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Ocean Point Claims:insurance claim lifecycle
Core Guide

The Insurance Claim Lifecycle

Florida insurance claims move through a predictable sequence of stages, each governed by specific deadlines and each with characteristic carrier and policyholder actions. Knowing the stage you're in, and what's supposed to happen next, is the single highest-leverage piece of claim-management knowledge.

Stage 1: First notice of loss (FNOL)

You report the claim. Fla. Stat. 627.70132 requires notice within 1 year of loss; prompt notice is always better. The carrier creates a claim number, assigns a claim file, and routes to a field or desk adjuster.

Typical duration: Hours to days after loss.


Stage 2: Acknowledgment

The carrier must acknowledge receipt within 7 days (Fla. Stat. 627.70131). This is a statutory deadline: missing it is a bad-faith indicator.


Ocean Point Claims:claim reserves and payouts

Stage 3: Inspection

An adjuster (field, independent, or catastrophe-team) inspects the property. They photograph damage, measure, and write up a scope note. Florida requires the inspection to begin within 30 days of notice.

Policyholder action: Be present or have your public adjuster present. Take your own photos.


Stage 4: Estimate and reserve

Back at the desk, the adjuster writes up the claim in Xactimate. A reserve (the carrier's estimated payout) is entered into the system. This is where scope reduction happens most aggressively.


Ocean Point Claims:claim dispute escalation paths

Stage 5: Pay, deny, or partial

Within 60 days of notice, the carrier must pay, deny, or advise of coverage status. Most claims resolve with a partial payment here.


Stage 6: Supplement / dispute window

If the payment is insufficient, the policyholder has 18 months to file a supplemental claim. This is where the real recovery often happens.


Ocean Point Claims:claim reserves and payouts

Stage 7: Escalation

Appraisal, DFS mediation, or Civil Remedy Notice depending on the dispute type.


Stage 8: Settlement and release

Final payment, signed release, claim closure. Release language matters: generic releases can foreclose future-damage claims.

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