165 DOCUMENTS · FLORIDA AND SOUTH CAROLINA
Denials in the public file.
Real denial language, in the words the insurer or the policyholder actually used. Each document is labeled by what it is: the denial letter itself in a court exhibit, a court filing or appellate opinion quoting one, a Civil Remedy Notice filed with Florida DFS, a consumer complaint, or news reporting. Every quoted passage links to its source.
UPDATED AUG 2026165 DOCUMENTS ON FILE EVERY SOURCE CITED
REPRESENTATIVE FOOTAGE · THE DOCUMENTS BELOW ARE REAL
What do Florida and South Carolina insurance denials actually say?
Most run the same few arguments: the damage is wear and tear rather than wind, the loss falls below the hurricane deductible, the damage is cosmetic, or a water or fungi exclusion applies. This archive collects public documents where that language appears, court exhibits and opinions, regulator filings, consumer complaints and news reports, each labeled by what the document is.
| Entries on file | 165 public documents; 7 are a denial letter itself, 90 quote one inside a court filing |
|---|---|
| What the rest are | 35 Civil Remedy Notices filed by policyholders, 15 consumer complaints, 11 appellate opinions, 7 news reports |
| Most common argument | Wear and tear, then below deductible: the two moves in most Florida roof denials |
| Milton closures | 34.8% of 385,146 claims closed without payment; below deductible was the top reason at 38.5% (FLOIR) |
| The legal floor | FL denials must state the policy basis in writing within 60 days, Fla. Stat. 627.70131 |
| What answers a letter | A better-documented file: dated photos, storm data, an independent estimate |
UPDATED AUGUST 21, 2026
HOW THIS LIBRARY WORKS
- • Public documents in which a Florida or South Carolina insurer's denial language appears. 7 are the denial letter itself, complete in a court exhibit; 90 more are quoted inside a court filing.
- • 35 are Civil Remedy Notices, which a policyholder files against an insurer with Florida DFS. Every one is published with the insurer's own written response alongside it.
- • 11 are appellate opinions: who, what, where, when, why, and what the court held.
- • 15 are complaints policyholders posted publicly and 7 are news reports. Each says on its own page which it is.
- • Every quoted passage is checked by script against the source document before it publishes. An entry that does not match is held back and does not appear here.
- • These are the individual documents. The 12 arguments behind them, across 1,891 filings, are on the arguments page.
01WHAT THESE DOCUMENTS ARE
Every entry is labeled by the kind of document it is. Pick a type to show only those.
02THE ARGUMENTS ON FILE
03THE DOCUMENTS · CITED, CHECKED AND DECODED
The documents, by argument
Grouped by the primary argument each denial runs. Court records lead each group, then regulator filings, press, and consumer reports.
WEAR & TEAR · 59 ON FILE
The counter-guide → DENIAL LETTER SC
State Farm: Helene did not damage this roof, and the rot and mold are excluded
HURRICANE HELENE (2024) WEAR & TEAR MOLD & FUNGI SEEPAGE OTHER
“Based upon the results of our discussions, site inspection, and investigation, it was determined there was no storm damage to the roof and no coverage for rotted wood and mold. Damage resulting from this cause of loss is not covered by your policy.”
Aiken Blvd LLC v. State Farm Fire and Casualty Company, No. 2025CP0202475 (S.C. Ct. Common Pleas, Aiken County), removed to No. 1:25-cv-13076-JFA (D.S.C.), Entry 1-1, Exhibit 4 at 72 to 75 of 89.
DENIAL LETTER FL
Liberty Mutual: a $193,623 estimate answered with a $2,687 valuation and a zero-dollar check
HURRICANE MILTON (2024) WEAR & TEAR BELOW DEDUCTIBLE UNDERPAID SEEPAGE
“The roof tiles were not damaged by wind or wind-borne debris associated with Hurricane Milton. The causes of damage to the roof tiles were slippage due to gravity, age-related deterioration, construction deficiency, and/or foot traffic. No coverage is afforded for the repair or replacement of the roof system.”
Andersen v. Liberty Mutual Fire Ins. Co., No. 6:25-cv-01479-JSS-NWH (M.D. Fla.), Doc. 1-1, Exhibit C at 106 to 108 of 314. Removed from Fla. 9th Jud. Cir. (Orange County), filing no. 226519797.
APPELLATE OPINION FL
Citizens: Irma roof claim, wear and tear finding affirmed on appeal
HURRICANE IRMA (2017) WEAR & TEAR PRE-EXISTING
“Citizens' inspection concluded the interior water damage occurred as a result of wear and tear, and deterioration of the roof materials.”
Full Pro Restoration a/a/o Fernandez v. Citizens Prop. Ins. Corp., No. 3D21-2312 (Fla. 3d DCA Mar. 15, 2023)
APPELLATE OPINION FL
Security First: denied for wear and tear, then won on a late-notice defense the letter never mentioned
HURRICANE IRMA (2017) WEAR & TEAR LATE NOTICE
“Security denied the claim, explaining that the policy excluded coverage because the damages resulted from wear and tear, not Hurricane Irma. The coverage letter did not cite untimely notice of loss as a basis for the denial.”
Security First Ins. Co. v. Visca, No. 4D2023-0435 (Fla. 4th DCA June 5, 2024)
REGULATOR COMPLAINT FL
People's Trust: Helene shed, siding, and downspout written off as wear
HURRICANE HELENE (2024) WEAR & TEAR
“According to the claims determination letter, the Insurer's field adjuster observed damage to the shed, siding, and downspout, but attributed the cause of this damage to wear and tear.”
Fla. DFS Civil Remedy Notice, Filing No. 793169 (Dirling v. People's Trust), Pinellas Park, FL
REGULATOR COMPLAINT FL
Slide: a $131,075 claim claim file withheld
HURRICANE HELENE (2024) WEAR & TEAR OTHER LATE NOTICE
“On or about October 14, 2024, the Public Adjuster prepared an estimate for repairs totaling $47,921.06 and forwarded same to Slide.”
Fla. DFS Civil Remedy Notice, Filing No. 808838 (Tampa), accepted 2/27/2025
REGULATOR COMPLAINT FL
Tower Hill Signature: roof denied, then a $14,195 roofer quote nobody confirmed would do the work
HURRICANE IAN (2022) WEAR & TEAR UNDERPAID
“The Insurer responded with an initial coverage determination accepting coverage for minimal interior work and the capped screen enclosure, but denying coverage for the roofing system despite widespread damage. A revised coverage determination was rendered on or about March 7, 2023, wherein the Insurer provided a bottom-dollar quote from a roofer totaling $14,195.00 for roof replacement, without confirming whether the roofer would actually do the work.”
Fla. DFS Civil Remedy Notice, Filing No. 686494 (Wallace v. Tower Hill Signature)
REGULATOR COMPLAINT FL
Kin: Ian damage attributed to age, thermal movement, and foot traffic
HURRICANE IAN (2022) WEAR & TEAR PRE-EXISTING
“The Insurer denied coverage based on the rationale that the damage sustained was a result of age-related wear, thermal expansion/contraction, foot traffic, and installation/maintenance deficiencies damages.”
Fla. DFS Civil Remedy Notice, Filing No. 794720 (Williams v. Kin Interinsurance), Brandon, FL
LETTER IN A COURT FILING FL
Castle Key: blistering, and half-inch hail said to be too small
WEAR & TEAR COSMETIC
“we're unable to provide payment for the claim because: the anomalies on the shingle are the result of blistering and age-related wear and tear. Storm data for the date of loss show maximum size .5-inch hail which would not have caused damage to the shingles.”
Florida DFS Civil Remedy Notice, filing no. 804111, accepted 1/29/2025, Saint Johns. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where following its inspection, Castle Key denied the claim and noted.
LETTER IN A COURT FILING FL
Frontline: no wind or hail observed, the tile cracks blamed on installation and foot traffic
WEAR & TEAR PRE-EXISTING
“The inspection revealed no wind, hail, or weather-related damage was observed on the roof. The cracks and displacement of the roof's tiles are the result of a combination of improper installation, foot traffic/work, and age-related deterioration (wear and tear). The staining on the guest bathroom and front porch ceiling is the result of long-term roof leakage due to inadequate flashing installation.”
Florida DFS Civil Remedy Notice, filing no. 786715, accepted 10/14/2024, Port St. Lucie. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where FRONTLINE submitted a Denial Letter to the policyholders on June 18, 2024.
LETTER IN A COURT FILING FL
People's Trust: faulty workmanship outside, pre-existing inside
WEAR & TEAR PRE-EXISTING
“[s]pecifically, but without limitation, the damage to your property is due to faulty, inadequate or defective workmanship, maintenance and wear and tear,”
Florida DFS Civil Remedy Notice, filing no. 785477, accepted 10/2/2024. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter explained the damages found, the facts provided, and the pertinent provisions and coverages of the policy.
LETTER IN A COURT FILING FL
SafePoint: the four-exclusion roof denial, sent two months after the inspection
WEAR & TEAR SEEPAGE
“Unfortunately, your policy does not cover damage to your property's exterior, roofing system, and/or other structure(s) caused by wear and tear, age-related damage, deterioration, faulty or inadequate workmanship, repair, and or maintenance. Additionally, your policy does not provide coverage for damages attributed to constant or repeated seepage or leakage of water.”
Florida DFS Civil Remedy Notice, filing no. 787510, accepted 10/18/2024, Apopka. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where a field adjuster went to the home and the denial letter was sent two months after the inspection.
LETTER IN A COURT FILING FL
TypTap: the two-sentence denial
WEAR & TEAR
“We have determined that this loss was caused by wear and tear. The policy does not cover damages that are not from a covered peril.”
Florida DFS Civil Remedy Notice, filing no. 804984, accepted 2/4/2025, Boca Raton. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where by letter dated September 25, 2023 the insurer notified the insured that it was denying coverage for the loss.
LETTER IN A COURT FILING FL
Universal Property: roof and ceiling attributed to wear, tear and inadequate maintenance
WEAR & TEAR
“Universal has been investigating your property damage claim since it was reported on January 12, 2024. During our investigation, it was concluded that the claimed damage to the roofing system covering the dwelling and the interior ceiling conditions reported as related to the loss are due to wear, tear and deterioration, and/or inadequate maintenance. Pursuant to the applicable Policy, the claimed roof damage is not covered.”
Florida DFS Civil Remedy Notice, filing no. 786380, accepted 10/10/2024, Orlando. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where on February 6, 2024 the insurer issued a denial letter.
LETTER IN A COURT FILING FL
Castle Key: no sudden and accidental damage, on the roof, the gutters and the AC fins
WEAR & TEAR PRE-EXISTING
“Our inspection found that the roof shingles do not have any sudden and accidental damages but instead show signs of wear and tear and aging. We can also see that the gutters have unrelated damage and prior repair attempts to these sections. Lastly, the AC fins appear to also have unrelated damage that is not from a sudden and accidental loss covered on this policy.”
Florida DFS Civil Remedy Notice, filing no. 793875, accepted 11/22/2024, Fort Pierce. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where in correspondence dated October 17, 2024 the insurer determined.
