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Florida law provides informal alternative dispute resolution programs for certain types of insurance claims. If you have a claim dispute with your insurer, our programs may help you to resolve it prior to taking legal action. If your insurer maintains a position regarding your claim which you find unsatisfactory, mediation will allow you to sit down face to face with the company and a neutral third party mediator certified by the Department of Financial Services (DFS) to try and resolve your differences. The mediator acts to encourage and assist in the resolution of the dispute without dictating the outcome. If you have a sinkhole claim dispute, our sinkhole Neutral Evaluation program will provide a neutral third party professional to review the findings of the insurer.

Both mediation and sinkhole neutral evaluation are non-binding. Neither the insured nor the insurance company is legally obligated to accept the outcome of the mediation conference.

The following programs are currently available:

Automobile Mediation

Mediation is available to anyone filing a claim with an insurance company for property damage for any dollar amount, or for bodily injuries up to $10,000, which includes injuries covered under PIP. Either party (consumer or insurance company) may request mediation of the claim prior to the institution of litigation or the appraisal process. The insured may have an attorney present but must notify the company in advance.

Mediation is non-binding and neither the consumer nor the insurance company is legally obligated to accept an offer that they consider unsatisfactory. If a settlement is reached, the consumer has three days in which to change their mind as long as the check has not been cashed.

Both 1st party claims (claims against your insurance company) and 3rd party claims (claims against the other party's insurance company) are eligible for mediation. The cost of mediation is $100.

Automobile Mediation is a voluntary program. If the other party chooses not to participate in mediation, the $100 fee will be refunded to the requesting party.

Additional Information:

Reference: Florida Statute 627.745 and Rule 69O-176.022

Residential Property Mediation

Mediation is an informal way to resolve a claims dispute between the policyholder and the insurance company. It is a process where a neutral third party acts to encourage and assist in the resolution of a dispute without dictating the outcome. The insurer must provide a representative with full authority to settle the claim at the mediation conference. The conference should be held at a location near the policyholder residence.

The insured and the insurer shall attend the mediation conference, have full knowledge of the facts of the dispute, and be fully authorized to make an agreement to completely resolve the claim. An insurer will be deemed to have failed to appear if the insurer’s representative lacks authority to settle the full value of the claim. The authority to settle the claim includes the ability to disburse the full settlement amount within 10 days of the conclusion of the conference.

Mediation is non-binding. Neither the policyholder nor the insurance company is legally obligated to accept the outcome of the mediation conference. Settlements reached at the conference can be rescinded within three days of the agreement as long as the check has not been cashed.

Eligibility:

Effective 07/01/2012, mediation may be requested only by the policyholder, as a first-party claimant, or the insurer. Disputes or denials of residential property claims (flood claims not included as they fall under rules of FEMA) in excess of $500 are eligible. Mediation is not binding on either party. The insurance company pays the entire cost of mediation. Eligibility: All property insurance claims (hurricane and non-hurricane) are eligible for mediation unless either of the following issues is present - 1) if a fraud complaint has been filed, or 2) if the insured and insurer agreed as to what has caused the loss and that cause is not covered under the policy. If there is a dispute concerning the cause of loss, and it could be covered, then it is eligible for mediation.

Cost of Mediation:

Property mediation is free for the policyholder. The insurance company pays the entire cost of the conference. However if the conference has to be rescheduled, there are associated fees. If the policyholder fails to appear for the conference, it can be rescheduled after the policyholder pays the mediator’s fee. Generally, the cost of mediation is $350. If the insurance company fails to appear, without good cause, they must pay actual cash expenses of the policyholder in attending the rescheduled conference and they must pay the mediator’s fee for the rescheduled conference.

Legal Representation:

The policyholder can bring their attorney to the mediation conference. However, the insurer must be notified of the attorney’s attendance prior to the conference.

Additional Information:

Reference: Florida Statute 627.7015 and Rule 69J-166.031

Commercial Residential Mediation

Mediation is an informal way to resolve claims between the policyholder and the insurance company. It is a process where a neutral third party acts to encourage and assist in the resolution of a dispute without dictating the outcome. Mediation is non-binding. Neither the policyholder nor the insurance company is legally obligated to accept the outcome of the mediation conference.

Note: Effective July 1, 2012, mediation may be requested only by the policyholder, as a first party claimant, or the insurer.

Disputes or denial of personal property claims in excess of $500, not including deductibles, are eligible. To have an attorney present is optional; however, if the policyholder chooses to have an attorney present, the company must be notified in advance.

