Mold Damage Property Insurance Claim Denial Guide Tampa FL

Introduction: Why Mold Damage Claim Denials Matter for Tampa Homeowners

Tampa’s warm, humid climate and frequent summer storms create an ideal breeding ground for mold. According to the Hillsborough County Property Appraiser’s public data, more than 60 % of Tampa’s housing stock was built before 1990—well before today’s stricter moisture-barrier standards. That combination of older construction and subtropical weather explains why mold is one of the most common property insurance claims filed by Tampa homeowners. Unfortunately, mold damage claims are also among the most likely to be partially or fully denied by insurers. This guide delivers a step-by-step, Florida-specific explanation of what to do when your property insurance company denies your mold damage claim.

The information is drawn strictly from authoritative sources such as the Florida Statutes, Florida Administrative Code, the Florida Department of Financial Services (DFS), and published Florida court decisions. While the discussion slightly favors the policyholder, it remains rooted in verifiable law and industry standards. If your claim has been denied, do not lose hope: Florida law provides strong consumer protections, and several local resources can help you fight back.

Understanding Your Rights in Florida

Key Statutory Protections

Two of the most important statutes governing residential property insurance claims in Florida are:

• Florida Statutes § 627.70131 – Requires insurers to acknowledge and respond to communication within 14 calendar days and to pay or deny a claim (in whole or part) within 90 days after receiving notice of loss, unless factors outside the insurer’s control prevent a timely decision.

• Florida Statutes § 624.155 – Allows policyholders to file a civil remedy notice (CRN) alleging an insurer’s bad-faith claim handling, a prerequisite to certain lawsuits for extra-contractual damages.

Statute of Limitations to Sue

Under Florida Statutes § 95.11(2)(e), a homeowner generally has five years from the date the insurance contract is allegedly breached (often marked by a denial letter) to file a lawsuit for breach of contract. That window is shorter for hurricane-related losses, which are governed by § 627.70132 (three years to give notice), but most mold claims in Tampa arise from plumbing leaks, roof failures, or flood-related moisture rather than named storms.

The Duty of Good Faith

Florida recognizes an implied covenant of good faith and fair dealing in every insurance contract. In Berges v. Infinity Insurance Co., 896 So. 2d 665 (Fla. 2004), the Florida Supreme Court affirmed that an insurer must investigate claims thoroughly and communicate promptly. If the insurer’s denial of a mold damage claim is unreasonable, you may have a bad-faith action after satisfying the CRN process.

Common Reasons Property Insurance Companies Deny Mold Damage Claims in Florida

Although policy language varies, insurers tend to rely on a handful of arguments when denying mold claims:

Policy Exclusions or Sublimits

Many Florida policies contain a mold/fungus exclusion or a low sublimit—sometimes $10,000 or less—unless you purchased an endorsement. Review the “Additional Coverage – Fungi, Wet or Dry Rot, or Bacteria” section to confirm your limits. Failure to Mitigate

Insurers often argue the homeowner did not act swiftly to dry out the water source, allowing mold to spread. Yet Florida law, including Gonzalez v. State Farm Lloyds, 250 So. 3d 1165 (Fla. 3d DCA 2018), places the burden on the insurer to prove prejudice from delayed notice. Late Notice of Loss

Under § 627.70132, notice of a non-hurricane loss must be given “promptly.” Tampa homeowners sometimes discover mold inside walls months after a slow plumbing leak; insurers may deny such claims as untimely. However, courts evaluate “promptness” based on reasonableness under the circumstances. Pre-Existing or Long-Term Damage

Policies typically cover “sudden and accidental” events. An insurer might label long-term moisture intrusion as maintenance, not an insurable peril. Always document dates of discovery and prior inspections to challenge this position. Excluded Cause of Loss

If mold results from flood (rising surface water), standard homeowners policies exclude it. Tampa neighborhoods near the Hillsborough River and Old Tampa Bay are in FEMA flood zones; separate flood insurance is required for those losses.

Understanding the insurer’s cited basis for denial is the first step toward overturning it.

Florida Legal Protections & Regulations

Prompt Pay Requirements

As noted, § 627.70131(5)(a) requires payment of undisputed amounts within 90 days. Failure to pay triggers interest at the rate set by the Florida Chief Financial Officer (DFS website). If your insurer admits some coverage but drags its feet on payment, you may demand statutory interest.

Unfair Claim Settlement Practices

The Florida Administrative Code, Rule 69O-166.024, lists claim practices considered unfair, such as misrepresenting policy provisions, failing to conduct a reasonable investigation, or compelling litigation by offering substantially less than the amount ultimately recovered. You can cite this rule when drafting a complaint to DFS.