LETTER IN A COURT FILING FL
Frontline: seven exclusions recited, then the sentence that closes the claim
WEAR & TEAR
“Your Homeowner's Pol-icy does not provide coverage for wear and tear, deterioration, corrosion, settling, shrinking, or expansion, maintenance and mechanical damage. As such, based upon the terms and conditions of your insurance policy, Frontline must respectfully deny your claim.”
Florida DFS Civil Remedy Notice, filing no. 802564, accepted 1/21/2025, Palm Bay. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where on June 20, 2024 the insurer sent a coverage determination letter denying the claim.
LETTER IN A COURT FILING FL
Heritage: an Ian claim closed on wear and tear, faulty construction and maintenance
WEAR & TEAR PRE-EXISTING
“because the observed condition of your property was due to wear and tear, faulty construction or workmanship, and inadequate maintenance, we are unable to cover the claim.”
Florida DFS Civil Remedy Notice, filing no. 796845, accepted 12/13/2024, Sarasota. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer issued correspondence to the insured on September 25, 2024 denying the damage.
LETTER IN A COURT FILING FL
Heritage: 43 creased shingle tabs counted, then denied on the wrong date of loss
WEAR & TEAR LATE NOTICE
“However, the damages reported are not covered due to the incorrect date of loss and the nature of the damages being attributed to wear and tear and deterioration, which are specifically excluded under your policy.”
Florida DFS Civil Remedy Notice, filing no. 810053, accepted 3/7/2025, Palm Harbor. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the same letter records 18 creased tabs on the front slopes and 25 on the rear slopes, and continues.
LETTER IN A COURT FILING FL
Nationwide: heat blisters, and creased shingles assigned to a different storm
WEAR & TEAR PRE-EXISTING
“Our review showed that the roof covering condition is due to wear and tear and deterioration in the form of heat blisters. The creased field shingles occurred from a different date of loss than what was being claimed. Accordingly, we respectfully deny coverage for the portion of your claim for wear and tear.”
Florida DFS Civil Remedy Notice, filing no. 803075, accepted 1/23/2025, Ocoee. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where within the denial letter the insurer included the following statement.
LETTER IN A COURT FILING FL
State Farm Florida: damage spread across multiple storms, so attributed to none
WEAR & TEAR PRE-EXISTING
“Based upon the results of our discussions, site inspection, and the investigation, it was determined that there was no covered accidental direct physical loss to the insured property.”
Florida DFS Civil Remedy Notice, filing no. 801869, accepted 1/17/2025, Miami Lakes. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the claim was denied by letter dated April 8, 2024, the same day the adjuster inspected and observed long-term damages.
LETTER IN A COURT FILING FL
State Farm Florida: no wind or hail tied to the storm date, the roof called cumulative
WEAR & TEAR
“[based] upon the results of our discussions, site inspection and investigation, it was determined there was no wind or hail to the roof or exterior of your home related to the weather event on April 27, 2023. The overall condition of your roof is consistent with progressive and cumulative wear, tear, deterioration, and weathering over time. Damage resulting from these cases of loss are not covered by your policy.”
Florida DFS Civil Remedy Notice, filing no. 801513, accepted 1/16/2025, Jacksonville. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where State Farm issued its coverage determination letter to its insured on March 29, 2024.
LETTER IN A COURT FILING FL
Universal Property: no covered wind damage found, the rest called long-term
WEAR & TEAR
“found no evidence of covered wind damage to the roof and that which was observed is attributed to long term wear and tear, deterioration, and mechanical breakdown.”
Florida DFS Civil Remedy Notice, filing no. 790147, accepted 11/4/2024, Orlando. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the denial came in Universal's letter dated February 8, 2022, resting on the field adjuster's finding.
LETTER IN A COURT FILING FL
Foremost: the roof is letting rain in, and that is the reason for refusing to pay
WEAR & TEAR
“wear and tear to the roof which is allowing rain to leak in.”
Florida DFS Civil Remedy Notice, filing no. 794277, accepted 11/26/2024, Orlando. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer based the denial on the rationale that the damage sustained was a result of this.
LETTER IN A COURT FILING FL
Garrison: the entire stated reason, in ten words
WEAR & TEAR
“Your policy does not cover wear, tear, marring or deterioration.”
Florida DFS Civil Remedy Notice, filing no. 811263, accepted 3/14/2025, Orlando. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the filing records this as the insurer's sole justification for the denial, a conclusory statement offered without substantive explanation.
LETTER IN A COURT FILING FL
Olympus: a consultant found no storm damage, and the screens blamed on wear
WEAR & TEAR
“no storm related damage was found to the exterior elevations and the screen and down spouts damage is from wear and tear”
Florida DFS Civil Remedy Notice, filing no. 796916, accepted 12/16/2024, Port Saint Lucie. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the determination relies on the findings of a third-party consultant.
LETTER IN A COURT FILING FL
SafePoint: pooling and ponding around the roof drains and scupper vents
WEAR & TEAR PRE-EXISTING
“wear and tear/deterioration, pooling, and ponding to the roof around the roof drains/scupper vents.”
Florida DFS Civil Remedy Notice, filing no. 790385, accepted 11/5/2024, North Palm Beach. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer based the denial on the rationale that the damage sustained was a result of this.
LETTER IN A COURT FILING FL
State Farm Florida: shingles called commensurate with the age of the roof
WEAR & TEAR COSMETIC
“are exhibiting wear, tear, and deterioration, commensurate with the age of the roof, along with blistering and granular loss.”
Florida DFS Civil Remedy Notice, filing no. 809807, accepted 3/6/2025, Riverview. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the claims determination letter additionally claims the insured's shingles.
LETTER IN A COURT FILING FL
Castle Key: the clay tiles slid by gravity, and the claim fell under the deductible
WEAR & TEAR BELOW DEDUCTIBLE
“the claim was partially denied and determined that there were no storm damages to the roof. The clay tiles that have slid down are from install and over time the clay tile has slid due to gravity. The claim was under deductible, and no payment was made.”
Florida DFS Civil Remedy Notice, filing no. 663406, accepted 12/20/2022, Tampa. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the desk adjuster advised this after the public adjuster reported unanswered phone calls.
LETTER IN A COURT FILING FL
Federal: damages observed and noted, and attributed to typical aging
WEAR & TEAR
“typical aging, natural wear and tear, and lack of maintenance.”
Florida DFS Civil Remedy Notice, filing no. 649352, accepted 9/28/2022, Jacksonville. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter dated April 25, 2022 states that although damages were observed and noted, they were caused by this.
LETTER IN A COURT FILING FL
First Community: wind ruled out by an engineering report, in four numbered findings
WEAR & TEAR PRE-EXISTING
“1. Damage to the shingle roofing at the [name redacted] residence as a result of wind-related forces can be ruled out. 2. The shingle roofing at the [name redacted] residence is experiencing normal wear and tear. 3. The cause of damage to the exterior walls of the [name redacted] residence is from ground settlement.”
Florida DFS Civil Remedy Notice, filing no. 672089, accepted 2/3/2023, Kissimmee. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the denial letter cited the conclusions of EFI Global's engineering report.
LETTER IN A COURT FILING FL
Homeowners Choice: no wind or hail damage, the leak assigned to wear
WEAR & TEAR
“there was no wind or hail damage to the roof. The roof has leaked due to wear, tear, and deterioration which are all specifically excluded under the policy.”
Florida DFS Civil Remedy Notice, filing no. 658637, accepted 11/28/2022, Cape Coral. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the same letter accounts for the deductible and recoverable depreciation on the balance of the claim.
LETTER IN A COURT FILING FL
State Farm Florida: no accidental direct physical damage, listed elevation by elevation
WEAR & TEAR PRE-EXISTING
“Thank you for speaking with me on October 17, 2022, when we discussed the damage to your property. Based upon the results of our discussions, site inspection, and investigation, it was determined that there is no accidental direct physical damage to the following sections of the property: left elevation, rear elevation, dwelling”
Florida DFS Civil Remedy Notice, filing no. 659957, accepted 12/6/2022, Largo. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the filing records that the insurer had addressed the same damages in a prior claim reported three months beforehand.
LETTER IN A COURT FILING FL
State Farm Florida: roof damage called consistent with historical weather over time
WEAR & TEAR BELOW DEDUCTIBLE
“normal age wear, tear, defect, and deterioration as consistent with evidence of daily, historical weather elements over time.”
Florida DFS Civil Remedy Notice, filing no. 656367, accepted 11/10/2022, Orlando. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer denied coverage for other damages to the roof caused by excluded perils, after applying the deductible to the balance.
LETTER IN A COURT FILING FL
State Farm Florida: nothing on the roof, long-term leaks and mold inside
WEAR & TEAR MOLD & FUNGI
“Based upon the results of our discussions, site inspection, and investigation, it was determined no storm related damage was observed to the roof or elevations of your home. Therefore, coverage will not be extended for the roof or elevations. Inspection of the interior revealed long term, repeated water leaks and mold.”
Florida DFS Civil Remedy Notice, filing no. 699456, accepted 6/9/2023, Miramar. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the claim determination letter is dated September 21, 2022 and recites the inspection observations.
LETTER IN A COURT FILING FL
State Farm Florida: damage observed, and attributed to sunlight and heat
WEAR & TEAR
“wear, tear, and deterioration from exposure to sunlight, heat, and normal weather conditions over time to the roof and elevations of the home.”
Florida DFS Civil Remedy Notice, filing no. 663386, accepted 12/20/2022, Cape Coral. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer's field adjuster observed damage to the roof and elevations, and attributed the cause of that damage to this.
LETTER IN A COURT FILING FL
United Property: zippering and thermal cracking, called installation and age
WEAR & TEAR PRE-EXISTING
“blistering, thermal cracking, zippering, and loose/unsealed shingles, attributable to mechanical damage, faulty installation and/or materials and wear, tear, and/or deterioration over time.”
Florida DFS Civil Remedy Notice, filing no. 651248, accepted 10/13/2022, Cape Coral. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the claimant was informed there was no wind damage to the roof, but that the roofing system revealed signs of.
LETTER IN A COURT FILING FL
United Property: standing on the partial denial, tile blamed on install and foot traffic
WEAR & TEAR WIND-DRIVEN RAIN
“Based upon the facts revealed during our investigation, the observed damages to the tile roof system are due to wear and tear, installation deficiencies, and foot traffic. The interior damages were not the result of storm-created damages, nor was there a storm created opening found to the roofing sy”
Florida DFS Civil Remedy Notice, filing no. 652135, accepted 10/19/2022, Longwood. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer advised it would be standing on its original partial denial letter.
LETTER IN A COURT FILING FL
USAA: foot fall damage on the tiles, and repairs priced under the deductible
WEAR & TEAR BELOW DEDUCTIBLE
“Additionally, the initial field report has been returned, and at this time the cost of repairs is less than the Insured's deductible. Please find enclosed a copy of our estimate. Also, given that non-covered damages were noted to the roof, specifically mechanical damage to the tiles in the form of foot fall damage, and slippage”
Florida DFS Civil Remedy Notice, filing no. 682593, accepted 3/17/2023, Alva. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter signed by the desk adjuster accompanied the estimate.
LETTER IN A COURT FILING FL
ASI Preferred: granule loss called age, high nailing called the roofer
WEAR & TEAR PRE-EXISTING
“found granule loss and high nailing to the roof. There was no sudden and accidental wind damage observed for your roof. Granule loss is a result of long term wear and tear and high nailing is a result of improper installation. These perils are excluded from coverage in the homeowners policy.”
