Detailed Answer
Short answer: If an insurance company refuses to increase its final offer in Florida, you have options: negotiate further, use contract-built procedures (like appraisal or arbitration), file a complaint with regulators, or sue for breach of contract and, in some cases, pursue a bad-faith claim. Which path fits depends on your policy language, the size and type of the claim, and whether the insurer acted reasonably.
1. Read your policy and any “appraisal” or dispute clauses
Your insurance policy is a contract. Many property and homeowner policies include an appraisal clause or an alternative-dispute clause that requires appraisal or arbitration before you can sue. If your policy contains an appraisal clause, it can require each side to select an appraiser and, if those appraisers disagree, to appoint an umpire. That procedure can force a new valuation without immediate litigation. Check the exact wording and deadlines in your policy before rejecting an insurer’s final offer.
2. Try one more structured negotiation: demand letter and documentation
Before filing a claim or a lawsuit, send a clear written demand that documents the full basis for the higher amount (photos, repair estimates, medical records, invoices, and a calculation of damages). A well-documented demand can sometimes prompt the insurer to re-evaluate. Note any policy provisions, estimates from licensed contractors, and supporting evidence that show the insurer’s offer was too low.
3. Use administrative remedies: file a complaint with Florida regulators
If you believe the insurer is engaging in unfair claim settlement practices or refusing to pay fairly, you may file a complaint with state regulators. Two primary agencies are the Florida Department of Financial Services (DFS) and the Office of Insurance Regulation (OIR). Regulators can investigate patterns of misconduct and sometimes intervene. For background on statutory rules governing insurer claim practices and administrative remedies, see Florida law such as Fla. Stat. § 627.428 (claims practices) and Fla. Stat. § 624.155 (administrative civil remedy procedures):
- Fla. Stat. § 627.428 — Insurer claim-handling and payment rules
- Fla. Stat. § 624.155 — Administrative civil remedy notice provisions
4. Consider appraisal, mediation, or arbitration
Many policies require appraisal for disputes about the amount of loss. Even when not required, the insurer may agree to mediation or arbitration. These alternative dispute resolution (ADR) methods are usually faster and less expensive than trial. If the insurer refuses ADR, that refusal may be relevant later in court as evidence of unreasonable behavior, depending on the facts.
5. File a lawsuit—breach of contract and possible bad-faith claims
If other steps fail, you can usually file a civil suit in Florida. Common claims include breach of contract (seeking the policy benefits you claim) and, in some cases, an action for insurer bad faith. Florida recognizes remedies when an insurer unreasonably refuses to pay a valid claim or intentionally mishandles a claim, but bad-faith claims involve a higher legal standard and depend heavily on the insurer’s conduct and the evidence.
Practical consequences if the case goes to court:
- You can ask the court to order the insurer to pay the policy benefits you claim.
- You may seek attorney’s fees and costs if applicable under contract or statute, or if the court finds certain misconduct.
- In extreme cases of intentional or reckless misconduct, additional damages (including punitive damages) may be considered, but these are rarely awarded and require strong proof.
6. Small claims and timing
If your claim amount fits the county/court small-claims limit in Florida, small-claims court can be a cost-effective option. Small-claims procedures are faster and simpler, but limits vary and you should confirm the current limit for your county before proceeding.
7. Preserve evidence and communications
Keep all emails, letters, notes of phone calls (date, time, who you spoke with), photographs, receipts, and estimates. Preserve your claim file and any documents the insurer sends you. This evidence is critical if you pursue appraisal, mediation, a regulatory complaint, or litigation.
When an insurer’s final offer is truly final
Some insurers will say an offer is “final.” That statement does not necessarily eliminate your legal rights. If they refuse to budge and you have documentation showing the offer is unreasonably low, you may pursue appraisal, regulatory complaint, or a lawsuit. However, weigh cost, time, and likely recovery before pursuing litigation—sometimes negotiating down the line or using ADR yields quicker results.
How courts treat refusals to increase offers
Florida courts look at whether the insurer investigated the claim, communicated reasonably, relied on a legitimate basis for denial or low payment, and complied with policy terms and applicable statutes. If a court finds the insurer unreasonably refused to pay, the insured can recover policy benefits and potentially additional relief. Each case turns on its facts.
Bottom line: Don’t accept a final offer without checking your policy, collecting supporting evidence, and exploring appraisal or ADR. If the insurer still refuses and you have a strong factual and legal basis, you can escalate to regulators or the courts. The best path depends on the policy wording, the size of the claim, and the strength of your documentation.
Disclaimer: This article is for general information only and is not legal advice. It does not create an attorney-client relationship. For advice about your specific situation, consult a licensed Florida attorney.
Helpful Hints
- Immediately review your insurance policy, focusing on appraisal, arbitration, suit limitations, and proof-of-loss deadlines.
- Document everything: photos, repair estimates, medical records, invoices, and written communications with the insurer.
- Send a written demand that itemizes damages and attaches supporting documents before filing suit.
- If your policy has an appraisal clause, follow it. Appraisal can resolve value disputes without a lawsuit.
- Consider mediation or arbitration to save time and costs compared with full litigation.
- File a complaint with the Florida Department of Financial Services or Office of Insurance Regulation if you suspect unfair claim handling.
- Check small-claims limits in your county as a possible quick option for lower-value claims.
- Preserve all records and avoid deleting messages or documents related to the claim.
- If you plan to sue, talk with a Florida-licensed attorney to understand deadlines (statutes of limitation) and likely remedies.