Property Insurance Claim Denial Guide – Deerfield Beach FL

Introduction: Why Mold Damage Claims Matter in Deerfield Beach

If you own a home in Deerfield Beach, Florida, you already know why mold is more than an eyesore. Average annual humidity over 75%, frequent summer thunderstorms, and the city’s proximity to the Atlantic Ocean create ideal conditions for fungal growth. According to the Florida Climate Center, Broward County typically records more than 130 days of precipitation per year, and Deerfield Beach’s older housing stock near the Intracoastal Waterway is especially vulnerable to moisture intrusion. Unsurprisingly, mold-related property insurance claims have risen in the area. Yet insurers often deny or underpay those claims, citing policy exclusions, late reporting, or allegations of pre-existing damage. This guide explains—step by step—how Deerfield Beach homeowners can protect themselves when a property insurance claim for mold damage is denied.

The information draws exclusively from authoritative sources: the Florida Statutes, Florida Administrative Code, Florida Department of Financial Services (DFS) materials, and published decisions from Florida courts. While the guide slightly favors policyholders, it remains strictly factual so you can make informed decisions about next steps.

Understanding Your Rights in Florida

Key Policyholder Protections

• Prompt Pay Requirements – Under Fla. Stat. § 627.70131(5)(a), insurers must pay undisputed amounts within 90 days of receiving notice of a claim unless the failure to pay is caused by factors beyond the insurer’s control.

• Fair Claim Handling – Sections 624.155 and 626.9541 create a private right of action for “bad-faith” conduct and prohibit unfair claim settlement practices, such as misrepresenting policy provisions or failing to conduct a reasonable investigation.

• Right to Appraisal – Many Florida policies include an appraisal clause, allowing either side to demand a neutral valuation when there is a dispute over the amount of loss (not coverage).

• Statute of Limitations – Contract lawsuits for property insurance disputes in Florida generally must be filed within five years of the date the insurer breaches the policy (Fla. Stat. § 95.11(2)(e)).

Mold-Specific Coverage Issues

Florida does not require homeowners policies to cover mold damage unconditionally. Most policies contain a microbial or mold exclusion but then add back limited coverage via an endorsement—often capped at $10,000. Under Fla. Admin. Code r. 69O-170.0155, insurers must offer at least $10,000 in additional mold coverage, but policyholders may purchase higher limits.

The Burden of Proof

Once you submit a claim, you bear the initial burden to show that a covered peril caused the loss (Citizens Prop. Ins. Corp. v. Munoz, 158 So. 3d 671, Fla. 2d DCA 2014). If you clear that hurdle, the burden shifts to the insurer to prove that an exclusion applies. Understanding this burden allocation can guide how you present evidence such as moisture readings, laboratory reports, and contractor estimates.

Common Reasons Property Insurance Companies Deny Mold Claims in Florida

Water Damage Not Caused by a Covered Peril

  Insurers often argue that the moisture source was *maintenance-related* (e.g., long-term plumbing leaks), not sudden and accidental.

Failure to Mitigate

  Policies typically require homeowners to take “reasonable measures” to prevent further damage. Waiting weeks to dry-out saturated drywall can prompt a denial.

Late Notice

  For hurricane or windstorm losses, *Fla. Stat. § 627.70132* imposes a *one-year* deadline for initial notice. Although mold claims may arise months later, insurers may assert that the underlying water loss was reported too late.

Mold Sublimit Exhausted

  Even when coverage exists, the insurer may claim your damages exceed the sublimit and deny additional payment.

Exclusion for Microbial Growth

  Some exclusions remove coverage for “fungus, mildew, or rot” unless caused by a *specified peril.*

Understanding the exact reason for denial is critical. Florida Administrative Code Rule 69O-166.024 requires insurers to provide a written explanation referencing specific policy provisions.

Florida Legal Protections & Regulations

Statutory Framework

• Florida Statutes Chapter 627 – Governs homeowners insurance policies, including cancellation, non-renewal, and claim handling.

• Florida Insurance Code Violations – Fla. Stat. § 626.9541(1)(i) lists unfair claim practices such as “failing to adopt and implement standards for the proper investigation of claims.”

• Civil Remedy Notice – Under Fla. Stat. § 624.155(3), a policyholder must file a Civil Remedy Notice (CRN) with DFS and give the insurer 60 days to cure the alleged bad faith before filing suit.

• Attorney Fee Shifting – If you prevail on at least one coverage count, Fla. Stat. § 627.428 entitles you to reasonable attorney’s fees.