Florida DFS Civil Remedy Notice, filing no. 660521, accepted 12/8/2022, Parrish. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer's coverage letters stated that it.
LETTER IN A COURT FILING FL
Nationwide: no wind or hail found, and every other defense reserved
WEAR & TEAR
“review showed that there is no evidence of wind or hail damage to your roof. There is evidence of wear, tear, deterioration and rot which is excluded under your policy as outline above. We expressly reserve all other rights, defenses, or contentions, which are available to us under the policy of ins”
Florida DFS Civil Remedy Notice, filing no. 789229, accepted 10/29/2024, Gainesville. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer denied the claim after the insured reported the loss and complied with the adjustment.
LETTER IN A COURT FILING FL
Truck Insurance Exchange: tile corner cracks and chips called slippage, not wind
WEAR & TEAR COSMETIC
“that the tiles on your roof are showing signs of normal wear and tear for a tile roof in the form of corner cracks and chips due to slippage of the tiles, this damage is not caused by wind but rather is wear and tear which is not covered by your policy, therefore, this damage is not included in the”
Florida DFS Civil Remedy Notice, filing no. 686157, accepted 3/31/2023, Fort Myers. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the filing records that the insurer reached this conclusion without retaining anyone capable of formulating opinions on causation.
LETTER IN A COURT FILING FL
United Property: the lanai screens blamed on lichen and vine overgrowth
WEAR & TEAR
“Your roof did show signs of normal blistering and degranulation, all of which is indicative of long-term wear and tear and deterioration and is consistent with the age of your roof. The pool lanai screens appeared to have long-term damage that originated from lichen and plant/vine overgrowth and is”
Florida DFS Civil Remedy Notice, filing no. 676780, accepted 2/21/2023, North Port. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the carrier denied full coverage for the loss and noted this in the denial letter.
LETTER IN A COURT FILING FL
American Integrity: conditions excluded whether observed or not
WEAR & TEAR PRE-EXISTING
“there would be no coverage extended due to wear and tear, marring, deterioration, inherent vice, latent defect, defect, mechanical breakdown and/or improper installation, etc., as it relates to conditions on your roof whether observed or not.”
Florida DFS Civil Remedy Notice, filing no. 654933, accepted 11/1/2022, Cape Coral. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer set this out in a letter dated April 6, 2022 after investigating the roof system.
LETTER IN A COURT FILING FL
American Integrity: the same whether-observed-or-not paragraph, a second claim
WEAR & TEAR PRE-EXISTING
“there would be no coverage afforded for conditions due to wear and tear, marring, deteriorations, inherent vice, latent defect, mechanical breakdown and/or improper installation, etc., as it relates to conditions whether observed or not.”
Florida DFS Civil Remedy Notice, filing no. 650842, accepted 10/11/2022, Port Charlotte. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer inspected the home and roof system and provided a coverage determination letter concluding this.
LETTER IN A COURT FILING FL
American Integrity: a third claim, the same whether-observed-or-not paragraph
WEAR & TEAR PRE-EXISTING
“there would be no coverage afforded due to wear and tear, marring, deterioration, inherent vice, latent defect, defect, mechanical breakdown and/or improper installation, etc., as it related to condition whether observed or not.”
Florida DFS Civil Remedy Notice, filing no. 656700, accepted 11/11/2022, Punta Gorda. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer inspected the home and roof system and provided a coverage determination letter concluding this.
LETTER IN A COURT FILING FL
American Traditions: no storm openings found, the failures put down to deferred maintenance
WEAR & TEAR WIND-DRIVEN RAIN
“Unfortunately, the policy does not provide coverage for damage related to exterior failures due to wear, tear, age related deterioration, and deferred maintenance of the”
Florida DFS Civil Remedy Notice, filing no. 701993, accepted 6/26/2023, Ocoee. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter first records finding no wind, hail, or tree impact openings to the system, and then states this.
LETTER IN A COURT FILING FL
Florida Peninsula: settling, shrinking and the cracking that results from them
WEAR & TEAR OTHER
“the policy does not afford coverage for loss that are caused by wear and tear, chipping, scratches, dents or deterioration. Settling, shrinking, shrinking, bulging or expansion, including resultant cracking of bulkheads, pavements, patios, footings, foundations, walls, floors, roofs or ceilings”
Florida DFS Civil Remedy Notice, filing no. 810692, accepted 3/12/2025, Boynton Beach. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the denial letter attributed the damages to the following exclusions.
LETTER IN A COURT FILING FL
Frontline: seven exclusions and the same closing, on a second claim
WEAR & TEAR
“[y]our Homeowners Policy does not provide coverage for wear and tear, deterioration, mechanical breakdown, cracking, faulty workmanship, inadequate materials used in construction and maintenance. As such, based upon the terms and conditions of your insurance policy, Frontline must respectfully deny”
Florida DFS Civil Remedy Notice, filing no. 812935, accepted 3/25/2025, Wesley Chapel. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter advised that no coverage was found consistent with the terms, conditions and exclusions of the subject policy, and Frontline noted this.
LETTER IN A COURT FILING FL
Homesite: the interior leak a covered ensuing loss, the roof it came through not covered
WEAR & TEAR
“while the interior leaking would be the covered ensuing loss the areas noted on your risk roof would not be covered due to age, wear and tear and maintenance….An additional letter will be forthcoming in regards to the coverage for the interior water damages.”
Florida DFS Civil Remedy Notice, filing no. 654539, accepted 10/29/2022, Palm Coast. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where Homesite advised this in written correspondence to the insureds dated November 19, 2021.
LETTER IN A COURT FILING FL
State Farm Florida: the leaks traced to worn flashing, the cracks to settlement
WEAR & TEAR SEEPAGE
“was caused by long term, repeated water leaks from wear tear deterioration to the roof flashing as well as settlement cracks to the drywall. This type of damage is not covered by your policy.”
Florida DFS Civil Remedy Notice, filing no. 694923, accepted 5/15/2023, Longwood. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter states the roof damage was not caused by a covered cause of loss and that the interior damage.
LETTER IN A COURT FILING FL
State Farm Florida: repeated leaking said to indicate damage from multiple events
WEAR & TEAR SEEPAGE
“the damages to your roof and exterior are a result of wear, tear, and deterioration. It was determined that the damages to your interior are the result of repeated leaking. This indicates the damages are from multiple events.”
Florida DFS Civil Remedy Notice, filing no. 698730, accepted 6/7/2023, Parrish. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the denial correspondence dated October 30, 2022 carries this language.
LETTER IN A COURT FILING FL
State Farm Florida: what was found described as non-loss conditions
WEAR & TEAR
“[b]ased upon the results of our discussions, site inspection, and investigation, it was determined other non-loss conditions associated to wear, tear, deterioration, mechanical breakdown, and maintenance related issues were present.”
Florida DFS Civil Remedy Notice, filing no. 666857, accepted 1/10/2023, Fort Myers. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer inspected the home and roof system and provided a coverage determination letter concluding this.
LETTER IN A COURT FILING FL
Truck Insurance Exchange: the claim closed on the caulking around the meter mast
WEAR & TEAR BELOW DEDUCTIBLE
“Our investigation revealed wear and tear of the caulking on the roof around the meter mast. Unfortunately, there is no coverage for this portion of your claim based on the facts known to us at the present time.”
Florida DFS Civil Remedy Notice, filing no. 654260, accepted 10/27/2022. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the same letter states that the loss is under the deductible, no payments can be issued at this time, and the claim file is being closed.
LETTER IN A COURT FILING FL
TypTap: a letter containing, the filing says, nothing more than the exclusion
WEAR & TEAR
“Policy does not cover loss caused by wear and tear, marring, deterioration; inherent vice, latent defect or mechanical breakdown, or rust, decay or other corrosion.”
Florida DFS Civil Remedy Notice, filing no. 804833, accepted 2/3/2025, Port Saint Lucie. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the filing records this as a response that failed to justify the prolonged inaction, containing nothing more than these statements.
LETTER IN A COURT FILING FL
Truck Insurance Exchange: no coverage, based on the facts known at the present time
WEAR & TEAR
“[n]o wind damage was noted to the roof. There was wear and tear to the roof. Unfortunately, there is no coverage for this portion of your claim based on the facts known to us at the present time.”
Florida DFS Civil Remedy Notice, filing no. 685305, accepted 3/28/2023, Orlando. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer sent a Claim Outcome Letter to the public adjuster, enclosing a copy of its estimate.
NEWS REPORT FL
Citizens: an EF-3 tornado's damage, denied as wear, tear, and age
HURRICANE MILTON (2024) WEAR & TEAR
“Citizens denied their claim in a May 15 letter, blaming wear, tear, and age-related deterioration. A private engineer's report the couple paid for found the tornado caused more than $65,000 in damage.”
WPTV Investigates (Kate Hussey), Nov. 13, 2025, Vero Beach: the Citizens denial letter is quoted; the piece documents Citizens funding the DOAH judges who hear its disputes
CONSUMER COMPLAINT FL
Florida Peninsula: the wear, deterioration, and faulty installation triple
WEAR & TEAR PRE-EXISTING
“Damage to property that is caused by wear and tear, deterioration, faulty installation.”
BBB complaint No. 22086474 against Florida Peninsula (Boca Raton profile); the exclusion recital appears verbatim
CONSUMER COMPLAINT FL
People's Trust: storm damage reattributed to long-term ground settling
WEAR & TEAR PRE-EXISTING
“Track issues attributable to long-term ground settling and wear and tear; the vent pipe damage was not caused by a storm.”
BBB complaint No. 23513817 against People's Trust (Deerfield Beach profile); the carrier response carries the verbatim position
CONSUMER COMPLAINT FL
Tower Hill: roof refused as normal wear, in one sentence
WEAR & TEAR
“The roof had normal wear and they will not repair or replace.”
BBB customer review of Tower Hill (Gainesville profile, Dec. 18, 2025); the reviewer reports the carrier's stated ground
UNDERPAID · 24 ON FILE
The counter-guide → DENIAL LETTER FL
Western World: water damage covered, the tile floor excluded as bad workmanship, net check $553.38
UNDERPAID ENDORSEMENT OTHER
“Based on the information you provided, your policy, and the inspection we have determined that the damage caused by water is a covered loss. However, we are unable to provide coverage and payment for a portion of the claim. Unfortunately there is no coverage for the tile floors from construction and workmanship issues, as this is excluded by the policy.”
Bracho v. Western World Insurance Company, No. 1:21-cv-22199-BB (S.D. Fla.), Doc. 1-1, Exhibit B at 71 to 74 of 74. Removed from the 11th Judicial Circuit, Miami-Dade County.
APPELLATE OPINION FL
Homeowners Choice: the Sally scope dispute that unwound a $541,257 verdict
HURRICANE SALLY (2020) UNDERPAID OTHER
“The carrier disagreed with the estimate and the scope of the damages related to the loss, retaining an engineering firm to re-inspect the roof, exterior and interior, for cause and duration; earlier letters required the insureds to make reasonable and necessary repairs and keep an accurate record of the repair expenses including any invoices or receipts.”
