Cause of loss disputed
Wind, rain intrusion, flood, settling and age can all be named as causes. Which one the file points to decides coverage, so the inspection and the photos have to address causation directly.
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Disclaimer: AF Claims is not affiliated with, endorsed by, or sponsored by Tower Hill Insurance Exchange. Carrier names are used only to identify the insurer. Every claim is different; results are not guaranteed.
Tower Hill Insurance Exchange is a reciprocal insurer, a type of insurance company owned by its policyholders and managed by an attorney-in-fact. Tower Hill is based in Gainesville, Florida, and writes residential property insurance in Florida.
In the Florida Office of Insurance Regulation’s Q2 2026 market-share report, Tower Hill Insurance Exchange had 423,759 residential policies in force as of June 30, 2026, ranking 4th among Florida residential property insurers by policy count.
Common reasons Florida carriers cite when they deny or reduce a claim (general patterns, not Tower Hill’s internal policy):
Wind, rain intrusion, flood, settling and age can all be named as causes. Which one the file points to decides coverage, so the inspection and the photos have to address causation directly.
Many Florida policies cap mold remediation at a sublimit. The underlying water damage may still be covered separately, so check whether the estimate treats the two correctly.
Actual cash value payments subtract depreciation. Heavy depreciation on labor or on newer materials can shrink a payment. Under replacement cost coverage, some of it may be recoverable after repairs.
Other-structures coverage and screen enclosure limits are often misunderstood. Some policies limit or exclude screen enclosures unless you bought coverage for them.
Damage sometimes shows up months later during repairs. Florida allows supplemental claims within 18 months of the date of loss (s. 627.70132), so document new findings right away.
Mitigate to prevent more damage, but photograph and measure first, keep removed materials if you can, and give the insurer a chance to inspect before permanent repairs.
Within 60 days after notice of an initial, reopened or supplemental claim, a Florida residential insurer must pay or deny it, or a portion of it, and give a reasonable written explanation of the basis in the policy. If it pays less than its own detailed estimate, it must explain the difference in writing (s. 627.70131(7)(a), Fla. Stat.).
The insurer must send you any detailed estimate within 7 days after its adjuster generates it (s. 627.70131(3)(e)). Compare it room by room with the damage.
Look up the exclusion or condition named in the letter, plus your declarations page and endorsements: hurricane deductible, roof settlement terms, water damage limits.
Notice of a new or reopened claim is due within 1 year after the date of loss, and a supplemental claim within 18 months (s. 627.70132, as amended through 2024). For weather events, the date of loss is the landfall or NOAA-verified date. Lawsuit deadlines are separate.
If the dispute is about the amount of loss and your policy has an appraisal clause, appraisal may apply. Florida’s DFS mediation program (s. 627.7015) is available for many residential disputes.
More on Florida claims: Florida public adjusters · Florida denied claim guide
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A reciprocal is an insurer owned by its policyholders (called subscribers) and run by a separate company called the attorney-in-fact. For a claim, it works like any other insurer: your policy terms and Florida claim-handling law apply.
Often, yes, if you have new information and you are within the Florida deadlines: 1 year from the date of loss for a reopened claim, or 18 months for a supplemental claim for additional damage from the same event (s. 627.70132).
Not always. Florida law lets insurers investigate with photos, video or drones (s. 627.70131(3)(d)). If a physical inspection is done, it must happen within 30 days after the insurer receives the proof-of-loss statements, and the adjuster must give you his or her name and license number.
Under s. 627.70132, Florida Statutes, notice of a new or reopened claim must be given within 1 year after the date of loss, and notice of a supplemental claim within 18 months after the date of loss. For hurricanes and other weather events, the date of loss is the landfall date or the date NOAA verifies the event. Lawsuit deadlines are separate; ask a Florida-licensed attorney about those.
No. No one can honestly guarantee an outcome. We review the file, tell you what we see, and represent you if it makes sense to work together. Every claim is different, and prior results do not guarantee a similar outcome.
The claim review is free, and asking questions doesn’t hire us. If it makes sense to work together, the fee and services are explained in a written agreement before you sign.
General information, not legal advice. Policies and state laws differ, and laws change.
Sources checked September 27, 2026.
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Disclaimer: AF Claims is not affiliated with, endorsed by, or sponsored by Tower Hill Insurance Exchange. Carrier names are used only to identify the insurer. Every claim is different; results are not guaranteed.
American Financial Claims is a licensed public adjusting firm, not a law firm. We do not provide legal advice. Office: Brickell Arch, 1395 Brickell Ave, Suite 800, Miami, FL 33131. Every insurance claim is different, and prior results do not guarantee a similar outcome.