The lever: appraisal
The biggest lever on a stuck claim — and sometimes just demanding it moves the number.
Florida Insurance Glossary
Every term a Florida homeowner will encounter — declarations page, policy language, carrier letters, claim correspondence — defined in plain English.
71 terms · with Florida-specific notes where the law diverges from the U.S. norm.
A
- Actual Cash Value (ACV)
- The replacement cost of damaged property minus depreciation for age, wear, and condition. ACV is what the carrier typically pays first on a Replacement Cost policy, with the remaining 'recoverable depreciation' paid only after repairs are completed and documented.
- Additional Living Expense (ALE)
- Coverage that pays the increased costs of living elsewhere when your home is uninhabitable due to a covered loss — hotel, rental, restaurant meals above normal grocery spending, pet boarding, laundry, and similar real expenses. You must save receipts to recover ALE. (See also: Loss of Use.)
- Adjuster
- A person who investigates, evaluates, and settles insurance claims. Three categories: company (staff) adjusters, independent adjusters, and public adjusters. Only the public adjuster legally represents the homeowner.
- Appraisal Clause
- A provision in many policies that lets either party demand a binding valuation process when there's disagreement on the amount of loss. Each side picks an appraiser; the two appraisers pick an umpire; two of the three must agree. Appraisal resolves amount, not coverage.
- Assignment of Benefits (AOB)
- A document transferring the homeowner's rights under the policy to a third party (most often a contractor) so they can bill and sue the carrier directly.
- AOP Deductible (All Other Perils)
- The standard deductible that applies to claims other than hurricane or named-storm losses. Usually a fixed dollar amount (e.g., $1,000, $2,500).
Florida note: Appraisal can be a powerful tool, but recent reforms have constrained how and when it applies. Read your specific clause carefully before invoking it.
Florida note: AOB was the subject of major reforms in 2019 (HB 7065) and again under SB 2A in 2022, which substantially restricted AOBs in residential property claims. Most new AOBs in residential property claims are now sharply limited or effectively unavailable.
B
- Bad Faith
- A carrier's failure to handle a claim fairly and in good faith — for example, by lowballing without justification, ignoring evidence, or unjustifiably delaying payment.
Florida note: Bad-faith actions in Florida are governed by §624.155. A Civil Remedy Notice (CRN) must be filed with the Department of Financial Services as a precondition to a bad-faith lawsuit, and the carrier has 60 days to cure.
C
- Citizens Property Insurance Corporation
- Florida's state-created insurer of last resort, for homeowners who cannot get coverage on the private market. Citizens is its own world with its own quirks — including specific eligibility rules, depopulation programs, and claim procedures.
- Civil Remedy Notice (CRN)
- A formal notice filed with the Florida Department of Financial Services (DFS) alleging that an insurer has violated specific statutory duties. It triggers a 60-day cure period. Required before filing a bad-faith action.
- Coinsurance
- A clause that penalizes the policyholder if the property is insured for less than a stated percentage (often 80%) of its replacement cost. More common in commercial policies than residential, but still appears.
- Concurrent Causation
- When more than one cause contributes to a loss (e.g., wind and flood).
- Coverage A — Dwelling
- The structure of your home itself, including attached structures (an attached garage, for example).
- Coverage B — Other Structures
- Detached structures on the property: a detached garage, shed, fence, gazebo. Usually a percentage of Coverage A (often 10%).
- Coverage C — Personal Property
- Your contents — furniture, electronics, clothing, kitchenware. Usually a percentage of Coverage A. Often subject to specific sub-limits for jewelry, firearms, cash, and certain other categories.
- Coverage D — Loss of Use
- ALE plus fair rental value if applicable. See Additional Living Expense.
- Coverage E — Personal Liability
- Coverage if someone is injured on your property and sues you, or if you injure someone or damage their property elsewhere.
- Coverage F — Medical Payments to Others
- A small no-fault medical coverage (often $1,000–$5,000) for minor injuries to guests, regardless of fault.
- Code Upgrade Coverage
- See Ordinance and Law.
Florida note: Florida case law has historically used the Concurrent Cause Doctrine, which can allow coverage if at least one covered cause contributed — but many policies now contain anti-concurrent causation clauses designed to override this. Read your policy.
D
- Declarations Page (Dec Page)
- The cover sheet of your policy that shows: the named insured, the property address, policy period, premium, all coverage limits, deductibles, and endorsements. The Dec Page is the summary. The full policy is the contract. They are not the same document.
- Deductible
- The amount you pay out of pocket before coverage kicks in. Florida residential policies typically include multiple deductibles: an AOP deductible, a hurricane deductible, sometimes a separate named-storm deductible, and occasionally a separate wind/hail deductible.
- Depreciation
- Reduction in value due to age, wear, and condition. Splits into recoverable depreciation (paid back to you upon documented completion of repairs on a Replacement Cost policy) and non-recoverable depreciation (gone for good — typical of an ACV policy).
- Department of Financial Services (DFS)
- The Florida state agency overseeing insurance. Administers the licensing of public adjusters, the CRN process, the mediation program, and consumer assistance.