Homeowners Choice Prop. & Cas. Ins. Co. v. Clark, No. 1D2023-1622 (Fla. 1st DCA Mar. 19, 2025)
APPELLATE OPINION FL
Universal: a Hurricane Sally payment letter that showed its arithmetic, and held up at trial
HURRICANE SALLY (2020) UNDERPAID
“From this total, Universal subtracted recoverable depreciation of $6,145.81, non-recoverable depreciation of $256.72, and the wind deductible for the dwelling of $6,008.00. This resulted in the $8,125.20 net payment to Appellants.”
Bailetti v. Universal Prop. & Cas. Ins. Co., No. 1D2024-1695 (Fla. 1st DCA Oct. 8, 2025)
LETTER IN A COURT FILING SC
State Farm: an oak tree through the roof, 14 months, and eight adjusters
HURRICANE HELENE (2024) UNDERPAID OTHER
“But for 14 months, State Farm has conducted no diligent investigation of the loss, provided no meaningful claims service, refused to accept the full scope of the loss, and bandied Brown to and from eight different adjusters.”
Brown v. State Farm Fire & Cas. Co., No. 3:25-cv-13575 (D.S.C., filed Nov. 25, 2025), Complaint (free, 17 pp.)
LETTER IN A COURT FILING FL
Hartford Midwest: the Ian coverage-determination letter, thirty-five days after landfall
HURRICANE IAN (2022) UNDERPAID WIND-DRIVEN RAIN
“On or about November 2, 2022, Defendant issued a coverage determination letter (CDL) that it undertook a complete and thorough investigation of the damages and found damage to the interior as result of water but issued severe underpayment instead of issuing the rightful contractual amount due for benefits.”
Marchetti v. Hartford Ins. Co. of the Midwest, No. 2:24-cv-00152 (M.D. Fla.), Complaint with 86-page policy attachment (free)
LETTER IN A COURT FILING FL
GeoVera: an appraisal award the homeowners say was not paid in full
HURRICANE IAN (2022) UNDERPAID
“GeoVera maintains that it has satisfied its contractual obligations because it fully paid the Woods what was due to them under the insurance policy. Plaintiffs maintain, however, that GeoVera did not pay the entire amount of an appraisal award they believe was due under the insurance policy.”
Wood v. GeoVera Specialty Ins. Co., No. 2:23-cv-00294 (M.D. Fla.), Doc. 46 (free summary-judgment order reconstructing the coverage letter)
REGULATOR COMPLAINT FL
State Farm Florida: a $78,946 claim priced under the deductible
HURRICANE MILTON (2024) UNDERPAID WEAR & TEAR BELOW DEDUCTIBLE OTHER
“After assessing the damage and the true scope of repairs, the public adjuster produced an estimate identifying $78,946.87 in covered damage to the dwelling.”
Fla. DFS Civil Remedy Notice, Filing No. 812672 (Tampa), accepted 3/24/2025
REGULATOR COMPLAINT FL
Vyrd: a $207,591 claim backed by a retained engineer
HURRICANE HELENE (2024) UNDERPAID OTHER WEAR & TEAR
“Given the vastly underestimated cost of repairs, the Insured's disagreement with the coverage decision, and the scope and nature of the damage resulting from the loss, the delays in payments for incurred costs, the Insured disputed the coverage determination and submitted a sworn statement in proof of loss for $207,591.39 which was a fair and reasonable assessment of the loss and included incurred ALE expenses to date.”
Fla. DFS Civil Remedy Notice, Filing No. 786313 (Odessa), accepted 10/10/2024
REGULATOR COMPLAINT FL
Slide: a partial roof payment the filing says cites no policy language for being partial
HURRICANE IAN (2022) UNDERPAID WEAR & TEAR
“The payment letter does not cite any policy language in support of the carrier's decision to afford only partial coverage for the roof rather than provide for a complete roof replacement. Clearly, the Insurer failed to provide a reasonable explanation in writing to the Claimant of the basis in the insurance policy for the offer of this compromised and insufficient settlement.”
Fla. DFS Civil Remedy Notice, Filing No. 686492 (Nelson v. Slide Insurance)
REGULATOR COMPLAINT FL
ASI: the Ian lowball, alleged in four words
HURRICANE IAN (2022) UNDERPAID
“The carrier was immediately put on notice of the insured's Hurricane Ian claim. The carrier initially attempted to low-ball the claim.”
Fla. DFS Civil Remedy Notice, Filing No. 654847 (McWeeney v. ASI Preferred), Cape Coral, FL
REGULATOR COMPLAINT FL
First Protective: a $90,152 claim decided without a real inspection
HURRICANE IAN (2022) UNDERPAID OTHER
“Moreover, CCS determined that at least $90,152.17 worth of repairs would be required to return the property to its pre-loss condition as a result of the windstorm loss.”
Fla. DFS Civil Remedy Notice, Filing No. 797441 (Naples), accepted 12/18/2024
REGULATOR COMPLAINT FL
Florida Peninsula: a $44,741 payment against a $267,527 documented loss
HURRICANE IAN (2022) UNDERPAID
“The insurance company performed a cursory inspection, failing to retain the experts necessary to adequately inspect the property, and issued a low-ball payment to the insured in the amount of $44,741.62.”
Fla. DFS Civil Remedy Notice, Filing No. 794809 (Stewart v. Florida Peninsula), Bokeelia, FL
REGULATOR COMPLAINT FL
Heritage: the supplemental payment that never came
HURRICANE IAN (2022) UNDERPAID
“Heritage has refused to issue a supplemental payment and/or fully indemnify the insured for covered hurricane damage which occurred on September 28, 2022.”
Fla. DFS Civil Remedy Notice, Filing No. 794830 (Polanco v. Heritage P&C), Fort Myers, FL
REGULATOR COMPLAINT FL
People's Trust: multiple roof openings, one lowball estimate
HURRICANE IAN (2022) UNDERPAID WIND-DRIVEN RAIN
“Hurricane Ian created multiple openings to the roof of the insureds' property. Instead, the carrier gave the insureds a lowball estimate that failed to encompass all covered damages.”
Fla. DFS Civil Remedy Notice, Filing No. 793021 (Pujols v. People's Trust), Orlando, FL
REGULATOR COMPLAINT FL
Universal Property: checks without a report on an uninhabitable Ian house
HURRICANE IAN (2022) UNDERPAID OTHER
“An agent of Universal came out and informed the insured the home is no longer safe to live in and has since sent multiple checks but refuses to send a report of their inspection. Universal keeps sending checks that are below her coverage.”
Fla. DFS Civil Remedy Notice, Filing No. 654871 (Glover v. Universal P&C), Tampa, FL
REGULATOR COMPLAINT FL
Amica Mutual: a $166,493 claim decided without a real inspection
UNDERPAID OTHER
“Given the vastly underestimated cost of repairs, the Insured's disagreement with the coverage decision, and the scope and nature of the damage resulting from the loss, the Insured through its retained representatives disputed the coverage determination and submitted an estimate prepared by Hunter Claims for $166,493.64.”
Fla. DFS Civil Remedy Notice, Filing No. 791092 (Naples), accepted 11/8/2024
REGULATOR COMPLAINT FL
Edison: a $248,170 claim valued far below the repair
UNDERPAID OTHER
“On May 2, 2023, the insured obtained a fire damage new construction estimate from DBR Construction totaling $248,170.73 to re-build the fire destroyed home.”
Fla. DFS Civil Remedy Notice, Filing No. 809544 (Kenansville), accepted 3/4/2025
REGULATOR COMPLAINT FL
Frontline: a $82,258 claim blamed on workmanship
UNDERPAID WEAR & TEAR BELOW DEDUCTIBLE OTHER
“After assessing the damage and the true scope of repairs, the public adjuster prepared an estimate identifying $82,258.38 in covered damage to the dwelling.”
Fla. DFS Civil Remedy Notice, Filing No. 806581 (Jacksonville), accepted 2/12/2025
REGULATOR COMPLAINT FL
Heritage: coverage found, claim valued at $18,000, and no payment issued
UNDERPAID OTHER
“After reporting the claim, Heritage retained an unqualified and biased field adjuster who has a financial relationship with Heritage. Despite Heritage finding coverage for his claim, it significantly undervalued the claim at only $18,000. Because this amount was an offer pre-mediation, Heritage did not issue any payment.”
Fla. DFS Civil Remedy Notice, Filing No. 649770 (Truong v. Heritage P&C), Lehigh Acres, FL
REGULATOR COMPLAINT FL
Typtap: a $88,747 claim valued far below the repair
UNDERPAID WEAR & TEAR OTHER
“After assessing the damage and the true scope of repairs, the public adjuster prepared an estimate identifying $88,747.74 in covered damage to the dwelling and $213.57 in damage to contents.”
Fla. DFS Civil Remedy Notice, Filing No. 805752 (Sarasota), accepted 2/7/2025
REGULATOR COMPLAINT FL
Underwriters At Lloyd's, London: a $111,657 claim called wear and tear
UNDERPAID WEAR & TEAR OTHER
“The Insurer based this denial on the rationale that the damage sustained was a result of ' wear and tear, deterioration and prior deficiencies.' As the discovery process will uncover, the Insurer's adjuster intentionally ignored the damage observed and has failed to make truthful and unbiased reports of the facts following the investigation.”
Fla. DFS Civil Remedy Notice, Filing No. 795332 (Sebring), accepted 12/4/2024
REGULATOR COMPLAINT FL
Universal Property & Casualty: a $188,920 claim called wear and tear
UNDERPAID WEAR & TEAR
“Based on the insufficient adjustment of the claim as outlined herein, Universal issued a wholly unsatisfactory valuation of $4,896.13 replacement cost value for the loss.”
Fla. DFS Civil Remedy Notice, Filing No. 794865 (Miami), accepted 12/2/2024
LETTER IN A COURT FILING FL
Nationwide: the letter that told the homeowner their policy covers ADD DETAILS ABOUT WHAT IS COVERED
UNDERPAID BELOW DEDUCTIBLE
“We've completed our investigation and have determined a portion of your Homeowners claim is covered under your policy. Your policy covers ADD DETAILS ABOUT WHAT IS COVERED.”
Florida DFS Civil Remedy Notice, filing no. 696774, accepted 5/25/2023, Winter Garden. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the filing quotes this as the second letter sent, on or about November 17, 2022, and adds the emphasis.
LETTER IN A COURT FILING FL
Florida Peninsula: a $3,000 emergency services invoice reduced to $920.42
UNDERPAID
“The invoice submitted by FORTIFICATION TESTING & EMERGENCY SERVICES LLC, in the amount of $3,000.00, is not covered in its entirety. It was determined that the reasonable costs should be $920.42. This amount is based on a comparative estimate prepared after the review of FORTIFICATION TESTING & EMER”
Florida DFS Civil Remedy Notice, filing no. 663463, accepted 12/20/2022, Lehigh Acres. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter accompanied a payment of $920.42 for the undisputed amount of services.
BELOW DEDUCTIBLE · 17 ON FILE
The counter-guide → APPELLATE OPINION FL
Anchor: below deductible, no wind damage noted, then the fraud defense
HURRICANE IRMA (2017) BELOW DEDUCTIBLE WIND-DRIVEN RAIN MISREPRESENTATION
“No payment: the $2,462.40 estimate fell below the deductible; no coverage for interior water because there was no peril-created opening and the inspection found no physical evidence of any wind damaged shingles. No covered storm damage noted to any slopes of roof during inspection.”
