How Long Does an Insurance Company Have to Investigate an Auto Claim in Florida?
In Florida, insurance companies typically have 30 days to investigate auto claims, but many factors can affect how long the insurance claim process lasts.
As Insurify’s home and pet insurance editor, Danny also specializes in auto insurance. His goal is to help consumers navigate the complex world of insurance buying.
Lequita Westbrooks is a Senior Editor at Insurify. With extensive experience in writing and editing across industries like insurance, personal finance, higher education, and more, she’s passionate about helping readers understand complex topics so they can make informed financial decisions and save money. Outside of work, Lequita enjoys reading and spending time with her family (and two pups: Bella and Simba). She holds a bachelor’s degree in English from the University of South Florida.
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After receiving proof-of-loss statements, Florida insurers typically have 30 days to investigate car accident claims. No one wants a long insurance claims process, but situations like a complicated property damage case or policyholder fraud can delay the claims process.
Understanding Florida laws and insurance policy guidelines is essential to navigating the auto insurance claims process. Here’s what you need to know about car insurance claims in Florida, including your insurer’s obligations and what to do if your insurer denies or delays your claim.
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Time limits for auto insurance investigations in Florida
Florida laws establish four different time frames that account for each step of the claims process if you’re filing a car insurance claim with your insurance company. If you’re filing a claim against another driver’s insurance, the time frames may differ since you don’t have an insurance contract with the other driver’s company.[1]
Take a look at what each time frame entails below.
Initial acknowledgement period
When you file a claim with your insurance company, it must review and acknowledge receipt of your car accident claim within seven business days. The acknowledgment ensures the insurer actively manages your insurance claim as outlined in your insurance policy.
Investigation period
Once your insurance company receives proof-of-loss statements, it has seven business days to begin its claims investigation. The insurance adjuster will then have 30 days to assess and investigate the damages. This step involves gathering information about the car accident, determining fault, and verifying the insurance policy to ensure the claim’s validity.
Decision deadline
After an investigation, your insurer must send you its decision regarding the claim payout within seven days of the insurance adjuster’s estimate.
Payment deadline
Insurers must either pay or deny the claim within 60 days of receiving your claim notice. Florida law doesn’t hold insurance companies to this deadline due to factors outside the insurer’s control.
Factors that affect claim processing times
In some cases, insurers can extend deadlines for the claims process. The Florida Office of Insurance Regulation (OIR) must approve the extension.[2] Some complicating factors that can result in an extension include:
Claim complexity: If a claim is particularly complicated, an insurance company may request an extension. One example of this would be if the claim involves multiple vehicles colliding with severe injuries and property damage. The OIR would likely grant the insurer an extension so it can conduct a thorough investigation.
Evidence and documentation availability: If third parties cause delays that prevent the insurance company from accessing necessary information and documentation, the insurer can request an extension.
Your cooperation as a policyholder: To avoid delays and speed up the process, be sure to cooperate with your insurer. If you don’t provide timely information, this can slow down the investigation and potentially delay your claim.
When insurers can request an extension
Insurers can request an extension if factors beyond the insurer’s control cause delay, according to Florida law. In most cases, insurance companies can’t extend the period for payment or denial of a claim for longer than 30 days.
Factors beyond an insurer’s control include:
A state of emergency
A breach of security
An information technology issue
Policyholder fraud or intentional misrepresentation
Insurers must request an extension with the OIR through the Regulatory Electronic Filing System (REFS). To get an extension approved, insurers must provide proof of which factors beyond their control affect timelines. Insurance companies must also notify you about the request for an extension and keep you updated on the progress of the claim investigation.[3]
For Example
If your insurance company experiences a data breach or major technology failure that compromises its claims process, it may request a deadline extension. The OIR would likely approve this request, as your insurance company is unable to access the necessary information to process your claim on time.
Your rights during delays
If you feel that your insurance company is delaying the claims process without adequate justification, you have the right to:
Timely claims processing: Your insurer must comply with state laws regarding deadlines unless the state approves the insurance company for a deadline extension.
Get a written explanation for any delays: You can submit a request to your insurer asking it to explain any delays to you in writing and keep you updated on any developments.
Collect interest on late payments: If your insurance company fails to pay your claim by the payment deadline, you’re entitled to interest on your claim at 12% per year.
File a complaint: If you believe the delay is unreasonable, you can file a complaint with the OIR to investigate your insurance company.
