Orlando Harmon
If you're facing issues with your insurance company in Florida, you can file a complaint with the state. Common reasons for filing a complaint include delays, denials, and unsatisfactory settlements. Before filing a complaint, you should gather supporting documents and information such as your name, address, type of insurance, and the reason for your complaint. You can file your complaint online or over the phone with Florida's Chief Financial Officer or the Florida Department of Financial Services, which provides resources and assistance through insurance specialists.
| Characteristics | Values |
|---|---|
| Who to file a complaint with | Florida's Chief Financial Officer, Florida Insurance Commissioner, or the state department of insurance (DOI) |
| How to file a complaint | Online, by email, by phone, or by mail |
| What to include in the complaint | Name, address, type of insurance, and reason for the complaint. Supporting documents and photographs, including email correspondence and a log of phone calls with the insurance company |
| What the department will do | The department will assign an insurance specialist to assist in resolving the matter and protecting your rights as a consumer. They may also contact the insurance company directly to mediate the dispute |
| What if it's a UM claim? | If you're trying to get more than the UM coverage limit, you may need to file a Civil Remedy Notice (CRN) of insurer violation. CRNs are usually filed by lawyers |
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What You'll Learn
Common reasons to file a complaint
There are several reasons why a person may need to file an insurance complaint in Florida. The most common reasons for filing a complaint include delays, denials, and unsatisfactory settlements. Here are some detailed examples of common reasons to file an insurance complaint:
Unresponsive Insurance Carrier: If you have been unable to get ahold of your insurance company after filing a claim, you may decide to file a complaint. This situation can be frustrating and cause delays in resolving your claim.
Delay in Claim Payment: An unusually long delay in receiving your claim payment can be a significant issue. Insurance companies have an obligation to process and pay out claims in a timely manner. If you experience excessive delays, you may need to escalate the matter by filing a complaint.
Underpayment or Lowball Claim: If you believe that your insurance company has offered a settlement that is too low or does not adequately cover your losses, you may file a complaint. Insurance companies should provide fair and reasonable compensation based on the terms of your policy.
Denial of Claim: In some cases, insurance companies may deny or reject your claim. If you believe that your claim has been wrongfully denied or that the reasons provided for the denial are unjustified, you can file a complaint to dispute the decision and seek a reconsideration.
It is important to remember that before filing a complaint, you should gather all the necessary documents, information, and supporting evidence related to your claim and interactions with the insurance company. This includes items such as email correspondence, phone call logs, claim forms, and any other relevant paperwork.
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What to prepare before filing
If you are facing issues with an insurance company and a Florida insurance policy, you can file a complaint. Before filing, it is important to prepare the following:
Documents and Information
Gather all the necessary documents and information pertaining to your case. This includes supporting documents, photographs, email correspondence, and a log of phone calls with your insurance agent or company. If it is a health insurance issue, provide a copy of the front and back of your insurance card. You may also need a copy of your declarations page. These documents will serve as evidence to support your complaint.
Contact Information
Ensure you have your up-to-date contact information, including your address and telephone numbers (home, cell, and work). This information allows the relevant authorities to reach you during the complaint process.
Insurance Policy Details
Be prepared to provide details about your insurance policy. This includes information such as the type of insurance you have, your policy number, and the dates of coverage. Knowing your policy details will help expedite the complaint process and allow for a more thorough investigation.
Reason for Complaint
Clearly understand and articulate the reason for your complaint. Common reasons for filing a complaint include delays in claim payments, denial of claims, unsatisfactory settlements, or failure of the insurance company to respond to your inquiries. Be specific about the issues you have faced and the resolution you are seeking.
Legal Representation
Consider seeking legal representation. While it is not mandatory, having a lawyer can be beneficial, especially if you are dealing with complex insurance issues. Lawyers are knowledgeable about insurance laws and may employ strategies to strengthen your case. They can guide you through the process and ensure your rights as a consumer are protected.
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Ways to file a complaint
If you are facing issues with your insurance company, there are several ways to file a complaint in Florida. Here are the steps you can take:
Online Submission:
You can submit a complaint online by visiting the Florida Department of Financial Services' website, specifically the Online Insurance Assistance homepage. Here, you will find relevant forms and contact information. The website also provides resources to help resolve issues related to insurance products, including bonds, warranties, and annuities. After submitting your complaint, you will receive an email with instructions for attaching supporting documentation.