Anchor Prop. & Cas. Ins. Co. v. Trif, 322 So. 3d 663 (Fla. 4th DCA June 2, 2021)
REGULATOR COMPLAINT FL
Edison: a $173,710 loss package answered with below-deductible
HURRICANE MILTON (2024) BELOW DEDUCTIBLE UNDERPAID
“The insured prepared a loss package in the amount of $173,710.35 needed to restore the property to its pre-loss condition, whereas the carrier wrongfully represented the damages to be below the policy deductible.”
Fla. DFS Civil Remedy Notice, Filing No. 794899 (Wilson v. Edison), Sarasota, FL
REGULATOR COMPLAINT FL
Slide: the Milton below-deductible letter, in the carrier's response
HURRICANE MILTON (2024) BELOW DEDUCTIBLE
“The total cost to repair the covered damages was less than the Policy's hurricane deductible.”
Fla. DFS Civil Remedy Notice, Filing No. 800648 (Bond v. Slide), Bradenton, FL; the carrier's attached response states the ground
REGULATOR COMPLAINT FL
ASI: fifteen days after Ian, a $1,596.77 verdict on a Cape Coral house
HURRICANE IAN (2022) BELOW DEDUCTIBLE
“The original determination made by the carrier on October 13, 2022 was below the hurricane deductible, and valued at only $1,596.77, as determined by its field adjuster.”
Fla. DFS Civil Remedy Notice, Filing No. 794862 (Wojtukiewicz v. ASI Preferred), Cape Coral, FL
REGULATOR COMPLAINT FL
Monarch National: coverage opened, $0.00 tendered
HURRICANE IAN (2022) BELOW DEDUCTIBLE
“Monarch National Insurance Company has opened coverage but falls below the insured's deductible. Monarch National Insurance Company has tendered $0.00.”
Fla. DFS Civil Remedy Notice, Filing No. 657015 (Nelson v. Monarch National), Wimauma, FL
REGULATOR COMPLAINT FL
Stillwater: a $103,531 claim priced under the deductible
HURRICANE IAN (2022) BELOW DEDUCTIBLE OTHER
“As evidenced by an estimate sent to the Insureds, dated October 28, 2022, Stillwater determined the total value of the loss was $3,361.72 which was below the applicable deductible.”
Fla. DFS Civil Remedy Notice, Filing No. 793302 (Orlando), accepted 11/19/2024
LETTER IN A COURT FILING FL
Universal Property: the wind damage covered, and the payment still zero
BELOW DEDUCTIBLE WIND-DRIVEN RAIN
“The wind damage to the roof applicable to the above referenced loss, is covered. However, the estimated cost of repair for the direct physical loss to property for the above-referenced claim does not exceed your applicable policy deductible of $2,500.00. Therefore, the Policy does not extend allowance for the claim.”
Florida DFS Civil Remedy Notice, filing no. 810874, accepted 3/12/2025, Jacksonville. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the coverage determination denies the interior water damage and addresses the roof separately.
LETTER IN A COURT FILING FL
Heritage: the arithmetic of a below-deductible denial, line by line
BELOW DEDUCTIBLE
“Structure(s) $ 0.00 [name redacted] (Contents) $ 0.00 Loss of Use/Additional Living Expense (ALE) $ 0.00 Other Damages $ 0.00 Gross Loss $ 732.65 Less Recoverable Depreciation $ 0.00 Less Non-Recoverable Depreciation $ 0.00 Less Deductible $ 1,000.00”
Florida DFS Civil Remedy Notice, filing no. 650350, accepted 10/6/2022, Jacksonville. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter states that regrettably the amount of the claim falls under the $1,000.00 deductible, and sets out the calculation.
LETTER IN A COURT FILING FL
Edison: below the deductible, and the flood-damaged items excluded as well
BELOW DEDUCTIBLE WATER EXCLUSION
“Based on the estimate the damage to your property was less than your deductible. There were some items damaged by flood. Flood is not covered by your homeowner's policy. Therefore, we are unable to make a payment for your claim.”
Florida DFS Civil Remedy Notice, filing no. 664480, accepted 12/27/2022, Winter Garden. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where Edison sent its coverage determination letter to the insured explaining as follows.
LETTER IN A COURT FILING FL
Florida Peninsula: an itemized estimate, and a Punta Gorda claim under the deductible
BELOW DEDUCTIBLE
“Enclosed you will find an itemized estimate and statement of loss. Based on the estimate the damage to your property was less than your deductible. Therefore, we are unable to make a payment for your claim.”
Florida DFS Civil Remedy Notice, filing no. 664405, accepted 12/23/2022, Punta Gorda. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where Florida Peninsula issued its coverage determination on October 28, 2022.
LETTER IN A COURT FILING FL
Olympus: the wind-driven rain damage estimated, then swallowed by the hurricane deductible
BELOW DEDUCTIBLE WIND-DRIVEN RAIN
“[e]enclosed is our estimate for ensuing water damage resulting from wind driven rain related to the above referenced claim. As you will note, the estimated cost of the repairs does not exceed the policy deductible, and we are unable to offer any payment at this time.”
Florida DFS Civil Remedy Notice, filing no. 696866, accepted 5/26/2023, Ft. Myers. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the October 23, 2022 claim determination letter explained the coverage in these terms.
LETTER IN A COURT FILING FL
Universal Property: $1,861.97 of wind damage against a $4,750.00 deductible
BELOW DEDUCTIBLE
“As investigated and evaluated by our claim representative, the estimated cost of repair for claimed damage related to the above-refenced wind loss amounts to $1,861.97, which does not exceed your applicable policy deductible of $4,750.00.”
Florida DFS Civil Remedy Notice, filing no. 649973, accepted 10/4/2022, Delray Beach. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter first states that under the policy of insurance repair costs must exceed the applicable deductible.
NEWS REPORT FL
Citizens: Milton claim closed, damage priced under the hurricane deductible
HURRICANE MILTON (2024) BELOW DEDUCTIBLE
“Our evaluation shows the cost to repair or replace the front porch screen, roof repairs to shed will not exceed policyholders $3,774.00 calendar year Hurricane deductible. Therefore, no payment will be made regarding this claim.”
Tampa Bay 28 (ABC Action News), Hillsborough County, reporting on Milton claim denials; the Citizens letter is quoted in the story
CONSUMER COMPLAINT FL
American Integrity: under the deductible, and partly not covered anyway
BELOW DEDUCTIBLE OTHER
“The damages you reported from the hurricane did not meet your policy's hurricane deductible. Additionally, a portion of the damages were not covered under the policy.”
BBB complaint No. 22871842 against American Integrity (Tampa profile); the carrier's Feb. 14, 2025 response carries the language
CONSUMER COMPLAINT FL
Florida Peninsula: hurricane claim closed under the deductible, $500 food check
BELOW DEDUCTIBLE
“The Coverage A portion of the claim was less than the hurricane deductible; the only payment issued was a $500 food-loss check.”
BBB complaint No. 22615749 against Florida Peninsula (Boca Raton profile); the below-deductible closure is stated in the record
CONSUMER COMPLAINT FL
Homeowners Choice: under the $6,000 deductible, against a $33,481 estimate
BELOW DEDUCTIBLE UNDERPAID
“They denied my claim stating that the damage was less than my $6,000.00 deductible. The public adjuster's estimate was $33,481.74; a $10,000 offer was rescinded and a check for $2,395.53 sent.”
BBB complaint No. 23902802 against Homeowners Choice (Tampa profile), Sept. 19, 2025, hurricane roof and Florida-room claim
CONSUMER COMPLAINT FL
SafePoint: the below-deductible settlement, communicated
BELOW DEDUCTIBLE
“The covered damages to the insureds property did not exceed the policys Hurricane deductible. SafePoint communicated the below deductible settlement to the insured on April 24, 2025.”
BBB complaint No. 23507618 against SafePoint (Temple Terrace profile), June 2025; the carrier's response states the determination
OTHER · 13 ON FILE
LETTER IN A COURT FILING FL
Hartford: the engineer whose report came with the denial, then could not be deposed
HURRICANE IAN (2022) OTHER
“Hartford then retained its own engineering expert, Third-Party Makkaoui, to re-inspect the property. Makkaoui compiled his findings in a report, which Hartford sent to Plaintiffs along with a claim denial letter.”
Pauly v. Hartford Ins. Co. of the Midwest, No. 2:23-cv-00259 (M.D. Fla.), Docs. 50, 72, 75 (free orders and briefing quoting both letters)
REGULATOR COMPLAINT FL
Southern Oak: Milton denied for neglect, citing the unrepaired Ian claim
HURRICANE MILTON (2024) OTHER PRE-EXISTING
“On November 9, 2024, the insurer issued a letter denying the claim based on neglect; the letter states that a prior claim was filed for damage caused during Hurricane Ian covering the fence, porch screens, and replacement of the roof.”
Fla. DFS Civil Remedy Notice, Filing No. 796039 (Woods v. Southern Oak), Palm Bay, FL
REGULATOR COMPLAINT FL
Tower Hill: the Milton denial and the cookie-cutter report allegation
HURRICANE MILTON (2024) OTHER WEAR & TEAR
“TOWER HILL time and time again, relies upon cookie-cutter reports that less than ironically state the cause of the damage to be identical to those exclusions found inside of TOWER HILL's policy of insurance.”
Fla. DFS Civil Remedy Notice, Filing No. 794795 (Cervino v. Tower Hill Insurance Exchange), Clermont, FL
REGULATOR COMPLAINT FL
Tower Hill: Milton roof, gutters, and skylight refused outright
HURRICANE MILTON (2024) OTHER UNDERPAID
“There is no question the roof of the Insured's home was struck by hurricane winds so severe that caused damage requiring a full roof replacement, gutters, skylight, fascia. Despite this, TOWER HILL denied coverage for the clearly covered loss.”
Fla. DFS Civil Remedy Notice, Filing No. 795091 (King v. Tower Hill Insurance Exchange), Leesburg, FL
REGULATOR COMPLAINT FL
Homeowners Choice: a $41,800 estimate, then a denial anyway
HURRICANE HELENE (2024) OTHER
“Despite agreeing that the Insured Property sustained damage by Hurricane Helene at least in the amount of $41,800.28 (ACV) via its own estimate, Homeowners chose to wrongfully deny the claim; production of the estimate should not be construed as an approval or denial of coverage.”
Fla. DFS Civil Remedy Notice, Filing No. 794905 (Little v. Homeowners Choice), Cedar Key, FL
REGULATOR COMPLAINT FL
Olympus: a $145,109 claim left undecided
OTHER
“Carrier can cure the defects outlined in this Civil Remedy Notice and avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Insured's estimate of damages $145,109.57, and J&S Restoration in the amount of $3,104.86, less applicable deductible, which is the reasonable amount of the covered loss pursuant to the policy.”
