14.1 Florida Prompt-Pay Clocks Under F.S. § 627.70131

Quick Answer: Florida enforces some of the nation's strictest property insurance prompt payment and communication mandates under Florida Statutes § 627.70131 (as amended by Senate Bills 2-D and 2-A). Insurers must acknowledge claim communications within 7 calendar days, conduct physical inspections within 30 calendar days, deliver written adjuster estimates within 7 calendar days of completion, and pay or deny claims within 60 calendar days of initial notice (reduced from 90 days), with late payments accruing statutory interest from the date of notice. Under F.S. § 627.7011, insurers must offer 25% or 50% Ordinance or Law coverage to pay for mandatory code upgrades. Crucially, under F.S. § 553.844 (SB 4-D), roofs built under the 2007 Florida Building Code or later that suffer damage exceeding 25% of the roof surface are exempt from mandatory total replacement and require only repair of the damaged portion.

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1. Florida Statutory Claims Timelines & Prompt Pay (F.S. § 627.70131)

During special legislative sessions in 2022 (Senate Bill 2-D in May 2022 and Senate Bill 2-A in December 2022), the Florida Legislature enacted landmark property insurance reforms that compressed claims handling deadlines. Claims adjusters are held to strict statutory timelines under F.S. § 627.70131.

The single most common exam error is assuming every clock starts on the date of the first notice of loss. It does not. Two of the four clocks start when the insurer receives the proof-of-loss statements.

Florida Statutory Claims Timelines (F.S. § 627.70131)
├── Any claim communication received ──► 7 days to review and acknowledge          [§ 627.70131(1)(a)]
│     └── The acknowledgment must supply claim forms, instructions and a phone number [§ 627.70131(2)]
├── Proof-of-loss statements received ─► 7 days to begin a reasonably necessary investigation [§ 627.70131(3)(a)]
├── Proof-of-loss statements received ─► 30 days to complete any physical inspection [§ 627.70131(3)(b)]
├── Adjuster generates a detailed estimate ─► 7 days to send the policyholder a copy [§ 627.70131(3)(e)]
└── Notice of the claim received ──────► 60 days to pay or deny, in whole or in part [§ 627.70131(7)(a)]

The Four Core Statutory Milestones

1. 7 Calendar Days — Acknowledge the Communication (§ 627.70131(1)(a) and (2)). Upon receiving any communication with respect to a claim, the insurer must review and acknowledge receipt within 7 calendar days, unless it pays within that period or the failure is caused by factors beyond its control. If the acknowledgment is not in writing, the file must contain a dated note of it. The acknowledgment must be responsive; where the communication is a notice of claim, it must provide the necessary claim forms, instructions and an appropriate telephone number unless it reasonably advises that the claim appears not to be covered. This subsection does not apply to claimants represented by counsel beyond the communications needed to supply forms and instructions.
2. 7 Days — Begin the Investigation (§ 627.70131(3)(a)). Within 7 days after the insurer receives proof-of-loss statements, it must begin such investigation as is reasonably necessary, unless prevented by factors beyond its control.
3. 30 Days — Complete Any Physical Inspection (§ 627.70131(3)(b)). The insurer must conduct any physical inspection within 30 days after its receipt of the proof-of-loss statements. The licensed adjuster assigned must give the policyholder a printed or electronic document showing the adjuster's name and state adjuster license number, and every later communication about the claim must include that name and license number. The insurer may investigate by electronic methods — clear color photographs or video, video conferencing, or drone imagery — and may still assign a licensed adjuster to inspect physically.
4. 60 Calendar Days — Pay or Deny (§ 627.70131(7)(a)). Within 60 days after receiving notice of an initial, reopened, or supplemental property insurance claim, the insurer must pay the claim or a portion of it, or deny it, and must give a written explanation of the basis in the policy, in relation to the facts or applicable law, for the payment, denial, or partial denial. If the payment is less than the insurer's own detailed estimate, the insurer must explain the difference in writing.

The 7-Day Estimate Rule (§ 627.70131(3)(e))

The insurer must send the policyholder a copy of any detailed estimate of the amount of the loss within 7 days after the estimate is generated by the insurer's adjuster. The statute does not force the insurer to create a detailed estimate that is not reasonably necessary to the investigation. Note the citation: this duty sits in subsection (3)(e), not subsection (4), which is the recordkeeping provision.

Statutory Interest on Late Payments

Any payment of an initial or supplemental claim made more than 60 days after the insurer received notice bears interest at the rate set in F.S. § 55.03. Interest begins to accrue from the date the insurer received notice of the claim, not from day 61. This has always been the accrual rule; the 2022 reforms shortened the trigger from 90 days to 60. The subsection cannot be waived by policy language, the insured must elect either prejudgment interest or this statutory interest, and failure to comply is a violation of the code but does not by itself create a private cause of action.

Which Claims the 60-Day Rule Covers (§ 627.70131(5)(b) and (7)(b))

For the earlier subsections, "insurer" means any residential property insurer. For the 60-day pay-or-deny rule, "claim" means only:

1. a claim under a policy providing residential coverage as defined in F.S. § 627.4025(1);
2. a claim for structural or contents coverage under a commercial property policy where the insured structure is 10,000 square feet or less; or
3. a claim for contents coverage under a commercial tenant policy where the insured premises is 10,000 square feet or less.

The subsection does not apply to policies covering nonresidential commercial structures or contents in more than one state. The section does apply to surplus lines insurers writing residential coverage.

Tolling the Deadlines (§ 627.70131(8))

The statutory clocks are tolled:

• During any mediation under F.S. § 627.7015 or any alternative dispute resolution proceeding provided for in the contract, ending when that proceeding ends; and
• When the policyholder fails to provide requested material claims information within 10 days after the request is received, ending when the insurer receives it. This tolling only works if the insurer sent the request at least 15 days before the pay-or-deny deadline.

"Factors beyond the control of the insurer" is also defined narrowly: a Governor-declared state of emergency, a reportable security breach, or an information technology issue — each only where the office issues an order finding insurers unable to comply — plus fraud, lack of cooperation, or intentional misrepresentation by the policyholder. The office may not extend the payment or denial period by more than 30 additional days.

Partial Payments and Preliminary Estimates (§ 627.70131(6))

A preliminary or partial estimate must carry a 12-point bold uppercase statement telling the policyholder the estimate is a current evaluation that may be revised. A payment that is not the full and final payment must carry a similar 12-point bold uppercase statement that the insurer is continuing to evaluate the claim and may issue additional payments.