-of-pocket payment for repair.
7. Do not sit for an EUO or recorded statement without counsel.
8. Do not sign an assignment of benefits without understanding the limits under § 627.7152.

Common Defense Tactics

• Pre-existing damage. The carrier blames a current loss on prior wear and tear, age, or a previously denied claim.
• Late notice. The one-year and 18-month deadlines under SB 2A are aggressively enforced, and carriers also raise contractual late-notice arguments.
• Material misrepresentation. Discrepancies between the original application and the actual roof age, occupancy, or prior loss history are used as a basis to rescind the policy.
• Concurrent causation and excluded perils. Carriers attribute mixed-cause damage entirely to an excluded peril such as flood or earth movement.
• Failure to mitigate. The carrier argues the insured failed to tarp the roof, dry out the structure, or stop ongoing damage.

Frequently Asked Questions

Should I hire a public adjuster or a lawyer?

Public adjusters are licensed under Chapter 626 and are often useful early in a property claim to scope and document the loss. They cannot give legal advice, draft pre-suit notices, or file suit. When the carrier is denying coverage outright or the dispute is about more than the dollar amount, you need a lawyer.

What is a pre-suit notice and when is it required?

Florida § 627.70152 requires the policyholder to serve a Notice of Intent to Initiate Litigation on the carrier and the Department of Financial Services at least 10 business days before filing suit on a property claim. The notice must state the amount in dispute and attach a presuit settlement demand and an estimate.

What happens to attorney's fees in property cases now?

Florida's one-way fee statute under § 627.428 was repealed for most first-party property claims in 2022. Fees in declaratory actions are governed by § 86.121, which provides only limited recovery in narrow circumstances. Statutory bad-faith fees under § 624.155 remain available when the bad-faith claim itself is proven.

How long does a carrier have to pay or deny a claim?

Under § 627.70131, a homeowner's carrier generally must pay or deny a claim within 60 days of receiving notice, subject to circumstances beyond the carrier's control. Failure to meet that deadline accrues statutory interest and can support bad faith.

If your insurance carrier — auto, homeowner's, life, disability, or any other — has denied, delayed, or underpaid your valid claim, contact the Law Offices of Albert Goodwin. Call 786-522-1411 or email [email protected] for a free consultation.