- Direct Physical Loss
- The triggering language in most property policies: there must be a direct physical loss to covered property for coverage to attach. Wear and tear, gradual deterioration, and pure economic losses without physical damage typically do not qualify.
E
- Endorsement
- A written modification to the base policy. Endorsements add, remove, or change coverage. Examples: a sinkhole endorsement, a scheduled-jewelry endorsement, a screened-enclosure endorsement, a service-line endorsement. Read every endorsement listed on your Dec Page.
- Examination Under Oath (EUO)
- A formal recorded statement under oath, conducted by the carrier's attorney, before any lawsuit. The carrier may demand an EUO as a policy condition. Refusing to attend can void coverage. Treat an EUO request as a serious escalation.
- Exclusion
- Specific perils, types of property, or circumstances the policy does not cover. Common exclusions include flood, earth movement (sinkhole has special Florida rules), wear and tear, intentional acts, and certain types of mold.
F
- Field Adjuster
- The adjuster who physically inspects the property. May be a staff or independent adjuster.
- First-Party Claim
- A claim you file against your own policy. (A third-party claim is one filed against someone else's liability policy.)
- Force-Placed Insurance
- Coverage placed by a mortgage lender when the homeowner fails to maintain required insurance. Almost always more expensive and narrower than a homeowner-purchased policy.
H
- HO-3
- The most common Florida residential homeowners form. Covers the dwelling on an open-perils basis (everything not excluded) and personal property on a named-perils basis.
- HO-5
- A premium form that covers both dwelling and personal property on an open-perils basis. Less common but generally broader than an HO-3.
- HO-6
- Condominium unit owner's form. Coverage A is typically much smaller because the master association policy covers the building structure.
- HO-8
- Modified form, typically for older homes where actual replacement cost would exceed market value. Loss settlement is on a modified ACV basis.
- Homeowner Claims Bill of Rights
- A statutorily required notice (§627.7142) the carrier must provide within 14 days of initial communication about a claim. Summarizes the carrier's required acknowledgment, decision, and payment timelines.
- Hurricane Deductible
- A separate (usually percentage-based) deductible applied only to losses caused by a hurricane.
Florida note: The hurricane deductible is triggered by a National Weather Service hurricane declaration and applies during a defined window (generally from when watches/warnings issue until 72 hours after they end). It is typically 2%, 5%, or 10% of Coverage A — not a flat dollar amount — which can be a five-figure number on a $400,000 home.
I
- Indemnity (Principle of Indemnity)
- The foundational concept that insurance restores you to your pre-loss condition — not better, not worse. You should not profit from a loss.
- Independent Adjuster (IA)
- A licensed adjuster contracted by carriers to handle claims on the carrier's behalf. Despite the name, an IA is functionally aligned with the carrier that hires them.
L
- Limit
- The maximum amount the policy will pay for a covered loss. Each coverage (A, B, C, D, E, F) has its own limit, and certain categories may have separate sub-limits.
- Loss of Use
- See Additional Living Expense.
- Loss Settlement Provision
- The clause that explains how the carrier will calculate what they pay — ACV, RCV, special roof rules, etc. One of the most important clauses in the policy and one of the least read.
M
- Matching Statute
- Florida Statute §626.9744, often called the matching statute, requires that when a loss requires replacement of items and the replacement does not reasonably match in quality, color, or size, the carrier must replace items as needed to provide a reasonably uniform appearance — within the same line of sight. Frequently invoked for tile floors, cabinets, siding, and (historically) roofing.
- Mediation (DFS Program)
- A free, non-binding mediation program administered by DFS for residential property claims. The carrier must pay the mediator's fee. A useful step for many disputed claims.
- Mitigation Duty
- The policyholder's contractual and legal duty to take reasonable steps to prevent further damage after a loss — tarping a roof, extracting standing water, boarding a broken window. Failure to mitigate can reduce or void recovery for damage that follows.
Florida note: Roof matching has been narrowed by recent reforms — confirm current law and your specific policy language.
N
- Named Perils vs. Open Perils
- A named-perils policy covers only the perils specifically listed. An open-perils policy covers everything except what is specifically excluded. Open perils is broader. Most HO-3 dwelling coverage is open perils; most HO-3 contents coverage is named perils.
- Named Storm Deductible
- A deductible triggered by a named storm even if it does not become a hurricane. Some policies use this in addition to or instead of a hurricane deductible.
- Notice of Loss
- The formal communication to the carrier that a loss has occurred. Should always be in writing, dated, and retained. The clock on the carrier's statutory acknowledgment and decision deadlines starts here.
O
- Ordinance and Law (O&L) Coverage
- Coverage for the increased cost of repair or rebuilding required by current building codes — for example, when a partial roof replacement triggers a full code-compliant roof replacement under the Florida Building Code's 25% rule (where applicable). Often expressed as a percentage of Coverage A (10%, 25%, 50%). Frequently un-claimed by DIY homeowners.
- Overhead and Profit (O&P)
- A general contractor's overhead (10%) and profit (10%), totaling 20%, added to a repair estimate when a general contractor is reasonably required to coordinate the repair. The 'three trades rule' is a common (though not absolute) industry guideline: when a job involves three or more trades, a GC is reasonably required and O&P should be included.