Civil Remedy Notice (CRN) Procedure

Before filing a bad-faith lawsuit under § 624.155, a policyholder must submit a CRN via the DFS online portal, stating the specific statutory provisions violated and how the insurer can cure the violation (usually by paying the claim). The insurer then has 60 days to cure. If it fails to do so, you may seek extra-contractual damages in court in addition to policy benefits.

Assignment of Benefits (AOB) Restrictions

Many Tampa homeowners hire mold remediation firms that request an Assignment of Benefits. Under § 627.7152, effective July 1, 2019, AOB agreements must comply with strict notice and cancellation requirements, and assignees must follow pre-suit dispute resolution steps. If your insurer denied your claim because of an allegedly invalid AOB, consult a Florida attorney immediately.

Steps to Take After a Denial in Florida

Request a Certified Copy of Your Policy

Under § 627.4137, insurers must provide a certified policy copy within 30 days of a written request. Having the full policy—including endorsements—is essential to evaluate exclusions and sublimits. Collect Evidence

• Date-stamped photographs and videos of mold growth and water intrusion.

• Moisture meter readings or infrared images from a licensed inspector.

• Repair invoices, receipts for temporary mitigation (e.g., dehumidifiers), and any correspondence with the insurer.

Demand a Written Explanation

Florida Administrative Code Rule 69O-166.024 requires insurers to provide a reasonable explanation of the denial in writing. If the adjuster only gave a verbal reason, demand a formal letter citing specific policy language. File a Complaint with DFS

The Florida Department of Financial Services Consumer Services Division offers a free mediation program for property claims ≤ $500,000 and handles consumer complaints. Submit Form DFS-I0-614 via the DFS Consumer Assistance Portal. DFS will contact your insurer for a response, often expediting resolution. Consider Statutory Mediation

Under Florida Statutes § 627.7015, residential property claims disputes qualify for DFS-sponsored mediation before litigation. Insurers must pay the mediator’s fee; you only pay if you cancel late. Mediation is non-binding, but a settlement agreement signed by both parties is enforceable. Invoke Appraisal if Available

If the dispute is solely about the amount of loss, not coverage, your policy may contain an appraisal clause. Each side selects an appraiser; the two appraisers choose an umpire. Be aware appraisal cannot resolve questions of coverage (e.g., whether mold is excluded). Consult a Florida-Licensed Property Insurance Attorney

Florida rules require attorneys to be admitted to The Florida Bar. Many Tampa attorneys take denied-claim cases on contingency, meaning no fees unless they recover money for you.

When to Seek Legal Help in Florida

Red Flags Requiring Prompt Counsel

• The insurer cites complex exclusions, sublimits, or policy endorsements you cannot interpret.

• Your home has significant mold-related health hazards, and remediation quotes exceed your policy’s limit.

• The insurer claims you failed to give prompt notice, yet you discovered the damage only recently.

• You receive a “Reservation of Rights” letter indicating potential coverage issues.

• The insurer lowers its initial estimate after reinspecting the property or sends an engineer report blaming long-term maintenance problems.

An attorney can draft the CRN, negotiate with the insurer, and, if necessary, file suit within Hillsborough County’s 13th Judicial Circuit Court or federal court (Middle District of Florida). Under § 627.428, if you succeed in litigation, the insurer may be required to pay your reasonable attorney’s fees.

Local Resources & Next Steps

DFS-Sponsored Mediation Centers Near Tampa

Mediations are typically held virtually or at regional offices. The closest in-person location is DFS Region 6 in Tampa, serving Hillsborough, Pinellas, and Pasco Counties.

Building Codes & Permits

When repairing mold damage, Tampa homeowners must follow the Florida Building Code – Existing Building and obtain permits from the City of Tampa Construction Services Division. Failure to comply could jeopardize insurance coverage for subsequent claims.

Flood Zones and Supplemental Coverage

Large portions of South Tampa, including Davis Islands and Harbour Island, fall within FEMA Special Flood Hazard Areas (SFHAs). Standard homeowners policies exclude flood losses, so consider a separate National Flood Insurance Program (NFIP) policy to avoid future coverage gaps.

Where to Get Help

Florida Department of Financial Services – Consumer Services Florida Office of Insurance Regulation – Consumer Complaints Hillsborough County Clerk of Court – Small Claims & Circuit Civil

Conclusion

Mold damage can threaten both the structural integrity of your Tampa home and your family’s health. If your property insurance claim has been denied, Florida law offers multiple avenues for relief—statutory mediation, appraisal, CRN filings, and ultimately litigation. Acting quickly, keeping meticulous records, and leveraging the resources provided by the Florida Department of Financial Services can level the playing field against large insurance carriers. Remember, strict timelines apply, and professional guidance often makes the difference between an unpaid denial and a fair settlement.

Legal Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Consult a licensed Florida attorney regarding your specific situation.

If your property insurance claim was denied, call Louis Law Group at 833-657-4812 for a free case evaluation and policy review.