Phone Call:
You can file a complaint by calling the Insurance Consumer Helpline at 1-877-MY-FL-CFO (693-5236). This helpline is dedicated to assisting consumers with insurance-related concerns. Make sure to have all the necessary information and documents ready before making the call.
Email:
Another option is to send an email to the Division of Consumer Services at [email protected]. This method allows you to explain your concerns in detail and attach any relevant documents or evidence to support your case.
Mail:
If you prefer, you can submit a written complaint by mail. Be sure to include all the necessary information, such as your contact details, the nature of your complaint, and any supporting documentation. Send your complaint to the Florida Department of Financial Services, ensuring it reaches the relevant division or specialist who can assist with insurance-related issues.
Civil Remedy Notice (CRN):
If your issue involves an insurance policy in Florida and you are seeking compensation beyond the uninsured motorist (UM) coverage limit, you or your lawyer can file a Civil Remedy Notice (CRN) against the insurance company. This is a formal process that allows you to pursue legal action if your insurance company is not fulfilling its obligations.
Before filing a complaint, it is essential to gather all the necessary information and documents, such as policy details, correspondence with the insurance company, and any other evidence that supports your case. It is also recommended to review the complaint index of the insurance company to understand the context of your complaint and the company's track record.
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What happens after filing
Once you have filed an insurance complaint in Florida, your request will be assigned to an insurance specialist who will provide necessary assistance. If you file online, you will create an account and navigate through a fillable form before clicking "submit". If you call, you will give your information to a clerk. The information you need to supply includes your insurance company name, policy number, claim number, contact information, and a detailed description of your claim and dispute. After submitting your complaint, you will receive an email with your complaint number and instructions for attaching supporting documentation.
The DFS consumer complaint clerks will generally be sympathetic to your cause, but they can only ask the insurance company for its position, which in most cases you will already know based on a claim denial letter from the adjuster. Once the insurance company responds to the assigned clerk, your complaint file will be closed as "resolved".
When your complaint is deemed resolved and your file is closed, you will receive a letter thanking you for your correspondence and letting you know that the insurance company has not changed its position. The DFS will also advise you of two other remedies: DFS mediation or consultation with a lawyer. The standard DFS complaint response/closing letter states: “You may be able to pursue the matter through the legal system. Should you decide to explore this option, you will need to consult with an attorney to determine your rights and options.”
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Additional resources
The Florida Department of Financial Services – Division of Consumer Services provides resources to help consumers resolve issues with insurance products, including bonds, warranties, and annuities. You can submit a complaint on these insurance products online, by email, by phone, or by mail. An insurance specialist will be assigned to your case to provide assistance.
The National Association of Insurance Commissioners (NAIC) is a US standard-setting organisation that provides expertise, data, and analysis for insurance commissioners to effectively regulate the industry and protect consumers. The NAIC compiles closed, confirmed complaint information about insurance carriers from state insurance departments, which is available to consumers via the Consumer Insurance Search page. Here, you can look up information by state, company, and insurance type for the past three years.
If you are having issues with an insurance company and a Florida insurance policy, you or your lawyer can file a Civil Remedy Notice (CRN) of insurer violation. CRNs are a way to get more than the uninsured motorist (UM) coverage limit.
If your issue is with a Medicaid plan, you will need to file a complaint with the Agency for Health Care Administration (ACHA).
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Frequently asked questions
Common reasons for filing an insurance complaint include delays, denials, and unsatisfactory settlements. You may also file a complaint if your insurance company is not answering your phone calls, emails, or faxes.
You can file a complaint with Florida's Chief Financial Officer or the Florida Department of Insurance online or over the phone. You can also submit a complaint by emailing the Division: [email protected]. Before filing, gather supporting documents and photographs, including email correspondence and a log of phone calls with your agent or company.
You will need to provide your name, address, type of insurance, and the reason for the complaint. You may also need to provide a copy of your declarations page and, if it is a health insurance issue, a copy of the front and back of your insurance card.
Your complaint will be assigned to an insurance specialist who will assist in resolving the matter and ensuring your rights as a consumer are protected. The division may also contact the insurance company directly to mediate the dispute and work toward a resolution.
Typically, you cannot file a consumer complaint if you are making a claim against a self-insured company, unless your claim is worth more than their self-insured retention (SIR).
