Your insurance company is not your friend. It's a business

Your insurance company is not your friend. It's a business that earns money by collecting premiums and controlling what it pays out. That doesn't make it your enemy, but it does mean the adjuster works for the insurer, not for you. Know how claims are handled, keep everything in writing, and protect your claim from the start.

Many people think of their insurer the way they think of their local agent: friendly, familiar, someone who has their back. Then a storm hits, the claim goes in, and the tone changes. Here's why that happens, what to watch for, and how Florida homeowners can protect themselves.

How insurance companies make money

An insurance company takes in premiums from many policyholders and pays claims for the few who suffer a loss in a given year. What's left after claims and expenses is profit, along with investment income on the premiums it holds.

That means every dollar paid on a claim is a dollar of cost. Most companies want to pay valid claims, because that's what keeps customers and regulators satisfied. But they also have every reason to pay no more than they have to, and to look closely for reasons a claim isn't covered.

Florida adds pressure on top of that. Hurricanes, sudden windstorms and hail mean Florida insurers face large claims, and the state's property insurance market has been through years of rate increases, insurer insolvencies and law changes. When insurers are under financial strain, claims tend to get more scrutiny, not less.

Who you're really talking to

Once you file a claim, you'll likely hear from one or more of these people. It helps to know who each one works for.

The adjuster may be polite and helpful. Many are. But their job is to evaluate the claim on the company's behalf, and their estimate is the company's opening number.

Common tactics to watch for

Not every insurer does these things, and not every delay is bad faith. But these patterns come up often enough that you should recognize them.

Asking for a recorded statement early

An adjuster may call within days and ask to record a conversation about the damage, when you noticed it and what happened. Anything you say can later be used to argue the damage is old, was caused by something excluded, or was reported late. You can ask to answer questions in writing, take time to gather your records first, or talk to a lawyer before giving a statement.

Blaming age or wear and tear

"Wear and tear" and "long-term deterioration" are among the most common reasons Florida roof claims are denied. Storm damage on an older roof is still storm damage. A licensed roofer's inspection, dated photos and your repair history can show the difference.

A low first estimate

The first estimate often leaves out items like code upgrades, interior water damage, or matching materials. Sometimes it comes in just under your hurricane deductible, which produces a "no payment" letter that reads like a denial.

Delays and repeated document requests

Requests for the same records more than once, long gaps between contacts, or a new adjuster every few weeks can wear people down. Some homeowners give up, and the claim closes on the insurer's terms.

A check marked "final payment"

Read every check and letter before you cash or sign anything. A release or a check marked as full and final settlement may limit your ability to recover more later.

What Florida law requires of your insurer

Florida gives homeowners some protection during the claims process. For most residential policies, the insurer must generally:

• Acknowledge your claim within 7 days of your notice.
• Pay or deny the claim within 60 days of notice, unless factors outside its control prevent it (§627.70131).
• Explain a denial in writing, based on the language of your policy.
• Give you the Homeowner Claims Bill of Rights, a short summary of your rights from the Florida Department of Financial Services.

You also have options when you disagree. Many policies include appraisal for disputes over the amount of the loss, and the Department of Financial Services runs a free mediation program for many residential claims. Keep in mind the deadlines run both ways: you generally have one year from the date of loss to report a new claim and 18 months for a supplemental claim. We explain how those deadlines came about in what Florida Senate Bill 76 means for homeowners.

How to protect your claim

1. Read your policy before you need it. Check your declarations page for your deductibles, roof endorsements and coverage limits.
2. Document the damage right away. Take dated photos and video of every affected area, inside and out.
3. Prevent more damage. Tarp the roof, dry out water, and save every receipt. Most policies require reasonable steps to protect the property.
4. Put it in writing. Follow up every phone call with a short email summarizing what was said. Keep a claim journal with dates and names.
5. Get your own estimate. A licensed contractor's estimate gives you something to compare against the insurer's number.
6. Don't guess. If you don't know when damage started or what caused it, say so. Don't speculate on a recorded call.
7. Ask for copies. Request the adjuster's estimate, photos and any engineer's report.
8. Get a second opinion on the policy. A free policy review can show whether a denial or low offer matches what your policy really says.

If you're not sure whether your situation calls for a lawyer, our guide to knowing when you need an insurance lawyer walks through the signs.

Frequently asked questions

Do I have to give my insurance company a recorded statement?

Your policy likely requires you to cooperate with the investigation, which can include answering questions or an examination under oath. But you can usually ask to schedule the statement, review your records first, and have a lawyer present. Stick to facts you know, and don't guess about dates or causes.

Is the adjuster on my side?

The adjuster may be friendly and fair, but they evaluate your claim for the insurance company. Their estimate isn't the final word. You're allowed to disagree, submit your own evidence and estimates, and ask the insurer to reconsider in writing.

Will my insurer drop me if I file a claim?

Filing a valid claim is what your coverage is for. Insurers can consider claim history at renewal, and Florida law sets rules on when and how they can cancel or decline to renew. Not filing a legitimate claim can leave you paying for repairs yourself.

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Insurance is important, and many adjusters do their jobs fairly. But your insurer's interests and yours don't always line up, and it's reasonable to protect yourself. If your claim has been delayed, underpaid or denied, learn more about the homeowners claims we handle. We'll read the policy with you and explain your options in plain language, in English or Spanish.