Dolphin Claims

Ch 3 · Filing and Investigation

Module 3.1

Signing the Claim

Gather documentation. Determine value. Determine coverage. Hire your own experts.

10 min read

What you'll learn

The 4 actions that follow contract signing. The order of operations. The first 30 days of any new claim.


3.1.1 The contract is signed — what's next

Once your DFS-compliant contract is signed:

  1. File contract w/ DFS within 30 days
  2. Notify carrier in writing that you represent the insured
  3. Begin claim filing or take over existing claim (depends on stage)
  4. Build the claim file structure

These all happen in the first week.


3.1.2 Filing contract w/ DFS

Required by § 626.854. Procedural compliance.

Method: DFS MyProfile portal (myfloridacfo.com) or specific contract filing form.

Submit:

  • Signed contract
  • Date executed
  • Insured details
  • Claim # (if existing)
  • Loss type + date
  • Fee structure

Saves you from administrative violations.


3.1.3 Letter of representation to the carrier

Same day or within 24 hours of signing. Sample:

[Date]

[Carrier Name]
[Carrier Claims Address]

CERTIFIED MAIL — RETURN RECEIPT REQUESTED

Re: Letter of Representation
Insured Name: [Client Name]
Property Address: [Address]
Policy Number: [#]
Claim Number: [# or "Pending Filing"]
Date of Loss: [Date]

Dear [Carrier Claims Department]:

Please be advised I have been retained as the Public Adjuster
of record for the above-referenced insured pursuant to a written
contract dated [Date], filed with the Florida Department of
Financial Services per § 626.854.

Florida Public Adjuster License Number: W[#]

All future correspondence regarding this claim should be directed
to me at:

- Email: [your email]
- Phone: [your phone]
- Address: [your address]

I confirm authorization to:
- Communicate w/ the carrier on the insured's behalf
- Submit Proof of Loss + supporting documentation
- Negotiate scope + settlement
- Request inspections + reinspections
- Demand appraisal where applicable
- Demand DFS mediation where applicable

Pursuant to § 626.854(15), please confirm receipt of this letter
within seven (7) calendar days.

Sincerely,

[Your Signature]
[Your Name + License #]

3.1.4 The first 30 days — order of operations

Week 1

  • Day 1: Contract signed. Letter of representation sent. DFS contract filing initiated.
  • Day 2-3: Comprehensive site inspection (more thorough than initial).
  • Day 4-5: Photo documentation, contents inventory baseline, scope draft.
  • Day 6-7: Independent expert consultations (engineer, plumber, mold tester as relevant).

Week 2

  • Day 8-10: Receive expert reports. Refine scope.
  • Day 10-12: Build itemized estimate (Xactimate or equivalent).
  • Day 12-14: Review carrier's prior estimate (if any). Identify gaps.

Week 3

  • Day 15-21: Submit comprehensive scope + estimate to carrier.
  • Coordinate with carrier's adjuster for re-inspection if needed.

Week 4

  • Day 22-30: Prepare Proof of Loss for proactive submission (Module 3.3).
  • Manage carrier communication.

3.1.5 Documentation file structure

Build clean from day one:

ClaimName_DOL2025-03-15/
├── 01_Contract/
│   ├── PA Contract (signed)
│   ├── DFS Filing Receipt
│   └── Letter of Representation
├── 02_Policy/
│   ├── Declarations Page
│   ├── Full Policy
│   ├── Endorsements
│   └── DICE Summary (Module 2.2.8)
├── 03_Loss_Documentation/
│   ├── Photos (subfolder per inspection date)
│   ├── Videos
│   ├── Expert Reports
│   ├── Plumber/Roofer/Engineer Reports
│   └── Witness Statements
├── 04_Carrier_Communications/
│   ├── Letters (sent + received)
│   ├── Emails
│   ├── Carrier Estimates
│   └── Decision Letters
├── 05_PA_Work_Product/
│   ├── My Scope of Damage
│   ├── My Estimate (Xactimate)
│   ├── Rebuttals
│   ├── Proof of Loss
│   └── Supplements
├── 06_Mitigation_Receipts/
│   └── (vendor invoices, paid receipts)
├── 07_ALE_Receipts/
│   └── (hotel, food, etc.)
├── 08_Timeline/
│   └── Master Timeline Document
└── 09_Settlement/
    ├── Carrier Offers
    ├── Negotiations
    ├── Final Settlement
    └── Releases (signed only after PA review)

Use Dropbox, Google Drive, or dedicated PA software (CompanyCam, Jenesis, etc.). Stay organized.


3.1.6 The master timeline document

Build day 1. Update daily.

CLAIM: [Insured Name + Address]
POLICY #: [#]
CLAIM #: [#]
DATE OF LOSS: [Date]
PA RETAINED: [Date]
PA: [Your Name + License #]

TIMELINE:

[Date] — [Event]
[Date] — [Event]
...

CARRIER DEADLINES:
- 7-day acknowledgment: [Date by which due]
- 14-day Bill of Rights: [Date]
- 30-day coverage decision: [Date]
- 60-day pay/deny: [Date]
- 1-year notice deadline: [Date]
- 18-month supplemental deadline: [Date]

KEY CONTACTS:
- Carrier adjuster: [Name + Phone + Email]
- Carrier desk adjuster: [Name + Phone + Email]
- Insured: [Phone + Email]
- Independent contractor: [Name + Phone + Email]
- Expert(s): [Name + Phone + Email]
- Attorney (if engaged): [Name + Phone + Email]

NEXT ACTIONS:
- [Action] — [Due]
- [Action] — [Due]

3.1.7 The 60-day estimate requirement

§ 626.854(12) — PA must deliver a written, itemized estimate to the insured within 60 days of contract execution.

If you fail → insured can cancel without penalty.

What this means

Within 60 days of signing:

  • Comprehensive scope built
  • Itemized estimate w/ pricing
  • Delivered to insured in writing

Plan your timeline accordingly. 60 days isn't long, especially on complex claims requiring expert reports.


3.1.8 Insured education in the first 30 days

Spend time educating your client. Cover:

TopicWhy
Carrier deadlinesSets expectations
Recorded statement / EUO risksProtects them
What to + not to sayCritical for testimony
Cooperation requirementsAvoids cooperation breach
Mitigation dutyPrevents neglect arguments
Document everything adviceBuilds your evidence file
ALE expense trackingRecovers Coverage D

A well-educated client makes your job easier + produces better claim outcomes.


3.1.9 Action steps

  1. Immediately after signing: file w/ DFS + letter of representation to carrier.
  2. Build folder structure before you do anything else.
  3. Day 2-7: comprehensive inspection + documentation.
  4. Day 8-14: expert consultations + scope refinement.
  5. Day 15-30: estimate + proactive POL.
  6. Within 60 days: deliver written itemized estimate to insured.
  7. Update timeline daily.

Next: 3.2 Reservation of Rights — Reading and Responding.


Educational. Not legal advice. PA conduct governed by § 626.854. Verify current rules before relying on any specific approach.

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