The insured and the insurer must attend the mediation conference, have full knowledge of the facts of the dispute, and be fully authorized to make an agreement to completely resolve the claim. The authority to settle the claim includes the ability to disburse the full settlement amount within 10 days of the conclusion of the conference. The conference will be held within a reasonable proximity of the insured property.

To request mediation, the Commercial Residential Mediation Request Form must be completed by the policyholder and sent to the Mediation Section of the Department of Financial Services (DFS). Once they are contacted, the insurance company has 21 days in which to resolve the dispute. If the dispute is not resolved, the issue is assigned to a mediator. The process should be completed within 45 days of the request. The mediator is randomly selected by DFS.

Commercial Residential Property Mediation is free for the policyholder. The insurance company pays the entire cost of the conference. However if the conference has to be rescheduled, there are associated fees. If the policyholder fails to appear for the conference, it can be rescheduled after the policyholder pays the mediator’s fee. If the insurance company fails to appear, without good cause, they must pay actual cash expenses of the policyholder in attending the rescheduled conference and they must pay the mediator’s fee for the rescheduled conference.

Mediation settlements can be rescinded within three days of the agreement as long as the check has not been cashed.

Additional Information:

Reference: Florida Statute 627.7015 and Rule 69J-166.002

Sinkhole Neutral Evaluation Program

Upon receipt of a claim for a sinkhole loss to a covered building, Florida law requires insurance companies to inspect the premises to determine if there has been structural damage that may be the result of sinkhole activity.

If the insurer discovers structural damage which is consistent with a sinkhole loss, or if the insurer is unable to identify a valid cause of such damage, the insurer must engage a professional engineer or geologist to conduct testing to determine the cause of loss within a reasonable professional probability. The professional engineer or geologist will provide a report of their findings to the insurer.

Following the receipt of the report or the denial of a claim for a sinkhole loss, the insurer is required to notify the policyholder of their right to participate in the neutral evaluation program.

If your insurance company denied a claim for loss or damage based on the results of the testing, or you cannot agree on the method of repair and remediation, you have the option to request a Neutral Evaluation. This alternative dispute resolution process, which involves the use of a state-certified Neutral Evaluator, is authorized under Section 627.7074, Florida Statutes. “Neutral evaluator” means a professional engineer or professional geologist who has completed a course of study in alternative dispute resolution designed or approved by the Department of Financial Services (department) for use in the neutral evaluation process and who is determined by the department to be fair and impartial.

If the insurer denied the claim because it concluded there was no structural damage, you must demand testing to determine the cause of loss before you can request a Neutral Evaluation. Your demand for testing must be made to your insurer in writing within 60 days of the claim denial and you must pay 50% of the actual costs of the testing or $2,500, whichever is less. If a sinkhole loss is confirmed, your insurer will reimburse you. Either the insured or insurer can initiate the use of a Neutral Evaluator if a sinkhole report has been issued.

Neutral Evaluation is mandatory if requested by you or your insurer. The evaluator must be allowed reasonable access to the interior and exterior of the covered building to be evaluated. The insurer is required to pay the reasonable costs associated with the Neutral Evaluation program; however, it is not required to pay for a court reporter hired by the insured. The evaluation is non-binding and does not invalidate the appraisal clause that may be included in your insurance policy. Both parties retain their right to pursue legal action. However, filing a request for neutral evaluation tolls the applicable time requirements for filing suit for 60 days following the conclusion of the neutral evaluation process or the time prescribed in Florida Statute 95.11, whichever is later.

Additional Information:

Reference: Florida Statute 627.7074 and Rule 69J-8

Initiating Mediation

If you are having difficulty with your claim and are interested in one of our mediation programs, you may contact the Department of Financial Services (DFS) using the information listed below.

Note: The DFS may open a service request on your behalf and attempt to resolve the dispute with your insurer prior to scheduling a mediation hearing.

  • Online Request: Request Assistance
  • Telephone: Consumer Helpline 1-877-MY-FL-CFO (1-877-693-5236)
  • Out of State Callers: (850) 413-5818
  • Fax: Attn Mediation Section (850) 488-6372
  • Email: Mediation@MyFloridaCFO.com or NeutralEvaluation@MyFloridaCFO.com
  • Mail: Florida Department of Financial Services, Mediation Section, Bureau of Education, Advocacy, and Research, 200 East Gaines Street, Tallahassee, Florida 32399-0322