Fla. DFS Civil Remedy Notice, Filing No. 798807 (Lake Worth), accepted 1/2/2025
LETTER IN A COURT FILING FL
Kin: the damage from the tarp that covered the damage
OTHER
“the damage to the roofs right and front slope shingles caused by fasteners used to hold tarp down [sic.], is not covered by your policy”
Florida DFS Civil Remedy Notice, filing no. 808332, accepted 2/25/2025, Kissimmee. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter simply states this, without a reasonable explanation of the basis in the policy in relation to the facts.
LETTER IN A COURT FILING FL
Universal Property: a denial for documents not produced, acknowledging the pandemic that prevented it
OTHER
“Universal understands that due to the declared national emergency and state and local government restrictions to reduce the spread of the COVID-19 pandemic; special circumstances could have arisen that caused your inability to submit to the requested documentation.”
Florida DFS Civil Remedy Notice, filing no. 650043, accepted 10/4/2022, Sunrise. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the denial letter of August 12, 2020 stated this in part.
LETTER IN A COURT FILING FL
State Farm Florida: the drywall said to be the condominium association's responsibility
OTHER
“[b]ased upon the results of our discussions, site inspection, and investigation, it was determined that a portion of your damage is not covered by your policy. The costs associated with repairing the drywall along with any other interior repairs that are the condominium association”
Florida DFS Civil Remedy Notice, filing no. 652558, accepted 10/24/2022, Deerfield Beach. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer paid damages in the amount of $1,753.87 and noted this in its coverage determination letter.
LETTER IN A COURT FILING FL
Universal Property: a denial that declares its own good faith
OTHER
“This denial has occurred after a good faith evaluation of the total circumstances involved. If you know of any reason why our evaluation of the facts is not correct, please advise us in writing.”
Florida DFS Civil Remedy Notice, filing no. 668837, accepted 1/19/2023, Sanford. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where Universal advised the insureds of this in the July 23, 2020 claim denial letter.
NEWS REPORT FL
The green-wood report: when the engineer blames the builder instead of the storm
HURRICANE IAN (2022) OTHER PRE-EXISTING
“The main problem with the roof framing is that the builder used green wood that was probably already slightly warped.”
Tampa Bay 28 (Adam Walser), Ian era: an insurer's engineering report quoted in a public-adjuster segment on rising denials
CONSUMER COMPLAINT FL
Slide: the condo loss-assessment claim and the date-of-loss fight
HURRICANE IAN (2022) OTHER LATE NOTICE
“The insurers initial claim acknowledgment dated April 2, 2026, the Date of Loss was identified as March 16, 2026. However, the denial later relies on September 28, 2022 as the operative date.”
BBB complaint No. 24816134 against Slide (Tampa profile); a hurricane loss-assessment denial with the date of loss in dispute
CONSUMER COMPLAINT FL
People's Trust: the surge blamed on the utility, the doors on earth movement
OTHER PRE-EXISTING
“They declined that claim and blame the cause of the damage to the local electrical company; they declined the claim and blame the cause to earth movement.”
BBB complaint No. 22674509 against People's Trust (Deerfield Beach profile), Dec. 2024; the complaint quotes the grounds
SEEPAGE · 10 ON FILE
The counter-guide → APPELLATE OPINION FL
Safepoint: seepage and deferred maintenance, beaten by the carrier's own photo
SEEPAGE WEAR & TEAR WIND-DRIVEN RAIN
“The denial rested on the determination that there was no opening in the roof caused by a covered peril and the damage was the result of long-term repeated seepage due to wear and tear and deferred maintenance, quoting the exclusions for rain to the interior of a building and for wear and tear, marring, deterioration.”
Vega v. Safepoint Ins. Co., No. 3D19-2214 (Fla. 3d DCA Aug. 18, 2021)
LETTER IN A COURT FILING FL
Security First: the escaping water covered, the thing it escaped from not covered
SEEPAGE OTHER
“Inspections of the property revealed that the observed damages are attributed to water leaking from a p-trap under the kitchen sink. Sudden and accidental discharge or overflow of water from within a plumbing system is covered under the policy. There is no coverage to the system from which the water escaped.”
Florida DFS Civil Remedy Notice, filing no. 806600, accepted 2/12/2025, Winter Haven. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where a coverage determination letter was sent to the insured.
LETTER IN A COURT FILING FL
State Farm Florida: no accidental direct physical loss, the water said to have developed over time
SEEPAGE
“It was determined that there was no covered accidental direct physical loss to the insured property. The damage to the property was as a result of seepage or leakage of water that occurred or developed over a period of time which is not covered under the policy.”
Florida DFS Civil Remedy Notice, filing no. 800732, accepted 1/13/2025, Miramar. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where a coverage determination letter dated July 27, 2023, denying the claim.
LETTER IN A COURT FILING FL
State Farm Florida: the homeowner's own description of a slow leak used to deny it
SEEPAGE
“the water damage to the kitchen was caused by repeated and/or intermittent water leakage over a period of time from your kitchen plumbing system. We noted you described the leak as being very slow and that it had been leaking for approximately a year since you moved into the home. Damage resulting from this cause(s) of loss is not covered by your policy.”
Florida DFS Civil Remedy Notice, filing no. 793419, accepted 11/20/2024, Inverness. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where State Farm issued its coverage determination letter the same day as its investigation.
LETTER IN A COURT FILING FL
People's Trust: long-term seepage said to have caused the fungi growth
SEEPAGE MOLD & FUNGI
“Looking at the facts of your claim and reading the language of cited above, your policy does not provide coverage for your particular loss. Specifically, but without limitation, your policy does not provide coverage for long term seepage/leakage causing fungi growth.”
Florida DFS Civil Remedy Notice, filing no. 792831, accepted 11/18/2024, Orange City. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the carrier denied the claim after reviewing the documents and information submitted.
LETTER IN A COURT FILING FL
Edison: the escaping water, the appliance it escaped from, and a deductible above both
SEEPAGE BELOW DEDUCTIBLE
“The repair of the plumbing and/or appliance is not covered under the policy. The subject policy, under which you are seeking insurance benefits, does not afford coverage for wear and tear, deterioration, or loss to the system or appliance from which the water escaped.”
Florida DFS Civil Remedy Notice, filing no. 657083, accepted 11/15/2022, Saint Augustine. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter follows a determination that the loss fell below the policy deductible, so no payment was made.
LETTER IN A COURT FILING FL
Kin: the drain line collapsed, and the collapse is called age
SEEPAGE WEAR & TEAR
“the damage is the result of age-related wear and tear causing the drain line to collapse, and causing water damage to your home.”
Florida DFS Civil Remedy Notice, filing no. 660490, accepted 12/8/2022, St. Petersburg. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the claims determination letter offers two reasons for the denial, of which this is the first.
LETTER IN A COURT FILING FL
United Property: the rupture was sudden, the pipe that ruptured was worn
SEEPAGE WEAR & TEAR
“the sudden rupture of the line was understood to be the cause of the observed damages, this is supported from the water usage records provided to our office. The deterioration of the water line leading up to it's [sic] eventual failure is understood to be from wear and tear over time.”
Florida DFS Civil Remedy Notice, filing no. 649835, accepted 10/3/2022, Port Charlotte. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer's adjuster set this out in correspondence dated September 27, 2022.
LETTER IN A COURT FILING FL
Tower Hill Prime: a nail through the water line, blamed on the builder two years earlier
SEEPAGE PRE-EXISTING
“Start to Finish mentioned in their log that the plumber cut out a section of pipe that had penetrated the waterline pipe. Tower Hill also has a photo of that pipe with the nail in it. This appears to have been done by your builder 2 years ago and was an ongoing slow leak until recently, when it was”
Florida DFS Civil Remedy Notice, filing no. 650219, accepted 10/5/2022, Lakewood Ranch. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where Tower Hill made a coverage determination on June 11, 2019 stating this.
CONSUMER COMPLAINT FL
Slide: engineer attributes water loss to slab moisture, not the sudden event
SEEPAGE PRE-EXISTING
“Moisture migrating through the concrete slab rather than the toilet overflow; a second complaint reports water damage attributed to seepage (long term).”
BBB complaints No. 24997542 and 24748273 against Slide (Tampa profile); the responses quote the engineering attribution
WIND-DRIVEN RAIN · 9 ON FILE
The counter-guide → DENIAL LETTER FL
Indian Harbor: Ian roof damage refused for want of a storm-created opening, net claim $0.00
HURRICANE IAN (2022) WIND-DRIVEN RAIN PRE-EXISTING WEAR & TEAR BELOW DEDUCTIBLE
“Unfortunately, we are unable to offer coverage for various roof, exterior and interior (wind-driven) damage as the damage is not indicative to a storm-created opening and/or storm-related, but due to pre-existing repairs and long-term issues and therefore no coverage is afforded.”
G&M Estates USA, Inc. v. Indian Harbor Ins. Co., No. 2:23-cv-00842 (M.D. Fla.), Doc. 3 at 117 to 123 of 123. Letter issued on Tower Hill Claims Services, LLC letterhead and signed by a licensed Florida adjuster.
APPELLATE OPINION FL
Citizens: the no-opening rejection letter that a contractor affidavit beat
HURRICANE IRMA (2017) WIND-DRIVEN RAIN WEAR & TEAR
“The policy excludes rain to the interior of a building unless a covered peril first damages the building causing an opening in a roof or wall and the rain enters through this opening.”
Morales v. Citizens Prop. Ins. Corp., No. 3D21-276 (Fla. 3d DCA Mar. 16, 2022)
APPELLATE OPINION FL
Universal Property: contents denied as wind-driven rain, dwelling held back
HURRICANE IRMA (2017) WIND-DRIVEN RAIN UNDERPAID
“Personal property damaged by wind driven rain, no coverage under the policy; depreciation has been applied and is recoverable as work is performed and expenses are incurred.”
Goldberg v. Universal Prop. & Cas. Ins. Co., 302 So. 3d 919 (Fla. 4th DCA Sept. 9, 2020)
LETTER IN A COURT FILING FL
Heritage: wind-driven rain found, storm-created opening not found
WIND-DRIVEN RAIN
“the observed condition of [the] property was caused by wind driven rain, but no storm created openings were found”
Florida DFS Civil Remedy Notice, filing no. 797082, accepted 12/17/2024, Punta Gorda. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where HERITAGE submitted a Denial Letter to the policyholder on or about February 20, 2023.
LETTER IN A COURT FILING FL
Heritage: no storm-created opening inside, no evidence of wind outside
WIND-DRIVEN RAIN WEAR & TEAR
“no coverage was found for the interior damage as there was no storm created opening as [name redacted] as issues attributed to faulty, inadequate or defective design, workmanship and maintenance.”
Florida DFS Civil Remedy Notice, filing no. 798285, accepted 12/26/2024, Tampa. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where Heritage explained this in the coverage determination letter, having reviewed prior claims to investigate overlapping damages.
LETTER IN A COURT FILING FL
Edison: no peril-created opening, therefore no interior coverage
WIND-DRIVEN RAIN
“There was no peril-related wind damage found and no peril-created opening found during our inspection of the roof. There is no coverage for the interior damages caused by water, unless there is a peril-created opening that allows the water to enter.”
Florida DFS Civil Remedy Notice, filing no. 660416, accepted 12/8/2022, Fort Myers. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where Edison issued correspondence on November 26, 2022 denying coverage for the claim.
