Why a protocol
Property insurance claims are complex. Without discipline, scope gets missed, statutes get forgotten, deadlines slip, and negotiations meander. The Ocean Point Claim Protocol™ is our answer: a consistent 7-stage sequence that ensures every claim gets the same rigor regardless of complexity or claim type.
Stage 1: Free Claim Review
A licensed Florida public adjuster reviews the claim: policy, any carrier correspondence (denial letter, settlement offer), damage documentation. No cost, no obligation. At the end of the review, we tell the client one of three things:
- "Yes, representation is likely to improve your outcome": move to Stage 2
- "Maybe, but the likely upside is small; here's what you can do yourself": DIY guidance
- "No, representation isn't warranted here": we say so, explain why
Stage 2: Retention
If we and the client proceed, we sign a written contingency-fee agreement. Florida Statute 626.854 sets the statutory caps, with a reduced cap for declared-emergency claims during the first year after the declaration. The agreement discloses the specific fee clearly.
Florida law gives the policyholder a 10-day right to cancel without penalty. We surface this right at signing.
Stage 3: On-Site Inspection and Documentation
A licensed Ocean Point adjuster inspects the property and builds the scope documentation:
- Photographs (date-stamped, systematic room-by-room)
- Measurements
- Moisture readings where applicable
- Thermal imaging where applicable
- Drone or Matterport capture for larger properties
- Witness documentation
- Contents inventory
This stage is foundational: everything downstream relies on it.
Stage 4: Policy Review
Every coverage, endorsement, exclusion, and sublimit is identified. Specific to the claim at hand:
- Applicable deductibles (standard, hurricane, named storm)
- Dwelling, other structures, personal property limits
- ALE / loss of use limits
- Law and ordinance coverage
- Matching endorsement or statute application
- Mold sublimit
- Specific endorsements (water damage limits, sinkhole, flood)
Coverage gaps or sublimit traps are identified and factored into the claim strategy.
Stage 5: Xactimate Estimate Preparation
The full estimate, line by line, using the same Xactimate platform and pricing database the carrier uses. Our estimate captures every line item supportable by the damage:
- Demolition and haul-away
- Drying equipment hours
- Protection and containment
- Reconstruction per trade
- Code upgrades where L&O applies
- Matching per Fla. Stat. 626.9744
- O&P where scope warrants
- Contents
- ALE / BI where applicable
Stage 6: Submission and Negotiation
The complete claim package, estimate, documentation, policy review, cover letter, is submitted to the carrier. Then the negotiation:
- Line-item review with the carrier's adjuster
- Scope clarifications
- Supporting documentation responses to carrier questions
- Counter-offers with specific justification
- Regular follow-up with statute-grounded demands
- Interest tracking per Fla. Stat. 627.70131
Most claims resolve at this stage.
Stage 7: Resolution
Settled by direct negotiation, OR escalated to:
- Appraisal under the policy's appraisal clause
- DFS mediation under Fla. Stat. 627.7015
- Civil Remedy Notice under Fla. Stat. 624.155
- Litigation coordinated with counsel
Final settlement implemented. Carrier payment received. Contingency fee calculated on recovery. Client documentation complete.
What makes the Protocol effective
- Discipline. Every stage, every claim. Nothing skipped.
- Documentation. Every stage produces documentation; documentation is leverage.
- Statute grounding. Every demand cites statute; every deadline tracked.
- Specialty matching. Stages 3-5 assigned to the Ocean Point adjuster with the relevant specialty.
- Escalation readiness. Stage 7 options are prepared from Stage 1: we don't scramble at escalation.
The 500-mediation lens
Eli Goins has been through 500+ mediations. Every one produced a small adjustment to the Protocol: a new question to ask, a new tactic to counter, a new documentation technique. The current Protocol is the accumulated learning.
Related frameworks
- The Underpayment Decoder™: specific to identifying scope gaps
- The Ocean Point Appraisal Protocol™: specific to appraisal proceedings
- The Delay Log™: specific to delay tactics
- The Policy Audit Scorecard™: pre-loss policy review
Start with Stage 1
Request a free claim review: no cost, no obligation. We'll walk through your specific claim and tell you whether representation is likely to help.