Florida property insurance mediation, appraisal and neutral evaluation

The three processes at a glance

How DFS mediation works

The Florida Department of Financial Services (DFS), Division of Consumer Services, runs a mediation program for residential property insurance claims under section 627.7015. Your insurer must tell you about the program when you file a covered first-party claim, and at policy issuance and renewal.

Which claims qualify

The program covers personal residential and commercial residential policies. It does not cover commercial coverages generally, auto, or liability coverage within a property policy. A dispute is not eligible if:

• the insurer has a reasonable basis to suspect fraud;
• there is no coverage based on agreed-upon facts about the cause of loss;
• the claim was denied entirely because of an intentional material misrepresentation;
• less than $500 is in dispute, unless both sides agree to mediate anyway; or
• notice of the claim was not given within the deadlines in section 627.70132.

A claim generally becomes eligible once the insurer has paid or denied it in writing under section 627.70131(7), or has elected to reinspect after a pre-suit notice.

How to request it

1. Contact DFS. Use the online “Request Assistance” form on MyFloridaCFO.com, call the Consumer Helpline at 1-877-MY-FL-CFO (1-877-693-5236), or write to the Mediation Section, Bureau of Consumer Assistance, 200 East Gaines Street, Tallahassee, FL 32399-0322.
2. Prepare your numbers. Bring the insurer’s estimate, your contractor’s estimate, photos and invoices. Mediation is more productive when you can show exactly where and why the numbers differ.
3. Attend the conference. A DFS-approved mediator meets with you and an insurer representative, who must have authority to settle the full claim. If the insurer’s representative lacks that authority, the insurer is treated as having failed to appear and must pay your actual expenses plus a fee for rescheduling.
4. Decide. You are not required to accept anything. If you do sign a written settlement, you may rescind it within 3 business days, unless you have already cashed or deposited a settlement check.

Mediation and the clock

The insurer’s 60-day pay-or-deny deadline is tolled while mediation or other dispute resolution is pending (s. 627.70131(8)(a)). Mediation does not pause your own notice deadlines, so keep an eye on the 1-year and 18-month dates.

How appraisal works

Appraisal is not a statute; it is a clause in many homeowners policies. When the insurer agrees there is a covered loss but you disagree about how much it is, either side can usually demand appraisal in writing. The typical process:

1. Each side picks its own competent, impartial appraiser within a set number of days.
2. The two appraisers pick an umpire. If they cannot agree, a court can appoint one.
3. The appraisers each value the loss. Where they agree, that is the amount. Where they do not, an award signed by any two of the three sets the amount of loss.
4. Each side typically pays its own appraiser and shares the umpire’s fee, as the policy specifies.

Florida courts have long treated appraisal as deciding the amount of loss, not whether the policy covers the loss. Where coverage is admitted, Florida case law has allowed appraisers to resolve how much of the damage the covered event caused. When the insurer denies coverage outright, the dispute generally is not one appraisal can resolve.

Appraisal and the reforms

• After you send a pre-suit notice under section 627.70152, the insurer may respond by requiring appraisal or another dispute resolution method. If that process is not finished within 90 days after the notice period expires, you may file suit without further notice.
• For residential property claims, a civil remedy notice (the first step toward a bad-faith claim) cannot be filed within 60 days after appraisal is invoked (s. 624.155(3)(f)).
• Payment of an appraisal award is not, by itself, the court finding of breach that a bad-faith claim against a property insurer now requires (s. 624.1551).
• If your insurer did not give you the required notice of your mediation rights, or the insurer asked for mediation and either side rejected the result, section 627.7015 says you are not required to go through contractual appraisal before suing for breach of contract.

Appraisal can be quick and cost-effective, but it is binding on the amount and the clauses vary. Many homeowners have a lawyer review the policy language before invoking or agreeing to it.

Sinkhole neutral evaluation

For a sinkhole claim, once a sinkhole report has been issued, either you or the insurer may request neutral evaluation through DFS under section 627.7074. Once requested, it is mandatory for both sides, though it is not binding. The insurer pays the evaluator’s reasonable costs. The parties have 14 business days to agree on a certified evaluator before DFS appoints one, the conference should occur within 90 days of the request, and the evaluator’s report is due within 14 days after the conference. The report is admissible in later litigation, and filing the request tolls the deadline to sue.

Which should you choose?

• Mostly a price gap and the insurer seems willing to talk: DFS mediation is free and non-binding, so it is often a sensible first step.
• Coverage is admitted but the numbers are far apart: appraisal may resolve it, but review the clause and its costs first.
• The insurer denied coverage, or says the damage is wear and tear: neither process may fully resolve a coverage fight; talk to a Florida homeowner insurance lawyer.
• Sinkhole damage: neutral evaluation is available under its own statute.

Frequently asked questions

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