P
- Peril
- A cause of loss. Wind, fire, lightning, theft, water damage, and vandalism are all perils.
- Pre-Suit Notice
- Florida Statute §627.70152 requires a homeowner to send the carrier a specific written notice — including the alleged acts or omissions, the amount in dispute, and supporting documentation — at least 10 business days before filing a lawsuit on a residential property claim. Defective notice will get a lawsuit dismissed.
- Prompt Notice (Clause)
- A policy provision requiring you to report a loss promptly — usually phrased as 'as soon as practicable.' Late notice can be a basis for denial even within statutory windows.
- Proof of Loss (Sworn Statement)
- A formal, notarized statement signed by the policyholder listing the cause and amount of loss. The carrier may require one as a policy condition. Once a complete proof of loss is submitted, statutory clocks (30/60-day decision and payment windows) begin.
- Public Adjuster (PA)
- A licensed professional who represents the policyholder, not the carrier, for a fee capped by Florida statute.
Florida note: §626.854 governs PAs in Florida. Fees are capped at 10% during the first year following a state of emergency declaration for losses arising from that emergency, and 20% in other cases.
R
- Recoverable Depreciation
- The depreciation amount initially withheld on an ACV payment that is recoverable once you complete and document repairs on a Replacement Cost policy.
- Replacement Cost Value (RCV)
- The cost to replace damaged property with new property of like kind and quality, without deduction for depreciation. RCV is the gold standard of property coverage.
- Reservation of Rights (ROR)
- A letter from the carrier saying, in effect, 'we are investigating your claim, but we reserve the right to deny coverage based on policy provisions or facts we discover.' An ROR is a serious signal. The carrier is preserving its right to deny later. Do not handle a claim with an outstanding ROR alone.
- Reopened Claim
- A claim that was closed but is being reopened to address damage related to the original loss that has surfaced or worsened since.
Florida note: Under §627.70132, notice of a supplemental or reopened claim must be given within 18 months of the date of loss for losses on or after December 16, 2022.
S
- Salvage
- Damaged property the carrier may take possession of after paying the claim. For example, after a total-loss theft recovery, the recovered property may belong to the carrier.
- Scope of Loss (or Scope of Damage)
- The detailed list — typically by room or area — of every damaged item and what it will take to repair or replace it. The scope is the foundation of every estimate. A bad scope produces a bad number, regardless of how nicely the estimate is formatted.
- Statute of Limitations
- For losses on or after December 16, 2022, notice of a new property insurance claim must be given within 1 year of the date of loss. Notice of a supplemental or reopened claim must be given within 18 months. These are substantially shorter than older deadlines.
- Sublimit
- A cap that applies within a coverage. For example, Coverage C (Personal Property) might be $200,000, but jewelry might have a $2,500 sublimit. Sublimits routinely surprise homeowners after a theft or fire.
- Subrogation
- The carrier's right, after paying you, to recover from a third party who caused the loss. Example: if a faulty appliance burns down your kitchen, the carrier pays you and then pursues the manufacturer.
- Supplemental Claim
- A claim for additional damage related to the original loss that wasn't included in the initial settlement. Subject to the 18-month deadline above.
Florida note: Always verify the current statute against your specific date of loss.
U
- Underwriting
- The carrier's process of evaluating a risk and deciding whether (and on what terms) to insure it. Issues discovered during underwriting after a claim — especially alleged misrepresentations on the application — can be used to rescind the policy.
- Uninhabitable
- A condition in which the property cannot reasonably be occupied. Triggers Loss of Use / ALE coverage.
V
- Vacancy / Vacancy Clause
- Most policies modify or exclude coverage for properties that have been vacant for a stated period (often 60 days). Important for snowbirds, rental properties between tenants, and inherited homes.
W
- Wear and Tear (Exclusion)
- The standard exclusion for damage caused by ordinary wear, deterioration, or aging — as opposed to a sudden, accidental event. Frequently invoked by carriers to deny roof and water-damage claims.
- Wind/Hail Deductible
- A separate deductible applying to wind or hail losses. May be flat-dollar or percentage-based depending on the policy.
X
- Xactimate
- The dominant estimating software in U.S. property insurance. Both carrier adjusters and most public adjusters write estimates in Xactimate. Line items are pulled from a regional pricing database (e.g., FLMI for South Florida–Miami) updated periodically.
This glossary is educational and is not legal advice. Florida insurance law changes frequently — verify against current Florida Statutes before relying on any specific deadline or rule for your claim.
60-second videos
Claim tips from Joe
What is appraisal?
Each side picks an appraiser, an umpire decides if they disagree — and it settles the number outside of court.
Game 4: Holding back depreciation
Do the repairs, keep every receipt, and ask for the held-back depreciation in writing.
Check your policy for this
A $10,000 water sub-limit can cap a burst-pipe claim — even on a $300,000 policy.
Joe Ford, Licensed Public Adjuster W026874. Some narration uses an AI version of Joe's voice.
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