Florida OIR Fines Carriers for Adjuster Appointments, Lack of Disclosure Statements

Florida Insurance Comissioner Michael Yaworsky this year has levied more than $2 million in fines against 8 property insurance companies over claims-handling practices flagged by recent market conduct examinations.

Three of the companies, American Coastal Insurance, American Mobile Insurance, and Clear Blue Insurance, were fined the most this year – $400,000 each. The alleged violations included failures to pay or deny claims promptly; using adjusters who failed to adjust claims; a failure to provide disclosure statements about damage estimates to insureds; and neglecting to provide the license numbers of adjusters, as required by state law.

With the 2025 Atlantic hurricane season well underway, Yaworsky said in a statement that he “wants to make it clear that OIR’s Market Conduct Unit is ready to deploy during storms to make sure claims handling practices are up to standard.”

It’s the latest update on fines against property insurers. In May, OIR announced it had fined Centauri Specialty Insurance $100,000 for using adjusters who were not properly appointed. In 2024, the office penalized Heritage Property and Casualty Insurance with a $1 million fine. The carrier had hired unlicensed or non-appointed adjusters to review more than 4,800 claims after Hurricanes Irma and Ian hit the state in in 2017 and 2022, OIR said.

“These fines are proof positive that we are committed to holding them accountable,” Florida Chief Financial Officer Blaise Ingoglia said in a statement Tuesday, when the fines were reported.

Here is a sampling of some of the findings in the 2025 exam reports:

• For American Coastal, in almost 22% of claims reviewed by OIR, the carrier utilized adjusters who were not properly appointed. Also in 22% of claims reviewed, AmCoastal did not include the license number of the adjuster when communicating with insureds. In 20% of claims examined, the company did not pay or deny initial or supplemental claims within 90 days, as required by statute.
• In almost 38% of claims reviewed by OIR, Clear Blue used adjusters that were not properly appointed. In 19% of claims reviewed, the insurer did not acknowledge receipt of claims communications within 14 days.
• In 16% of claims examined, the OIR found that Sutton National utilized improperly appointed adjusters.
• Florida Statute 627.70131(6)(a) requires that insurers explain, in 12-point typeface, a statement making it clear that the damage estimate is not final: “THIS ESTIMATE REPRESENTS OUR CURRENT EVALUATION OF THE COVERED DAMAGES TO YOUR INSURED PROPERTY AND MAY BE REVISED AS WE CONTINUE TO EVALUATE YOUR CLAIM. IF YOU HAVE QUESTIONS, CONCERNS, OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM, WE ENCOURAGE YOU TO CONTACT US,” the disclosure statement must read.

Some insurers left the statement out of communications with insureds more than others. American Coastal, for example, was dinged for forgetting the statement in less less than 5% of claims reviewed. Monarch National Insurance was fined for failing to include the statement on 35% of claims examined. TypTap insurance failed to include the statement in almost 47% of claims studied by OIR. In 61% of claims reviewed — 148 of 241 claims — American Mobile Insurance included a statement that did not comply with the statute.

Tower HIll Prime Insurance paid restitution of $46,320 to policyholders after examiners discovered that adjusters did not adjust claims in keeping with the terms of the insurance contract, a July report shows.

Most of the insurers’ claims-handling manuals were found to be up to par.

Yaworsky noted that the fines will not lead to higher premiums for the carriers’ policyholders. Two additional exam reports are pending.

The market conduct examination reports can be found here.

Topics Carriers Florida