Detailed Answer
When your insurer stops responding or threatens to close your claim, it creates stress and uncertainty. Below is a clear, step-by-step guide that explains your rights under Florida law, what the insurer may be required to do, and the practical actions you can take immediately to protect your claim.
1. Understand basic terms
- Claim: Your request to the insurer for payment under your policy.
- Insurer’s duties: Investigate, communicate, and resolve covered claims fairly and promptly.
- Proof of loss: A written statement you may be asked to provide describing your loss and the amount you seek.
- Bad faith / unfair claim practices: When an insurer unreasonably delays, denies, or mishandles a claim.
2. Know the law that matters
Florida law prohibits unfair claim settlement practices by insurers. If an insurer unreasonably delays or refuses to communicate, that conduct may fall under Florida’s unfair insurance trade practices rules. See Florida Statutes § 626.9541 for examples of prohibited practices and regulatory enforcement: https://www.flsenate.gov/Laws/Statutes/626.9541.
If you believe your insurer is mishandling your claim, you can also contact Florida’s consumer insurance office for help and to file a complaint: https://www.myfloridacfo.com/division/consumers.
3. Immediate steps to protect your claim
- Create and maintain a claim file. Save every email, letter, text, voicemail summary, photograph, estimate, and bill. Note dates, times, and the names of people you spoke with.
- Review your policy. Find the sections that describe how to file a claim, what your duties are, any required timelines (for example, how long before a claim may be considered abandoned), and your proof-of-loss obligations.
- Ask for written explanations. If the insurer threatens to close or has stopped responding, demand a written explanation stating the reason. Ask what documents or information they still need and give a reasonable deadline in writing.
- Send a certified letter. If phone calls and emails fail, send a short written status request or proof-of-loss submission by certified mail (return receipt requested). This creates evidence you sought to comply and to keep the file active.
- Preserve deadlines. If your policy requires you to file or perfect a claim within a certain time, continue to meet those obligations. Don’t let a threatened closure cause you to miss a required deadline.
4. If the insurer wrongly closes the claim or keeps silent
- Request reconsideration. Ask the insurer to reopen the claim in writing and send any missing documentation they identify.
- File a complaint with the state. If the insurer refuses to respond or you believe the conduct is unfair, file a consumer complaint with the Florida Department of Financial Services (DFS) or the Florida Office of Insurance Regulation (OIR). The DFS consumer page is at: https://www.myfloridacfo.com/division/consumers.
- Consider alternative dispute resolution. Many policies include appraisal, mediation, or arbitration procedures. Review your policy and pursue those options if available and appropriate.
5. When to get legal help
If the insurer still refuses to communicate, denies coverage without a reasonable basis, or threatens closure unjustly, consider consulting an attorney who handles insurance claims. An attorney can:
- Explain whether the insurer’s actions may violate Florida’s rules on unfair claim practices (Fla. Stat. § 626.9541).
- Send a demand letter that documents your position and requests a specific action by a deadline.
- File a lawsuit on your behalf if the insurer has acted in bad faith or breached the policy.
6. Evidence to collect now
Gather evidence that strengthens your file and rebuts the insurer’s reason for closing the claim:
- Photos and videos of the loss/damage.
- Repair estimates and invoices.
- Receipts for emergency repairs.
- All written communications (letters, emails, texts) and detailed notes of all calls (date, time, person, summary).
- Copies of police or incident reports, if applicable.
7. Practical timelines and expectations
Insurers are generally expected to investigate and communicate in a reasonable time. If you experience unusual or unexplained delays, ask for specific dates: when will the investigation be done, when will you receive a coverage decision, and when will repairs or payment begin. If the insurer offers no timeline or keeps missing deadlines, escalate using the written steps above and file a complaint with the state regulator.
8. Sample short letter you can send
Use a concise, documentary letter sent certified mail:
To: [Claims Department]
Claim No: [your claim number]
Date: [today’s date]
Re: Status request and documentation of compliance
I request a written status update on the above claim. I previously submitted [list documents] and will provide any additional documents you identify. Please advise in writing within 14 days what further information you require and the expected timeline for resolution. If you close the claim, please provide a written explanation of the legal basis and the date of closure. Sincerely, [Your name]
9. Remedies the state or court can provide
If the insurance company has engaged in unfair claim settlement practices, the state regulator can investigate and take administrative action. In some cases, you may be able to sue the insurer for breach of contract or for statutory remedies if the insurer acted in bad faith. Filing a consumer complaint with the Florida Department of Financial Services is often the first non‑legal step to get regulatory attention: https://www.myfloridacfo.com/division/consumers.
Helpful Hints
- Always get important communications in writing or document phone calls (date, time, name, summary).
- Send key correspondence by certified mail so you have proof of delivery.
- Don’t agree to sign away rights or accept the insurer’s final offer without reviewing it carefully.
- Keep backup copies of everything you send and receive; build a simple chronological claim log.
- If the insurer says it will close the claim for lack of cooperation, ask for specifics on what is missing and a final reasonable opportunity to provide it.
- File a state complaint early if communications stall — regulators can sometimes prompt a response faster than courts.
- When in doubt, consult a lawyer experienced with insurance claims. A short consult can clarify your rights and potential remedies.
Disclaimer: This article explains general information about handling an insurance claim under Florida law. It is not legal advice and does not create an attorney‑client relationship. For advice about your specific situation, consult a licensed Florida attorney.