If Your Florida Carrier Wrote an Estimate, You Can Get a Copy

If the adjuster handling your claim generated a detailed estimate, yes. Florida Statutes section 627.70131(3)(e) requires your carrier to send you a copy of any detailed estimate of the amount of the loss within 7 days after that estimate is generated. The duty attaches to an estimate that already exists. It is not a duty to produce one on demand.

That distinction is the whole post. The paragraph closes with a sentence most summaries leave out: this paragraph does not require that an insurer create a detailed estimate of the amount of the loss if such estimate is not reasonably necessary as part of the claim investigation. So a request can be answered, lawfully, with the reply that no detailed estimate was ever generated.

One thing this post is not: legal or insurance advice. Restoration Doctor is a restoration contractor, not a public adjuster and not a law firm. What follows is the text of Florida's claim-handling statute and what a written request contains. What your own policy covers, excludes or requires of you is a question for your declarations page, your agent, a licensed public adjuster, or an attorney.

Read the paragraph in two halves. The first half is the duty: the insurer must send the policyholder a copy of any detailed estimate of the amount of the loss within 7 days after the estimate is generated by an insurer's adjuster. Four words in that sentence carry most of the weight.

The second half is the limit, and it sits in the same paragraph: the statute does not require an insurer to create a detailed estimate where such an estimate is not reasonably necessary as part of the claim investigation. On a small single-room loss that a carrier resolves from photographs, an honest answer to your request may be that no detailed estimate exists. That answer is not evasion and it is not a violation, and any post that tells you otherwise is setting you up for an argument you cannot win.

There is a second, quieter limit. For purposes of that section the statute defines insurer to mean any residential property insurer. The 60-day pay-or-deny subsection then reaches further, by redefining claim for its own purposes to include a commercial property policy where the insured structure is 10,000 square feet or less, and contents coverage under a commercial tenant policy of the same size. Subsection (7)(c) then removes claims under a policy covering nonresidential commercial structures or contents in more than one state. Which of those a given claim sits under is a reading of the policy, so take it to your agent, a licensed public adjuster, or an attorney rather than assuming every row below applies.

This is the sentence that makes a copy worth having. Section 627.70131(7)(a) says that if the insurer's claim payment is less than specified in any insurer's detailed estimate of the amount of the loss, the insurer must provide a reasonable explanation in writing of the difference to the policyholder.

Read in order, the two paragraphs do something useful. One gives you the carrier's own number. The other requires the carrier to put a reasonable explanation of the difference in writing. A difference you can see is a difference somebody has to explain in writing.

The same subsection sets the outer clock. Within 60 days after receiving notice of an initial, reopened or supplemental property insurance claim, the insurer shall pay or deny the claim or a portion of it, unless the failure to pay is caused by factors beyond the control of the insurer. A payment made after that bears interest at the rate set forth in section 55.03, accruing from the date the insurer received notice of the claim.

Section 627.70131 is mostly a list of deadlines, and reading them together tells you where in the process a claim actually sits. The table quotes the operative words rather than paraphrasing them, because the words are what an adjuster answers to. A proof of loss is the statement of the loss a property policy typically calls for, and several of the carrier's deadlines run from the day it is received. Subsection (1)(c) adds a limit worth knowing: the acknowledgment subsection does not apply to claimants represented by counsel, beyond the communications needed to provide forms and instructions.

Two of those rows are yours rather than the carrier's. Notice of a claim or a reopened claim is barred unless it was given to the insurer in accordance with the terms of the policy within 1 year after the date of loss. A supplemental claim is barred after 18 months on the same terms. A supplemental claim, in the statute's own definition, is a claim for additional loss or damage from the same peril the insurer has previously adjusted, or for which costs were incurred while completing repairs under an open claim.

For a loss from a hurricane, tornado, windstorm, severe rain or another weather event, the statute sets the date of loss as the date the hurricane made landfall or the date the National Oceanic and Atmospheric Administration verifies the event. When that date falls on any particular file is a reading of the policy and the record, so take it to your agent, a licensed public adjuster, or an attorney.

