Guide to American Integrity Claim Denials in Miami, Florida

13 min read

Introduction: Why Miami Homeowners Must Understand American Integrity Claim Denials

American Integrity Insurance is one of Florida’s leading residential insurers, covering more than 300,000 policyholders statewide. While the company pays thousands of claims every year, denials and underpayments are not uncommon—particularly in hurricane-prone markets such as Miami-Dade County. If you are a Miami homeowner whose claim has been rejected or partially paid, you are not powerless. Florida law affords strong policyholder protections, and local attorneys familiar with the insurer’s tactics can often turn a “no” into a full and fair recovery.

This comprehensive guide—written from the homeowner’s point of view—explains:

• Your legal rights under Florida insurance statutes, regulations, and court precedents;

• The most frequent reasons American Integrity cites for denying residential property claims in South Florida;

• Step-by-step actions you can take today to challenge a denial or lowball offer; and

• When it makes sense to engage a Florida-licensed attorney such as Louis Law Group for a free case evaluation.

Legal disclaimer: The information below is for educational purposes only and does not create an attorney–client relationship. For advice about your specific situation, consult a licensed Florida attorney.

Understanding Your Rights in Florida

Key Florida Statutes Protecting Policyholders

Florida’s Legislature recognizes the state’s unique exposure to catastrophic storms. Several statutes give homeowners leverage when an insurer refuses to pay:

• § 624.155, Florida Statutes – Civil Remedy for Insurer Bad Faith. This provision allows policyholders to recover extra-contractual damages (sometimes far beyond the policy limits) when an insurer’s denial or delay is “not fairly debatable.” You must first file a Civil Remedy Notice (CRN) with the Florida Department of Financial Services.

• § 627.70131 – Payment of Residential Property Insurance Claims. American Integrity generally has 90 days after receiving notice of loss to pay or deny a claim. Missed deadlines strengthen a bad-faith allegation.

• § 95.11(2)(e) – Statute of Limitations for Contract Actions. In Florida, you have five years from the date of loss to file a lawsuit for breach of an insurance contract. However, waiting can erode evidence; act promptly.

For the statutory text, visit the Florida Legislature’s official website.

Regulatory Oversight

American Integrity is regulated by the Florida Office of Insurance Regulation (OIR). Complaints may also be filed with the Florida Department of Financial Services, Division of Consumer Services. These agencies track complaint ratios and can pressure insurers to reconsider improper denials.

Bad Faith and Recent Case Law

In Cammarata v. State Farm Fla. Ins. Co., 152 So. 3d 606 (Fla. 2014), the Florida Supreme Court confirmed that homeowners may pursue bad-faith actions after a favorable appraisal award—clarifying that an insurer’s mere payment of the award does not absolve earlier misconduct. Miami courts have applied this reasoning in subsequent cases involving American Integrity, signaling that policyholders can and should challenge stonewalling.

Common Reasons American Integrity Denies Claims

Based on publicly available complaints, Florida OIR market-conduct studies, and firsthand client interviews, the following patterns emerge in South Florida:

• Late Notice Allegations. American Integrity often asserts that homeowners reported hurricane or water damage “weeks or months” after the event, allegedly preventing a thorough investigation.

• Wear, Tear, and Maintenance Exclusions. The company may categorize roof leaks as “age-related deterioration” despite clear wind uplift marks or missing shingles after a storm.

• Water Damage Caps and Exclusions. Post-Irma policy forms include a $10,000 water damage cap if you fail to use a preferred vendor—an issue frequently disputed in Miami’s humid climate, where secondary mold growth spreads quickly.

• Misrepresentation or Fraud Accusations. If documentation is incomplete, adjusters may claim material misrepresentation, leading to outright rescission.

• Understated Repair Pricing. Even when coverage is acknowledged, American Integrity’s estimates often rely on outdated price lists that do not reflect Miami-Dade’s elevated labor and material costs.

Policy Interpretation Disputes

Fine-print endorsements, like “Calendar-Year Hurricane Deductible” riders, can significantly reduce payouts. A skilled attorney or public adjuster can parse these provisions, compare them with Florida administrative rules, and challenge ambiguities. Under long-standing Florida precedent (Fayad v. Clarendon Nat’l Ins. Co., 899 So. 2d 1082 [Fla. 2005]), ambiguous language is construed in favor of the insured.

Florida Legal Protections & Regulations

The Homeowner Claims Bill of Rights

Enacted in 2014 (§ 627.7142), this statute requires insurers to:

• Notify policyholders of important rights within 14 days of a claim, and

• Provide status updates every 30 days.

A failure to deliver this notice does not void your claim but can bolster a bad-faith argument.

