Citizens Property Insurance Claims: How the Process Works

What Citizens is

If your home or building is insured by Citizens, you are dealing with a different kind of insurer. Florida law calls Citizens Property Insurance Corporation “a government entity that is an integral part of the state, and that is not a private insurance company.” It insures residential and commercial property for applicants who are entitled to coverage but, in good faith, cannot get it in the voluntary market (s. 627.351(6)(a)).

Citizens describes itself as “the state’s insurer of last resort.” It says the Legislature created it in August 2002 as a not-for-profit, tax-exempt government entity, and that it is funded by policyholder premiums. Florida law also requires Citizens to levy assessments on most Florida policyholders if a devastating storm leaves it with a deficit (Citizens, Who We Are).

Reporting a Citizens claim

Citizens says to report a claim as soon as you become aware of or suspect damage, even if you do not know the full extent. You can report 24 hours a day, seven days a week (Citizens, Report a Claim):

• Online: log in to myPolicy, open the Claims tab and choose Report a Claim.
• By phone: the Citizens claims line, 866.411.2742.
• Have ready: your policy number, contact details including any temporary address or phone, a description of the damage, and your mortgage company’s information. Citizens says to call even if you are missing some of it.

Florida’s notice deadlines in s. 627.70132 apply to property insurance policies and have no separate rule for Citizens. A new or reopened claim is barred unless notice is given within 1 year after the date of loss, and a supplemental claim within 18 months. For a hurricane, the date of loss is the date it made landfall. More detail is in Florida claim deadlines.

From inspection to payment

After you report, “a Citizens adjuster will contact you to discuss your loss and arrange an inspection,” according to its After a Loss page. Before that visit, Citizens asks you to label your damage photos, copy your temporary repair receipts, keep damaged items, and have your mortgage loan number ready. When the adjuster arrives, ask for and check their ID (Citizens, Loss Inspection).

Make temporary repairs to stop more damage, such as shutting off a broken supply line, boarding windows or tarping the roof. Citizens says your adjuster “must inspect your home and authorize any permanent tear out, removal or repair of items.” Citizens says some claims also need an engineer or a contractor who works on that kind of damage, and it says you are welcome to get your own contractor’s estimate for the adjuster to review.

After the inspection, a Citizens claims examiner reviews your policy to confirm coverage and deductibles. Citizens mails claim checks and does not transfer funds electronically. It is required to include your mortgage company as a payee, and every payee must endorse the check (Citizens, Claim Payments). If repair costs come in higher than the estimate, Citizens says to call the claims line so an adjuster can review it.

A Citizens claim at a glance

Citizens rules that differ from many private policies

A few rules in s. 627.351(6) apply only to Citizens:

• Water claims and flooding. A Citizens policyholder making a claim for water damage has the burden of proving the damage was not caused by flooding (s. 627.351(6)(kk)).
• Flood insurance requirement. Citizens does not provide flood insurance, and the law is phasing in a rule that most personal residential policyholders with wind coverage carry flood coverage from another insurer. It already applies in FEMA special flood hazard areas and reaches all remaining personal residential policies effective on or after January 1, 2027. Policies without wind coverage and condo unit owner policies are exempt.
• Dispute forms. Citizens may adopt policy forms that send claim disputes, including coverage or the scope and value of a claim, to the state Division of Administrative Hearings (s. 627.351(6)(ll)). Check whether your form has this.

Because wind and flood are handled so differently, read wind vs. flood coverage before a storm claim. If your claim moves into a formal dispute, the legal side, including any administrative hearing, is where a Florida attorney’s role starts.

Eligibility and depopulation offers

Citizens is meant to be a fallback. For a primary residence applying new, the risk is not eligible for Citizens if an authorized insurer offers comparable coverage at a premium no more than 20 percent above Citizens’ premium. For primary residence policies renewing on or after April 1, 2023, the same 20 percent test applies to private offers received at renewal (s. 627.351(6)(c)5.a.).

Citizens moves policies to private insurers through what it calls depopulation. It says you may receive a Policyholder Choice Offer or Policyholder Depopulation Offer letter. If you qualify to stay and want to, you or your agent must respond by the stated deadline, or the policy will be transferred. If an insurer assumes your policy, your Citizens premium and coverage stay the same until the term ends (Citizens, depopulation and policyholder choice).

Getting help with a Citizens claim

Many Citizens claims are handled directly between the policyholder and Citizens. A licensed public adjuster may help when the loss is large, the scope is disputed, or water and wind damage are mixed. If a contractor asks you to sign over the claim, read the guide to the assignment of benefits ban first. The ban covers residential property insurance policies and has no exception for Citizens.

If you are unsure whether you have covered damage, a free claim review can tell you. See homeowners claims or hurricane claims. If your private insurer failed and you landed at Citizens, what FIGA is explains what happens to the old claim.