Florida Insurance Claim Time Limit: What You Need to Know

Filing an insurance claim can be a stressful process, especially if you’re waiting a long time for the insurance company to settle the claim. If you have filed a claim in the state of Florida, you may be wondering – what is the time limit for insurance companies to settle claims here?

In this comprehensive guide, we will look at the Florida laws and regulations around insurance claim time limits. Having a clear understanding of the time frames and processes will help set proper expectations and empower you to get a fair settlement in a timely manner.

Overview of Florida Insurance Claim Laws

In Florida, insurance companies are regulated by the Florida Office of Insurance Regulation (OIR) and must follow specific claim handling guidelines set out in the Florida Insurance Code. This includes acting in good faith, communicating promptly, thoroughly investigating claims, and settling them within a reasonable time frame.

While there is no single hard-and-fast claims settlement deadline in Florida law, most standard property and casualty claims are expected to be resolved in 30-90 days after receiving all necessary documentation. However, the timeframe can vary depending on factors like claim complexity, required investigations, and policyholder cooperation.

For personal injury protection (PIP) claims under auto policies, Florida statute 627.736 does impose stricter time limits:

• Insurance companies have 30 days to investigate a PIP claim after receipt

• They must accept or deny the claim within this 30 day window

• If accepted, they must pay within 30 days of agreeing to cover the claim.

Failure to meet these PIP claim investigation and payment deadlines can make the insurer liable for penalties and interest.

Typical Florida Insurance Claims Process

To better understand the timeframes involved, let’s walk through the key steps in a standard Florida insurance claim process:

1. Notice of Loss – The policyholder reports the claim and provides initial details. The insurer creates a claim file and assigns an adjuster.

2. Investigation – The adjuster investigates, often including site inspections, documentation requests, and interviews. Complex claims may need special investigations.

3. Coverage Determination – The adjuster reviews the policy terms to determine if the loss is covered and the applicable coverage limits.

4. Loss Valuation – The adjuster calculates the loss amount based on damage assessments, cost of repairs, and other claim-specific factors.

5. Resolution Negotiations – The insurer makes a settlement offer. Negotiations take place until an agreed amount is reached.

6. Claim Closure – The policyholder accepts the settlement, signs releases, and receives payment. The claim file is closed.

Most Florida property insurance claims are settled within 30-90 days, provided there are no coverage disputes or delays. PIP claims have stricter 30-day investigation and payment deadlines.

Factors That Can Delay Florida Insurance Claim Settlements

While insurers strive to settle claims promptly, there are some common factors that can result in delays:

• Access to property – Inspections may be slowed if the property is unsafe or the policyholder restricts access.

• Third-party involvement – Claims involving other parties (e.g. car accidents) often take longer to investigate fault and liability.

• Disputes over policy coverage – Arguments over what is covered under the policy can prolong the process.

• Pre-existing damages – Identifying damages present before the loss event is time-intensive.

• Catastrophe losses – After major disasters, claim volume may overwhelm the insurer and cause delays.

• Specialized experts needed – Assessing complex damages may require hiring specific experts, adding time.

• Policyholder cooperation – Delayed information submissions or communications by the policyholder can slow response.

• Poor claims handling – Some insurers may deliberately delay settlements as a cost-saving tactic.

While delays are sometimes unavoidable due to complex claims, Florida regulations require insurers to communicate with policyholders on the claim status and progress.

Florida Bad Faith Insurance Actions

If an insurer engages in unreasonable delays or underpayment of a Florida insurance claim, they may be acting in “bad faith”, violating state laws and regulations. Policyholders can take legal action against insurers for bad faith practices such as:

• Failing to promptly investigate a claim
• Refusing to pay a valid claim
• Not attempting to settle a claim in good faith
• Failing to communicate properly during the claims process

To have a case, the insurer’s actions must be so extreme and unreasonable that they constitute a breach of the implied covenant of good faith and fair dealing under the policy.

An experienced Florida insurance bad faith attorney can assess the merits of the case and advise on the best actions to take for delayed or wrongfully denied claims. Damages awarded in successful bad faith cases can be substantial.

Tips for Navigating Florida Insurance Claims

To avoid excessive delays in getting your Florida insurance claim paid, follow these tips:

• Report the loss immediately – Early notice allows the insurer to start investigating sooner.

• Keep detailed records – Save all communications with the insurer and document damage with photos/videos.

• Provide complete documentation – Submitting all requested documents quickly aids prompt processing.

• Follow up consistently – Politely follow up with the adjuster on the claim status but avoid excessive contacts.

• Be reasonable – Have realistic expectations on claim timeframes and understand delays do occur.

• Hire a Public Adjuster – They act as your representative in negotiating with the insurer.

• Consult an attorney – If bad faith is suspected, legal counsel can advise on the best recourse.

Understanding Florida insurance claim time limit laws helps set proper expectations. While most claims are settled in 30-90 days, delays happen. Policyholders should cooperate fully in the claims process and proactively follow up. If the insurer acts egregiously by delaying or underpaying a valid claim, legal action may be warranted with help from a bad faith attorney. With a knowledgeable, diligent approach, Florida policyholders can avoid excessive frustrations and get fair claim settlements in a reasonable time frame.