LETTER IN A COURT FILING FL
Edison: rain through stucco cracks and missing caulk, with no opening from a covered peril
WIND-DRIVEN RAIN WEAR & TEAR
“the source of damage was rainwater penetrating the building envelope through cracks or stucco openings, missing window caulking and possible ground water from rain events seeping through the foundation. There were no openings from a covered peril, that allowed the rain water to enter the home.”
Florida DFS Civil Remedy Notice, filing no. 663907, accepted 12/21/2022, Riverview. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer issued a denial letter to the insured on December 3, stating.
LETTER IN A COURT FILING FL
Edison: one bedroom window carved out of an otherwise paid claim
WIND-DRIVEN RAIN
“We are denying the portion of your claim that is related to any damages related to the window in the downstairs bedroom. There is not a storm created opening. The damages related to the window is from wind driven rain and wind driven rain is an exclusion in the policy.”
Florida DFS Civil Remedy Notice, filing no. 661828, accepted 12/15/2022, Englewood. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the same letter records payment being mailed, including $9,094.00 for other structures.
CONSUMER COMPLAINT FL
Edison: the interior-rain exclusion, quoted straight from the policy
WIND-DRIVEN RAIN
“We do not insure for loss caused by rain, to the interior of a building, unless a covered peril first damages the building causing an opening in a roof or wall and the rain enters through this opening.”
BBB complaint No. 23920498 against Edison (Boca Raton profile); the carrier's response quotes the policy exclusion
WATER EXCLUSION · 8 ON FILE
The counter-guide → DENIAL LETTER FL
Scottsdale: Hurricane Ian damage denied twice over, water by the form and wind by endorsement
HURRICANE IAN (2022) WATER EXCLUSION ENDORSEMENT OTHER
“The field adjuster observed extensive damage to the exterior and interior walls due to storm surge and flooding. Loss caused by storm surge or flood is not a covered cause of loss under your policy. The field adjuster also determined that there was wind damage to the exterior elevations of both buildings. The policy carries an endorsement that excludes any damage cause by wind or hail.”
4205 Pine Island LLC v. Scottsdale Insurance Company, No. 2:23-cv-01235-JLB-NPM (M.D. Fla.), Doc. 4, Exhibit C at 208 to 215 of 215.
LETTER IN A COURT FILING FL
QBE: the Fort Myers Beach wind certificate, denied in full
HURRICANE IAN (2022) WATER EXCLUSION OTHER
“For the reasons discussed above, the Policy does not provide coverage for the Claim. We therefore deny coverage for this Claim under the Policy.”
Rosenbaum v. QBE Specialty Ins. Co., No. 2:24-cv-00541 (M.D. Fla.), Doc. 6 (free removed complaint quoting the denial letter)
LETTER IN A COURT FILING FL
Homeowners Choice: the anti-concurrent causation clause, quoted at a Fort Myers Beach loss
WATER EXCLUSION
“We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area.”
Florida DFS Civil Remedy Notice, filing no. 690366, accepted 4/27/2023, Fort Myers Beach. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter referenced pertinent portions of the policy and in particular the exclusions.
LETTER IN A COURT FILING FL
National Fire & Marine: the damage attributed to flood, on a policy with no flood coverage
WATER EXCLUSION
“The field adjuster did not find any damage caused by wind. The damage to the dwelling and personal property was caused by flood, and there is no coverage for flood on this policy.”
Florida DFS Civil Remedy Notice, filing no. 685077, accepted 3/27/2023. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the filing records that by that date no denial letter had been received, and quotes this from the correspondence.
DENIAL LETTER FL
Florida Peninsula: the Milton claim closed on the flood exclusion, one page
HURRICANE MILTON (2024) WATER EXCLUSION
“Your homeowner's insurance policy does not include coverage for damage resulting from flood even if hurricane winds and rain caused the flood to occur. Without separate flood insurance coverage, you may have uncovered losses caused by flood.”
Denial letter published in redacted full by Merlin Law Group's Property Insurance Coverage Law Blog, "Florida Policyholders Are Upset with Stupid Denials of Claims"; the five-page PDF is linked from that post and hosted there
NEWS REPORT FL
Citizens: the Helene surge denial its own engineer contradicted
HURRICANE HELENE (2024) WATER EXCLUSION
“We determined the damage sustained to your client's property was caused by storm surge resulting from a hurricane; Citizens' engineer: there was no damage to the roof covering system or exterior envelope from Hurricane Helene.”
ProPublica, Sept. 15, 2025 (Mario Ariza), Citizens arbitration investigation; the North Miami denial letter and the engineer's report are quoted
NEWS REPORT FL
Safepoint: the denied Ian wind claim that became the first jury verdict
HURRICANE IAN (2022) WATER EXCLUSION UNDERPAID
“According to court filings, a jury awarded more than $500,000 in the lawsuit against Safepoint Insurance Company. We took a denied claim and turned it into a fully covered claim.”
WINK News (Nov. 15, 2024), Fort Myers: the first Hurricane Ian jury verdict, a denied wind claim returned as a policyholder award exceeding $500,000
CONSUMER COMPLAINT FL
Homeowners Choice: no surge coverage, and an endorsement with conditions
HURRICANE IAN (2022) WATER EXCLUSION ENDORSEMENT BELOW DEDUCTIBLE
“Unfortunately, your policy does not include coverage for flood/storm surge and includes a hurricane endorsement which has specific requirements for interior damage coverage.”
BBB complaint No. 20669322 against Homeowners Choice (Tampa profile), Sept. 2023; the carrier's response states the grounds
PRE-EXISTING · 7 ON FILE
The counter-guide → DENIAL LETTER FL
Lexington: the full ten-page letter that blamed four older storms
STORM-ATTRIBUTION DISPUTE (IRMA 2017, ETA 2020) PRE-EXISTING UNDERPAID
“Nevertheless, we are willing to provide coverage for the ensuing damages that our experts think might have been related to a past windstorm or rain event. We prepared an estimate for the interior damages for $16,382.03. Recoverable depreciation is $1,023.53 and deductible is $2,500. Net payment on the claim is $12,858.50.”
Villamar v. Lexington Ins. Co., No. 1:23-cv-20325 (S.D. Fla.), Doc. 1-4, Exhibit B (pp. 96-105): the complete coverage-determination letter, free
REGULATOR COMPLAINT FL
Safepoint: the Ian roof denied as an ongoing issue present well prior
HURRICANE IAN (2022) PRE-EXISTING WEAR & TEAR
“The June 23, 2023 denial letter stated the roof system did not suffer from the date of loss/event as presented and that evidence shows an ongoing issue that was present well prior to 09/28/22.”
Fla. DFS Civil Remedy Notice, Filing No. 799332 (Hale v. Safepoint), Naples, FL
REGULATOR COMPLAINT FL
American Integrity: the engineer sees the damage, the letter sees exclusions
HURRICANE IAN (2022) PRE-EXISTING OTHER
“According to the claims determination letter, the insurer's engineer observed damage to the roof and interior, but attributed the cause of this damage to causes excluded under the policy.”
Fla. DFS Civil Remedy Notice, Filing No. 794984 (Manners v. American Integrity), Cape Coral, FL
LETTER IN A COURT FILING FL
Universal Property: the roof already paid for under a prior claim
PRE-EXISTING
“During our investigation, it was concluded that the claimed damage to the roofing system covering the dwelling and ensuing interior damages were addressed under a prior claim no. [redacted] that was reported on February 9, 2022, with a January 16, 2022, date of loss.”
Florida DFS Civil Remedy Notice, filing no. 696656, accepted 5/25/2023, Orlando. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where a coverage determination was issued in which Universal stated this.
LETTER IN A COURT FILING FL
People's Trust: the carrier's own 2018 underwriting inspection used to deny the claim
PRE-EXISTING WEAR & TEAR
“observed cracked/broken tiles due to age-related wear and tear as well as a prior repair to the roof which is noted in the underwriting inspection completed March 12, 2018”
Florida DFS Civil Remedy Notice, filing no. 686982, accepted 4/6/2023, Hialeah. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer notified the insured on February 16, 2023 that it was denying coverage for the loss, citing this.
NEWS REPORT FL
Integon: the lender-placed Milton claim the homeowner cannot even dispute
HURRICANE MILTON (2024) PRE-EXISTING UNDERPAID
“Basically, they're saying this damage was already there. Though she says she was quoted for $200,000 worth of damages by a contractor, she received a check for $1,111.51 for her claim.”
Tampa Bay 28 (Nadeen Yanes), New Port Richey: a lender-placed policy paid $1,111.51 against a $200,000 estimate; the mortgage company, not the homeowner, is the policyholder
CONSUMER COMPLAINT FL
Universal Property: new loss denied as related to a prior claim
PRE-EXISTING
“The investigation determined that damage to the water heater closet and downstairs ceiling was related to prior claim [number redacted] and was therefore not covered under this loss.”
BBB complaint No. 25092973 against Universal P&C (Fort Lauderdale profile); the carrier response states the prior-claim ground
ENDORSEMENT · 6 ON FILE
The counter-guide → REGULATOR COMPLAINT FL
Universal Property: the moved date of loss and the hurricane deductible
HURRICANE DEBBY (2024) ENDORSEMENT UNDERPAID
“The adjuster deliberately altered the reported date of loss to August 5, 2024. Due to the wrongful application of the hurricane deductible, the insured was deprived of $6,948.72 rightfully owed under the policy.”
Fla. DFS Civil Remedy Notice, Filing No. 794842 (Riley v. Universal P&C), Orange Park, FL
REGULATOR COMPLAINT FL
American Integrity: an adjuster came out, but the filing says the loss was never really adjusted
HURRICANE IAN (2022) ENDORSEMENT OTHER
“While the insurer did send an adjuster to evaluate the damages, there was no genuine adjustment of the claim by the insurer. That is to say, the insurer did not adjust the loss to include obviously related damages or ensuing damages related to Hurricane Ian.”
Fla. DFS Civil Remedy Notice, Filing No. 686293 (Hill/Laughlin v. American Integrity), Cape Coral, FL
LETTER IN A COURT FILING FL
Edison: the enclosure paid, the screen in it not covered because it was a hurricane
ENDORSEMENT COSMETIC
“Under the terms of your policy loss to the screened enclosure screen material is not covered due to hurricane damage.”
Florida DFS Civil Remedy Notice, filing no. 665138, accepted 12/30/2022, North Fort Myers. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the same letter records a check for $13,086.16 for Coverage A dwelling and screened enclosure being mailed.
LETTER IN A COURT FILING FL
Florida Peninsula: the interior covered to a $10,000 endorsement, the failed plumbing not covered
ENDORSEMENT SEEPAGE
“Although there is coverage for the damage to the interior of your home, the repair of the failed plumbing is not covered under the policy.”
Florida DFS Civil Remedy Notice, filing no. 660064, accepted 12/6/2022, Tampa. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter follows a payment of $10,000, the limit of a limited water damage endorsement applied to the claim.
LETTER IN A COURT FILING FL
Edison: screen enclosure coverage paid at $236.33, the screen material itself not covered
ENDORSEMENT COSMETIC
“Based on our investigation of your claim, and the terms of your policy, we have determined there is no coverage for the screen material of the pool enclosure.”