One, and it is the one nobody mentions. The statute uses the word toll, which here means pause: the deadlines stop running and start again later. The requirements of the section toll upon the failure of a policyholder or a representative to provide material claims information requested by the insurer within 10 days after the request was received. The tolling period ends upon the insurer's receipt of the requested information. An unopened message from the carrier is the cheapest way to lose the 60-day clock you were counting on.

The precondition is in the next sentence, and it cuts the other way. Tolling under that paragraph applies only to requests the insurer sent at least 15 days before the insurer is required to pay or deny the claim, or a portion of it, under subsection (7). A request that lands inside that window does not toll anything, whatever a later letter says about it.

The clocks also toll during the pendency of any mediation proceeding under section 627.7015, or any alternative dispute resolution proceeding provided for in the insurance contract, and that tolling ends when the proceeding does. Worth knowing before a request for mediation goes in and the 60 days appears to stop moving.

There is no statutory request form, and nothing in section 627.70131 conditions the carrier's duty on your asking. A written request does two other things. It creates a date, and it names documents by the description the statute already uses, which is harder to answer vaguely than a request to send everything.

The statute itself sets out what the carrier is keeping. Under subsection (4) the insurer maintains claim records, with dates, of each of the following. Asking for them this way is asking for a document the carrier already files under those words.

Two habits make the answer usable. Send the request in writing, so the 7-day acknowledgment duty has a dated thing to attach to, and keep your own copy of what went out. And an information request from the carrier that gets answered inside 10 days is a tolling period that never starts.

Two expectations are worth setting first. Nothing in section 627.70131 says what a detailed estimate must contain, and nothing in it promises that any particular line will appear, be priced a particular way, or be visible at all. The statute gives you the document, not its contents.

What the statute does require is a label. A preliminary or partial estimate has to arrive with a statement in at least 12-point bold, uppercase type saying that the estimate represents the carrier's current evaluation of the covered damages and may be revised as it continues to evaluate the claim. A payment that is not the full and final payment carries its own version of that statement.

Both labels are useful to somebody who has been told a number is final. When the file involved a physical inspection, the assigned adjuster has to give you a printed or electronic document with his or her name and state adjuster license number. Later claim communications have to carry the name and license number of the adjuster writing to you.

Honest reading matters more here than a strong headline. The subsection says that failure to comply constitutes a violation of this code. The next sentence says that failure to comply does not form the sole basis for a private cause of action. A missed deadline is a regulatory matter and an interest question, not a lawsuit standing on its own.

What it does build is a record. Dated requests, a dated non-answer and a deadline printed in a public statute are the kind of file a state insurance specialist can read quickly. Florida's Department of Financial Services asks consumers to contact the insurance company first and allow it the opportunity to resolve the issue, adding that most issues can be resolved within 30 days. A concern then goes through the department's Consumer Assistance Portal, where it is assigned to an insurance specialist.

Where the disagreement is about the amount of the loss rather than a missed date, the routes are different, and they belong to people licensed to walk them. Read your own policy's dispute provisions, then take the question to your agent, a licensed public adjuster, or an attorney.

Statutes change. Every sentence above traces to one of the primary sources below, published on the Legislature's own site, so the words are available to you rather than a summary of them.

One more thing worth saying plainly. Restoration Doctor of Miami is a water damage mitigation company, not a public adjuster. We do not prepare, file, negotiate, or settle claims, and we do not interpret policy coverage. Coverage decisions are made solely by your carrier. You are responsible for your deductible.

What we do instead is document the work and price it in line item detail. Under section 489.147(2)(e) a Florida contractor may not give an insured an agreement authorizing repairs on a property insurance claim without also giving a good faith estimate of the itemized and detailed cost of services and materials. The same paragraph adds that the actual cost may differ from that estimate once the insurer adjusts the claim. Your carrier's estimate and your contractor's estimate are two separate documents. Reading them side by side is the point of asking for the first one. We invoice the property owner, the owner owes that invoice in full for the work performed, and any reimbursement is between the owner and the carrier.