Relevant Administrative Rules

Rule 69O-166.024, Florida Administrative Code, obligates insurers to meet “time requirements for claims handling” and maintain claim files containing all documents “sufficient to reconstruct the insurer’s activities.” Failure can support a DFS complaint or evidence of bad faith.

Recent Florida Court Decisions on Mold Claims

• Mezadieu v. Safepoint Ins. Co., 315 So. 3d 26 (Fla. 4th DCA 2021) – The Fourth District (which covers Broward County) held that insurers bear the burden to prove mold exclusions when the policyholder establishes a covered water peril initiated the loss.

• Homeowners Choice Prop. & Cas. Ins. Co. v. Maspons, 211 So. 3d 1067 (Fla. 3d DCA 2017) – Clarified that “opening an HVAC system” to access mold remediation counts as a covered cost when necessary to repair a covered water loss.

Steps to Take After a Denial in Florida

1. Review the Denial Letter and Policy

Look for citations to specific policy provisions and the date of denial. Under Fla. Stat. § 626.9541(1)(i)3.f, insurers must provide a “reasonable explanation” in writing.

2. Collect & Preserve Evidence

• Photos/videos of mold growth and moisture intrusion.

• Moisture meter readings, infrared imaging reports.

• Licensed mold assessor or industrial hygienist lab results.

• Invoices for emergency dry-out or remediation services.

3. Demand a Certified Copy of Your Policy

Florida law permits you to request one free certified copy per year. Having the entire policy—including endorsements—lets you verify coverage and sublimits.

4. File a Supplemental Claim or Re-Open the Claim

Under most policies, you can submit additional documentation and request reconsideration. If you are within the one-year notice period for hurricane-related losses (§ 627.70132), do so promptly.

5. Utilize the Florida DFS Mediation Program

The Florida Department of Financial Services offers free, non-binding mediation for residential property insurance disputes under Fla. Stat. § 627.7015. Either party may request mediation after filing the claim but before litigation. To initiate, call DFS Consumer Services at 1-877-693-5236 or complete the online form at the DFS website.

6. Consider Appraisal

If the dispute is solely about the amount of loss—not coverage—invoke the appraisal clause. Each side selects an appraiser; the two appraisers pick an umpire. The process can resolve many valuation disputes without litigation.

7. File a Formal Complaint with DFS

If you believe the insurer violated Florida’s Insurance Code, file a complaint through the DFS Consumer Services portal. DFS will assign an analyst and require the insurer to respond in writing within 20 days.

8. Consult a Licensed Florida Attorney

When coverage is at issue or bad faith is suspected, legal counsel can help draft a Civil Remedy Notice, engage experts, or file suit within statutory deadlines.

When to Seek Legal Help in Florida

Although many disputes resolve through supplemental claims or mediation, certain red flags suggest it is time to contact a Florida attorney who focuses on property insurance:

• The insurer alleges fraud or misrepresentation.

• Significant structural damage requires extensive demolition.

• The denial references complex exclusions (e.g., concurrent causation, enforcement of building codes) beyond mold sublimits.

• Your contractor’s estimate far exceeds the insurer’s.

• The 60-day window before filing a lawsuit is approaching.

Florida attorneys must be licensed by The Florida Bar and comply with Rule 4-1.5 regarding contingency fees in property damage cases. Many firms, such as Louis Law Group, offer free consultations and handle cases on a contingency fee basis, meaning no fees unless you recover.

Local Resources & Next Steps

Deerfield Beach Building Codes

The City of Deerfield Beach enforces the Florida Building Code, which requires mold-resistant materials in certain applications. Obtaining a permit before major remediation can support your claim by demonstrating compliance.

Broward County Environmental Resources

Broward County’s Environmental & Consumer Protection Division provides guidance on indoor air quality and mold. Documentation from a county inspection can bolster your evidence that mold conditions were unsafe.

Flood Zones & Insurance Considerations

Many Deerfield Beach neighborhoods—including The Cove and areas east of U.S. Highway 1—lie in FEMA Special Flood Hazard Areas (Zones AE and VE). Mold that results solely from flooding is generally excluded under homeowners policies but may be covered under a separate National Flood Insurance Program (NFIP) policy.

Contact Points

• Florida DFS Consumer Services – 1-877-693-5236

• City of Deerfield Beach Building Division – 954-480-4250

• Broward County Environmental Complaint Line – 954-519-1499

Authoritative External Links

Florida DFS Consumer Assistance & Mediation Florida Statutes – Official Online Sunshine Portal Florida Administrative Code – Full Text of Rules Florida Supreme Court Opinions

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. Laws and regulations change. Consult a licensed Florida attorney for advice 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.