Mandatory Mediation and Neutral Evaluation

Before litigation, you may request free or low-cost mediation through DFS for hurricane claims (Rule 69J-166.002, Fla. Admin. Code). For sinkhole disputes—relevant in certain limestone areas of Miami—neutral evaluation is required (§ 627.7074).

Assignment of Benefits (AOB) Reform

Florida’s 2019 AOB statute (HB 7065) limits contractors’ ability to sue insurers directly, prompting American Integrity to scrutinize mitigation invoices more closely. If your claim involved an AOB, understand that you still retain independent rights to recover unpaid amounts.

Regulatory Trends Specific to American Integrity

In its 2022 Market Conduct Examination, OIR cited American Integrity for failure to timely acknowledge communications and failure to pay interest on overdue claims. Though the company agreed to corrective action, Miami claim records suggest ongoing compliance issues.

Steps to Take After an American Integrity Denial

1. Obtain and Study the Denial Letter

Florida law requires the insurer to cite specific policy provisions. Compare the cited exclusions with your declarations page and endorsements. Flag vague language.

2. Request the Entire Claim File

Under Florida’s Public Adjuster statute (§ 626.854) and Discovery Rules, you may demand adjuster notes, engineering reports, and photographs. These documents often reveal internal disagreements favorable to you.

3. Document Damage Thoroughly

• Take time-stamped photos or videos of all affected areas.

• Retain repair invoices, mitigation receipts, and hotel bills.

• Secure weather reports (e.g., NOAA wind speeds) to correlate storm impact—critical in hurricane-related roof claims.

4. Get an Independent Estimate

Hire a licensed Florida public adjuster or reputable contractor. Many use Xactimate software calibrated for South Florida pricing, exposing lowball insurer estimates.

5. Explore ADR Options

• DFS Mediation. Submit form DFS-I0-HM (10-18). If American Integrity fails to appear, you may recover mediation costs.

• Appraisal. Most policies include an appraisal clause. While quicker than litigation, appraisal awards are final—consult counsel first.

• Civil Remedy Notice. File a CRN through DFS as a prerequisite to bad-faith litigation. American Integrity then has 60 days to cure.

6. Keep an Eye on Deadlines

Remember the five-year breach-of-contract limitation (§ 95.11) and the shorter two-year window for hurricane supplemental claims (§ 627.70132). Calendar these dates.

When to Seek Legal Help in Florida

Indicators You Need an Attorney

• Denial based on alleged misrepresentation or fraud.

• Payment far below independent estimates (more than 20% variance).

• Evidence of delayed communications or missed statutory deadlines.

• Complex losses involving mold, code upgrades, or prior storm damage.

Florida attorneys may recover their fees from the insurer under § 627.428 (for policies issued before the 2023 reforms) or through proposal for settlement mechanisms. Contingency fee arrangements mean no upfront costs for most homeowners.

Louis Law Group is headquartered in Miami and has handled hundreds of American Integrity disputes—from modest water leaks to multimillion-dollar hurricane catastrophes. Our attorneys are fully licensed in Florida, fluent in Spanish and Haitian Creole, and ready to:

• Analyze your policy and denial letter free of charge;

• Order an independent engineering inspection, if needed;

• File CRNs and lawsuits within statutory timelines; and

• Negotiate settlements or take your case to trial.

If American Integrity denied your claim, call 833-657-4812 for a free case evaluation and policy review.

Local Resources & Next Steps

State and County Agencies

Florida Office of Insurance Regulation (OIR) – file insurer misconduct complaints. Florida Department of Financial Services, Consumer Services – mediation requests and insurance helpline. Miami-Dade Consumer Protection Division – local dispute resolution. Florida Bar Lawyer Referral Service – find additional attorneys.

Climate & Weather Considerations in Miami

Miami’s coastal geography makes wind-driven rain and flooding frequent. NOAA reports show six named storms affected Miami-Dade in the last five hurricane seasons. Salt-air corrosion accelerates roof deterioration, complicating “wear and tear” versus “storm damage” debates. Keep seasonal preparedness kits and photograph the property before hurricane season to establish pre-loss condition.

Your Action Plan Recap

• Secure your property and mitigate further damage.

• Collect the denial letter and request the full claim file.

• Document damages with photos, receipts, and weather data.

• Obtain an independent estimate.

• Consider DFS mediation, appraisal, or a CRN.

• Contact Louis Law Group at 833-657-4812 for legal guidance.

Conclusion & Call to Action

American Integrity denials are frustrating, but Miami homeowners possess powerful legal tools under Florida law. Whether the dispute centers on alleged late notice, water damage exclusions, or undervalued repairs, timely action can flip the outcome. Louis Law Group has the local experience, engineering partners, and courtroom track record to hold insurers accountable.

Don’t let an unfair denial jeopardize your home. Call Louis Law Group today at 833-657-4812 for a free, no-obligation case evaluation and policy review.