Insurance companies process thousands of claims at a time. Under that volume, some delay and confusion is inevitable. But there is a legal line between an honest mistake and a deliberate strategy to avoid paying what a policy promises. Florida law — specifically §624.155 — defines that line and creates real consequences for insurers that cross it. Here are seven warning signs that your insurer may have crossed it.
The Legal Backdrop: What Florida Law Requires of Insurers
Under Florida's Unfair Insurance Trade Practices Act and the common law duty of good faith, insurance companies are required to investigate claims promptly, communicate with claimants in a timely manner, and offer settlements that reflect the honest value of a covered claim. These are not aspirational guidelines — they are legal obligations. An insurer that violates them faces not only the original claim amount, but potentially consequential damages, attorney's fees under §627.428, and in serious cases, punitive damages.
The seven warning signs below are drawn from the statutory language of §624.155, the case law interpreting it, and more than three decades of bad faith litigation experience at Swope, Rodante P.A.
Sign 1: Unexplained Delays in Handling Your Claim
What It Looks Like
You filed your claim weeks or months ago. Every time you call, you get a different representative who tells you the claim is "still being reviewed" or "pending documentation." Deadlines are missed without explanation. Requests for updates go unanswered. The investigation seems to have no end date.
Why It Matters
Florida law requires insurers to acknowledge receipt of a claim within 10 days and to begin an investigation promptly. Under Florida Administrative Code Rule 69O-166.0045, insurers must pay or deny a claim within 90 days of receiving proof of loss. Deliberate delays — particularly delays that outlast the claimant's patience and lead them to accept a lower settlement — are among the most common forms of insurance bad faith.
Delay is particularly damaging in cases involving serious injuries, where medical bills continue to accrue and injured people cannot return to work. An insurer that knows this and uses delay as leverage to pressure a reduced settlement is acting in bad faith.
What to Do
Document every communication — date, time, representative's name, and what was said. Send written follow-up letters (not just phone calls) creating a paper trail. If delays persist beyond 60–90 days without a legitimate explanation, consult a bad faith attorney.
Sign 2: Denial Without a Meaningful Explanation
What It Looks Like
Your claim is denied in a letter that cites a policy exclusion in vague terms or references "policy language" without explaining how that language applies to your specific facts. Or the denial letter acknowledges the incident but simply states the claim "does not meet the threshold for coverage" without elaboration.
Why It Matters
A valid denial requires a reasonable basis — a specific policy provision, supported by specific facts, that legitimately excludes coverage. Blanket or boilerplate denials that do not explain the actual reasoning are a red flag. They often signal that the insurer has not conducted a real investigation, or that the actual basis for the denial would not withstand scrutiny.
Under Florida law, the insurer bears the burden of proving that an exclusion applies. If the denial cannot be supported by specific facts and specific policy language, it may be invalid — and the process of issuing it without a reasonable investigation may itself constitute bad faith.
What to Do
Request a written explanation citing the specific policy section and specific facts supporting the denial. If the insurer cannot or will not provide this, that response itself is evidence. Do not assume a denial is correct — have an attorney review the policy and the denial letter before accepting it.
Sign 3: A Lowball Offer With No Supporting Basis
What It Looks Like
You have submitted medical bills totaling $80,000. The insurer offers $12,000. When you ask how they calculated that number, you get a vague reference to "comparable claims" or a statement that their adjuster "assessed the injury severity." No medical review, no independent medical examination report, no written evaluation — just a number that is a fraction of your documented losses.
Why It Matters
Florida Statute §624.155(1)(b)(1) specifically identifies as an unfair claim settlement practice "attempting to settle claims for less than the amount to which a reasonable person would believe the insured was entitled." An offer that is not grounded in any legitimate evaluation of the claim is not a good-faith settlement attempt — it is a pressure tactic designed to see if the claimant will accept less than they deserve.
This is particularly common in cases involving soft-tissue injuries, where the insurer may claim that subjective symptoms are unverifiable. But even soft-tissue injuries that are adequately documented in medical records carry real value, and an insurer that refuses to pay that value without a legitimate medical basis may be acting in bad faith.
What to Do
Do not accept a lowball offer without first having an attorney evaluate the full value of your claim. Demand a written explanation of the valuation methodology. An experienced personal injury attorney will often uncover that the insurer's internal reserve — the amount it has set aside to pay the claim — is far higher than what it offered.
Sign 4: Misrepresenting Your Policy or Your Rights
What It Looks Like
An adjuster tells you that your policy "doesn't cover that type of claim" or that you "only have 30 days to accept this offer before it expires." They tell you that hiring an attorney will "only slow things down" or that a legal process "is not available" to you. They interpret policy language in a way that is favorable to the insurer but contradicted by the actual policy terms.