Florida DFS Civil Remedy Notice, filing no. 688115, accepted 4/13/2023, Englewood. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the same letter records $236.33 for Screen Enclosure Coverage being mailed to the insured.
CONSUMER COMPLAINT FL
Heritage: water claim denied on a Water Damage Exclusion added at renewal for $99
ENDORSEMENT
“Heritage investigated the claim and found water damage impacting the property, but unfortunately, the Insureds policy does not cover water damage. Since the Policy has the Water Damage Exclusion endorsement, there was no coverage for the claim.”
BBB complaint No. 23961124 against Heritage P&C (Clearwater, FL profile); Heritage's own written response states the endorsement-based denial and the $99.00 premium discount
LATE NOTICE · 6 ON FILE
The counter-guide → APPELLATE OPINION FL
Citizens: insufficient evidence plus late notice, the double-barrel letter
TROPICAL STORM ETA (2020) LATE NOTICE OTHER
“Based on all of the information gathered to date, there is insufficient evidence to substantiate a loss related to Wind - TS ETA on 11/08/2020. Citizens' ability to evaluate this claim has been prejudiced due to failure to report this loss in a timely manner; therefore, the claimed loss is excluded from coverage.”
Bouchard v. Citizens Prop. Ins. Corp., No. 3D23-2202 (Fla. 3d DCA Feb. 19, 2025)
APPELLATE OPINION FL
Frontline: 694 days late, and the wear-and-tear engineer to go with it
LATE NOTICE WEAR & TEAR
“Failure to notify Frontline of the loss as soon as possible may have prejudiced our ability to independently confirm the cause, origin, date of loss and duration of the reported damages; the carrier's engineer determined the damage was the result of normal wear and tear.”
You Restorations LLC a/a/o De Leon v. First Protective Ins. Co., No. 4D2024-1553 (Fla. 4th DCA July 23, 2025)
LETTER IN A COURT FILING FL
Heritage: late notice, and an investigation the carrier says was prejudiced
LATE NOTICE
“At this juncture, because of your failure to provide prompt notice of this claim, and due to your failure or inability to provide us with any facts or documents to support your claim, [name redacted] has absolutely no way to determine whether the storm caused any direct physical damage.”
Florida DFS Civil Remedy Notice, filing no. 656900, accepted 11/14/2022. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the November 11 letter denies all coverage, stating in pertinent part.
LETTER IN A COURT FILING FL
Security First: the claim denied because the proof of loss came back
LATE NOTICE OTHER
“The proof of loss document was mailed and emailed to the named insured on June 7, 2022 and reminders that the insurer was awaiting return of the completed proof of loss were issued throughout the sixty (60) day time period. Due to the requested proof of loss not being returned as required by the Con”
Florida DFS Civil Remedy Notice, filing no. 649453, accepted 9/28/2022, Ocala. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the carrier advised the insured the claim was being denied.
LETTER IN A COURT FILING FL
State Farm Florida: prejudiced, it says, by a claim reported about a month after the loss
LATE NOTICE
“since the property damage was reported approximately one month from the reported date of loss, it is not possible to establish when and how often the observed damages to your dwelling roof occurred. Therefore, State Farm has been prejudiced in [its] ability to thoroughly investigate this claim thus”
Florida DFS Civil Remedy Notice, filing no. 687415, accepted 4/10/2023, Gainesville. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter first states that winds were not strong enough to damage shingles on the dwelling roof, then goes on to state this.
LETTER IN A COURT FILING FL
Heritage: no prompt notice of Irma damage, and no factual information at all
LATE NOTICE
“you did not provide prompt notice of physical damage that would have occurred from Hurricane Irma … You have not provided us any factual information at all that would support your claim.”
Florida DFS Civil Remedy Notice, filing no. 676693, accepted 2/21/2023, Lake Worth. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the letter states the insureds had failed to prove the damages were the result of Hurricane Irma.
MOLD & FUNGI · 5 ON FILE
The counter-guide → REGULATOR COMPLAINT FL
Universal: an Ian claim denied under the fungi and third-party exclusions
HURRICANE IAN (2022) MOLD & FUNGI WIND-DRIVEN RAIN OTHER
“UPCIC denied the claim and took the position that the damage at the Property fell under the Policy exclusions for Fungi, Wet or Dry Rot, or Bacteria, and Assignees or Third Parties. Despite the significant damage to the Property, UPCIC has refused to issue any payment owed under the Policy.”
Fla. DFS Civil Remedy Notice, Filing No. 686362 (Kennedy v. Universal Property & Casualty), Ormond Beach, FL
LETTER IN A COURT FILING FL
State Farm Florida: mold in the house, and no coverage for anywhere else to live
MOLD & FUNGI ENDORSEMENT
“No coverage is provided [for] losses resulting from ordinance or law, mold or fungus, failure to act by any entity, defective design or materials, maintenance, or weather conditions. Due to these provisions, we are unable to cover alternate housing due to the presence of mold in”
Florida DFS Civil Remedy Notice, filing no. 797589, accepted 12/19/2024, Cocoa. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the adjuster advised this in the letter sent to the insured.
LETTER IN A COURT FILING FL
American Security: denied for mold, pending the plumber's report
MOLD & FUNGI OTHER
“[o]ur investigation indicates lack of documentation. Pending the plumber's report with the cause of loss and description of rate and flow of water release. Denied for mold.”
Florida DFS Civil Remedy Notice, filing no. 651000, accepted 10/12/2022, Miami. The filing is not the letter: the passage below is the denial letter's own language as the policyholder quoted it, where the insurer sent a claims determination letter which denied the claim, advising merely this.
NEWS REPORT FL
Ian mold claim denied for failure to mitigate: a county without power
HURRICANE IAN (2022) MOLD & FUNGI OTHER
“Mold still took off, and insurance denied her claim for mold damage on grounds that she should have done more to prevent it.”
Fox 13 Tampa Bay, Punta Gorda: consumer-watchdog report on Ian delays and disputes; a mold claim denied on the ground the family should have prevented the mold
CONSUMER COMPLAINT FL
Citizens: Milton mold denied after a steered refile to non-weather water
HURRICANE MILTON (2024) MOLD & FUNGI OTHER
“Citizens denied my claim based on milton. The adjuster who was handling the milton claim, after denying the mold claim, told me that this claim need to be filed under a non weather water damage, which I did filed cause I trusted citizens. This second claim was then kicked back to milton adjuster, denial was based on mold was caused by milton.”
BBB complaint No. 23453443 against Citizens (Jacksonville profile); the refile sequence is described in the record
MANAGED REPAIR · 1 ON FILE
The counter-guide → APPELLATE OPINION FL
People's Trust: the FULL AND FINAL check stub that wasn't final
HURRICANE MATTHEW (2016) MANAGED REPAIR UNDERPAID
“Your endorsement of this check memorializes your acceptance of the scope and amount of damages we previously reviewed; it is offered solely to bring about a complete and final resolution of your claim. Check stub: REASON: FULL AND FINAL PAYMENT.”
Lemon v. People's Trust Ins. Co., No. 5D21-2771 (Fla. 5th DCA June 3, 2022)
Quotes are verbatim from the cited public records. Consumer reports are the reviewer's account, quoted briefly and linked; they are demand signals and pattern examples, not verified claim files. Court and regulator documents speak for themselves at the linked source. Civil Remedy Notice descriptions are the filing party's allegations; the carrier's response is attached to each linked filing.
HURRICANE MILTON · FLORIDA · FLOIR DATA
134,177
Milton claims closed without payment: 34.8% of all claims filed. The documents above are how those closures were written.
REPRESENTATIVE FOOTAGE
WHERE THIS LEAVES YOU
Your letter is in this library somewhere
The arguments repeat because they come from shared clause libraries and the same short list of exclusions. Find the entry that matches your letter, read how the argument runs, then read the guide that answers it: wear and tear, wind-driven rain, cosmetic exclusions, or the full anatomy of a denial letter.
Then check whether your letter meets the legal floor at all: is your denial letter even legal? A letter that cites no policy language, arrived after the statutory deadline, or never mentioned your mediation rights is deficient, and deficiencies are leverage. The free claim review below reads your letter line by line.
03 · FREE LETTER REVIEW
Have a letter of your own? Put it on the desk.
Upload your denial letter and the adjuster estimate. You'll get a straight answer on which argument the carrier is running, how the same argument has fared before, and what the strongest next move is.
WHAT TO SEND
- 01 · THE DENIAL LETTER, EVERY PAGE, PLUS THE ENVELOPE
- 02 · THE ADJUSTER ESTIMATE, IF YOU HAVE ONE
- 03 · YOUR OWN DATED PHOTOS OF THE DAMAGE
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Halversen Law is a property-insurance law firm licensed in South Carolina and Florida that represents policyholders, never carriers. Since 2008, the firm has taken on denied, underpaid, and delayed claims across the full range of storm and property losses: wind and hurricane damage, water disputes, roof claims, and commercial and condominium losses. Its attorneys spent the early part of their careers defending insurance companies, and now use that inside knowledge of the carrier playbook, how an adjuster builds a denial and where the file is weak, to fight for the policyholder on the other side of it. Cases are handled on contingency: no fee unless you recover.
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Notice, supplemental, and suit windows under Florida and South Carolina statute.
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Appraisal, civil remedy notice, and bad-faith litigation when the carrier will not deal.
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HURRICANELAW.PRO A comprehensive property-insurance claim resource for policyholders: denied and underpaid claims, coverage and bad-faith law, storm dossiers, carrier profiles, city guides, and the complete claims playbook. Florida and South Carolina.
▸ SEE THE FULL SITE MAP →STORM ALERTS SOURCED FROM NOAA / NHC
HOW CLAIMS GET DENIED
Every denial argumentThey never decide the claimThe estimate comes in lowNobody really inspected itStorm damage called old ageTheir engineer says noYou cannot get your claim filePriced under your deductibleBlamed on how it was builtCalled water, not windMold capped after a covered lossThey pick the contractorYou reported it too late
STORM ARCHIVE, CITIES & NEWS
Most recent below. Every storm dossier, city resource, and article is on its hub (linked at each heading) or the grouped site map →. All 81 carriers and 95 public-adjuster firms are in the Directories column above.
NEWS & UPDATES · 20 →
2026 hurricane season so far: 2 storms, a quiet basin, and the Sept. 10 peak aheadThe 2026 Atlantic season: what policyholders should watchAre reciprocal exchanges safe to insure with?Appraisal vs. mediation vs. lawsuit: three ways to fight a property claimHow Citizens Property Insurance depopulation and takeouts workDocument storm damage before anyone touches it: the photo methodDemotech vs. AM Best: why your Florida carrier's rating looks differentFlorida's assignment-of-benefits (AOB) restrictions, explained View all 20 →
Coverage summaries, policy-language quotations, dollar figures, deadlines, and chart examples throughout this site are general information based on typical or standard policy forms and are illustrative only: they are not a quote, a guarantee of coverage, or a promise of any outcome. Every insurance policy is different: your own policy, endorsements, and state law control, so read your policy and confirm current statutes. Weather imagery courtesy of NOAA, the National Hurricane Center, and the National Weather Service. Legal services are provided by Halversen Law. Nothing on this site is legal advice; consult an attorney about your specific claim.
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