Initiate legal action for bad-faith delays: If your insurer delays your claim without adequate justification or in bad faith, you have the right to pursue legal action against it under Florida’s Unfair Insurance Trade Practices Act.[4]
What to do if your insurance company misses deadlines
If your insurance company misses claims-processing deadlines, you have a few methods of action.
Contact your insurance company
Your first step should be to get in touch with your insurer and ask for a status update and a written explanation of the delay.
Send a demand letter
If your insurance company continues to delay without sufficient justification, you can send a formal demand letter requesting immediate claims processing. You should cite Florida Statute 627.70131 in your letter.
File a complaint
You can also file a complaint with the Florida Department of Financial Services (DFS) if you’d like to escalate the issue further.[5]
Contact an attorney
Finally, if your insurer continues to delay without justification, you can hire an attorney or adjuster to negotiate with your company. You can also file a civil remedy notice with the DFS.
Your insurance company is subject to consequences for missing deadlines without getting approval for an extension. The insurance company may be subject to fines and even sanctions from the Florida OIR. Additionally, the state may require your insurer to pay interest on claim payments and may even revoke its state license.[6]
What to do if an insurance company denies your claim in Florida
First, review your claim denial letter and call your insurance company for clarification on why it denied the claim. If you feel that the denial is unfair, you can file an appeal with your insurance company by providing evidence of why you feel the company should cover the claim.
If your insurer continues to deny your claim, you can file a complaint with the Florida Department of Financial Services. It can provide you with free mediation for a denied claim or a low settlement offer in some cases. You can reach this department online or by phone at 1 (877) 693-5236.
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Tips to make the claims process go as smoothly as possible
To ensure your claims process goes smoothly, be as cooperative with your insurance company as possible. This prevents your insurer from claiming you refused to assist or cooperate with its investigation.
Here a few other things you can do to make sure the claims process goes smoothly:
Provide complete, accurate, and detailed information. Submit all the necessary details about your claim. Include the location, date, time, parties involved, and a clear description of what happened.
Keep detailed records of your communication with your insurer. Document every conversation you have with your insurance company. Keep track of dates, who you spoke with, and what the topic of discussion was.
Follow up regularly with your insurance company. Stay in touch with your insurance company to ensure the claims process continues.
Respond to requests from your insurer promptly. If your insurance company requests information — such as additional documents or actions — do your part to keep the claims process moving.
Understand your coverage. Knowing what your insurance policy covers can help you avoid any confusion and disputes in the claims process.
Claims investigation in Florida FAQs
If you’re still unsure of your rights during the car insurance claims process, check out these answers to some of the most commonly asked questions about claims investigation in Florida.
How long do insurance companies have to settle a claim in Florida?
Insurance companies in Florida have 60 days to settle a claim from the submission of the claim. Companies can request an extension of up to 30 days in some cases, making the full settlement claim time 90 days.
How long can an insurer delay a claim in Florida?
Insurance companies in Florida can delay a claim for 30 days if they can prove that factors outside of their control affected the claims process. In general, the delay period can extend up to 90 days if factors beyond the insurer’s control apply.
Do insurance companies have a time limit for processing claims?
Yes. Insurance companies have a time limit for processing claims. In Florida, insurers must acknowledge receipt of a claim within seven days, begin any investigations within seven days of receiving proof of loss, and complete investigations within 30 days of receiving proof of loss.
Can you sue an insurance company in Florida for taking too long to process a claim?
It’s possible. You may be able to sue an insurance company for delaying the claim process without proper justification. If your insurance company has delayed your claim or you believe it’s acting in bad faith, consult an attorney for legal advice.
Sources
The Florida Senate. "Section 627.70131: Insurance contract provisions; notice of premium increase."
Danny is a Brooklyn-based writer with a producer’s license for property and casualty insurance. A former editor at Insurify, he specializes in auto, home, and pet insurance. He works to translate his insurance expertise into digestible, easy-to-understand content for drivers, homeowners, and pet owners alike.
Danny has been a contributor at Insurify since March 2022.
Lequita Westbrooks is a Senior Editor at Insurify. With extensive experience in writing and editing across industries like insurance, personal finance, higher education, and more, she’s passionate about helping readers understand complex topics so they can make informed financial decisions and save money. Outside of work, Lequita enjoys reading and spending time with her family (and two pups: Bella and Simba). She holds a bachelor’s degree in English from the University of South Florida.
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