Why It Matters
Florida Statute §626.9541(1)(i)(3) prohibits insurers from misrepresenting pertinent facts or policy provisions relating to coverages at issue. This is one of the core prohibitions of the Unfair Insurance Trade Practices Act. An adjuster who tells you that you cannot hire a lawyer, or who mischaracterizes what your policy covers, is not just being unhelpful — they may be committing an unfair trade practice that gives rise to a bad faith claim.
Adjusters are employees of the insurance company. Their job is to resolve claims for as little as possible. They are not your advocates, and their characterizations of your policy are not authoritative legal interpretations.
What to Do
Read your policy yourself. If you do not understand it, have an attorney review it. Never take an adjuster's word about what your policy does or does not cover — get it in writing and have it independently verified.
Sign 5: Refusing to Conduct a Proper Investigation
What It Looks Like
The insurer sends an adjuster who spends 20 minutes at the scene of a major accident. The independent medical examination is conducted by a physician who spends less than 10 minutes with you and produces a report that ignores your MRI findings. The insurer declines to obtain surveillance footage that was available and that would have confirmed the other driver's fault. In a property damage case, the adjuster estimates repairs without consulting a licensed contractor.
Why It Matters
The duty to investigate is not satisfied by going through the motions. An investigation designed to reach a predetermined conclusion — denial or underpayment — is not a reasonable investigation. Florida courts have found bad faith where insurers selectively gathered evidence that supported denial while ignoring evidence that supported the claim.
Independent medical examinations (IMEs) are a particularly common battleground. Insurance companies routinely use IME physicians who have a financial incentive to find minimal injury. An IME that contradicts all treating physicians, ignores objective imaging findings, or is produced in an implausibly short examination time is a red flag worth investigating.
What to Do
Preserve all evidence on your own. Request copies of all investigation materials through your attorney. If an IME is scheduled, understand your rights regarding the scope of that examination and consult your attorney before attending.
Sign 6: Pressuring You to Accept a Settlement Quickly
What It Looks Like
The adjuster calls you within days of the accident, expresses sympathy, and presents a settlement offer described as "generous" or "the best we can do." The offer comes with an expiration date. You are told that if you wait or consult a lawyer, things will become "more complicated" or the offer will be withdrawn. You may still be in the hospital, or not yet fully aware of the extent of your injuries.
Why It Matters
Early settlement pressure is one of the insurance industry's most effective tactics — and one of the most damaging to claimants. Many serious injuries do not fully manifest for days or weeks. A disc herniation may worsen over time. A traumatic brain injury may not produce cognitive symptoms until weeks after the crash. A settlement accepted before the full extent of injuries is known will be inadequate, and the release signed with it forecloses any future claim.
An insurer that rushes to settle before the claimant can fully evaluate their losses is acting in its own interest, not the claimant's. This behavior — combined with offers that are inadequate relative to actual damages — can support a bad faith claim.
What to Do
Never accept a settlement offer before you have reached maximum medical improvement (or at minimum, have received a full diagnosis and prognosis from your treating physician). Never sign a release without having an attorney review it first. Take whatever time you need — you are entitled to consult a lawyer before responding to any offer.
Sign 7: Ignoring or Stonewalling Your Communications
What It Looks Like
You send letters and leave voicemails. Emails go unanswered for weeks. You are transferred between representatives with each call. Requests for your claim file, adjuster notes, or recorded statements are denied or simply ignored. After months, you still do not have a clear point of contact or a clear timeline for resolution.
Why It Matters
Florida's bad faith statute specifically identifies the failure to "acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies" as an unfair trade practice. This is not merely poor customer service — it is conduct that can form the basis of a legal claim.
Communication stonewalling also has a practical effect: it exhausts claimants, makes them feel powerless, and often leads them to accept inadequate settlements simply to end the ordeal. Insurers that deploy this tactic strategically understand exactly what they are doing.
What to Do
Switch all communications to writing immediately. Send letters via certified mail, return receipt requested, to create a documented record of your attempts to communicate and the insurer's failure to respond. This written record becomes critical evidence if you pursue a bad faith claim. Consult an attorney — an attorney's involvement often produces a dramatic change in an insurer's responsiveness.
What to Do If You Recognize These Warning Signs
If multiple signs on this list describe your situation, you may have a viable bad faith claim under Florida law. The steps to protect yourself:
- Assemble your documentation. Every letter, email, denial notice, settlement offer, and voicemail record you have is potentially evidence.
- Do not accept any settlement. Once you sign a release, your bad faith claim is almost certainly extinguished along with your underlying claim.
- Consult a Florida bad faith attorney as soon as possible. The 60-day Civil Remedy Notice required by §624.155 must be filed before a bad faith lawsuit, and how it is written matters enormously. Time spent waiting reduces your options.
"Insurance companies have teams of lawyers and decades of experience defending bad faith claims. The only way to level that playing field is to have an experienced bad faith attorney in your corner before you make any decisions about your claim."
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