Mediation vs. Appraisal: Your Options When You Disagree With Your Florida Insurer

You’ve filed your claim and received a decision, but the number is too low, or the insurer says part of the damage came from something the policy doesn’t cover. Before thinking about a lawsuit, most Florida policyholders have two other tools: DFS mediation and appraisal.

They sound similar, but they work very differently. Here’s a side-by-side look.

General information only, not legal advice. Your policy’s appraisal clause controls how appraisal works for you. For legal questions, talk to a Florida attorney.

Quick comparison

How DFS mediation works

Florida created its residential property mediation program to give policyholders an informal, nonadversarial way to resolve disputes (§ 627.7015(1)).

Eligibility, in general:

• Available for personal residential policies and commercial residential policies (such as condo associations), before appraisal or litigation.
• Not available for commercial coverages, liability disputes or NFIP flood policies.
• According to DFS, the dispute must generally be $500 or more after the deductible, and must be about the cause of damage or the amount offered.
• A claim becomes eligible after the insurer has paid or denied it under § 627.70131(7) (or elected to reinspect under the pre-suit process).
• Claims involving suspected fraud, agreed facts showing no coverage, or late notice under § 627.70132 aren’t eligible (§ 627.7015(9)).

What happens: You request mediation online, through the DFS Consumer Helpline or on Form DFS-I0-2082. A certified mediator meets with you and an insurer representative who must have authority to settle. Statements made at the conference are treated as settlement negotiations.

After mediation: If you sign a settlement, you have 3 business days to rescind it unless you’ve cashed or deposited the check (§ 627.7015(6)). If there’s no agreement, you keep your other options.

A notable rule: if your insurer failed to notify you of your right to mediation, or the insurer requested mediation and either party rejects the result, you aren’t required to go through the policy’s appraisal process before suing for breach of contract (§ 627.7015(7)). An attorney can explain how this applies to you.

How appraisal works

Appraisal is a contract process, so the details come from your policy. A typical appraisal clause works like this:

1. Either party makes a written demand for appraisal when you disagree on the amount of loss.
2. Each side picks a competent, independent (or “disinterested”) appraiser within a set time.
3. The two appraisers pick an umpire.
4. The appraisers estimate the loss. If they agree, that’s the amount. If not, they submit their differences to the umpire, and an award signed by any two of the three sets the amount.
5. Each side pays its own appraiser and shares the umpire’s fee, unless the policy says otherwise.

Things to know:

• Appraisal usually decides how much, not whether something is covered. Coverage disputes may remain afterward.
• Courts have found that a public adjuster with a contingency-fee interest in the claim can fail the “disinterested appraiser” requirement in some policies, so check your policy’s wording before choosing your appraiser.
• An appraisal award is generally binding on the amount of loss, so preparation matters: detailed estimates, photos and expert reports.

Which should you choose?

Every claim is different, but these patterns are common:

• A modest, focused disagreement (a few line items, a scope question): mediation is free for eligible residential disputes and nonbinding, so it’s often a sensible first step.
• A large amount-of-loss dispute with solid documentation: appraisal can resolve the number with finality.
• A coverage denial (the insurer says the cause isn’t covered): mediation can address cause-of-loss disagreements in eligible cases; appraisal typically can’t decide coverage. An attorney can advise on legal options.

Whatever you choose, watch the deadlines. Notice of a supplemental claim for newly found damage must still be given within 18 months after the date of loss (Fla. Stat. § 627.70132).

Where a public adjuster can help

A licensed public adjuster can prepare the detailed estimate and documentation you’d bring to mediation or appraisal, attend the mediation conference with you and present your position on the scope and cost of repairs. Public adjusters can’t give legal advice.

Preparing for either process

Whichever route you choose, preparation is similar:

1. A clear statement of the dispute. List each disputed item, the insurer’s amount and your amount.
2. Your own detailed estimate, itemized by room and trade, from a qualified source.
3. Photos and videos organized by area, with dates.
4. Expert reports where cause or scope is disputed (roofer, engineer, plumber, mold assessor).
5. The insurer’s estimate and letters, including its written explanation of any denial or partial denial.
6. Receipts for mitigation, temporary repairs and living expenses.

Bring copies for the mediator or appraisers. A well-organized file helps everyone focus on the real differences.

Frequently asked questions

Not sure which route fits your claim?

We can review your claim and the insurer’s position with you. Call 888-888-8591 or visit www.NorthsideAdjusters.com for a free claim review.

See how a claim moves from loss to payment on our claims process page.