Insurance Law News

What to Expect After Your Insurance Company Goes Insolvent and FIGA Takes Over

Written by Dave Murray | May 4, 2023 12:57:43 PM

What is FIGA?

The Florida Insurance Guaranty Association (FIGA) is a non-profit organization created by the Florida Legislature to provide protection and financial assistance to Florida residents in the event their insurance company has gone insolvent. FIGA works by stepping in and assuming the responsibilities of the insolvent insurance company, including paying outstanding claims and providing coverage to policyholders.

When an insurance company becomes insolvent, FIGA receives notice of the situation and begins an evaluation process to determine the extent of the company’s financial distress. If FIGA determines that the company is unable to meet its obligations, it will step in and take over the company’s policies and claims. FIGA provides coverage for certain types of insurance, including property insurance.

FIGA provides coverage for certain types of insurance, including property insurance. This coverage ensures that policyholders who are affected by an insurance company’s insolvency will still receive the protection they need.

FIGA is a financial safety net created by the state of Florida to protect policyholders in the event of an insurance company’s insolvency. FIGA assumes the responsibilities of the insolvent insurance company, paying outstanding claims and providing coverage to policyholders. The organization is funded by assessments of insurance companies operating in Florida, and policyholders should file claims with FIGA if their insurer becomes insolvent and is unable to pay their claims.

Companies currently in liquidation:

Limitations with FIGA

While the Florida Insurance Guaranty Association provides important protection and financial assistance to Florida residents, there are some limitations to its coverage that policyholders should be aware of. These limitations could impact a policyholder’s ability to receive full compensation for a claim in the event of an insurance company’s insolvency.

One major limitation is the maximum amount that FIGA will pay for any single property claim. The maximum amount FIGA will pay is $300,000 with special limits applying to (1) damages to structure and contents on homeowners’ claims and (2) on condominium and homeowners’ association claims. For damages to structure and contents on homeowners’ claims the FIGA cap is an additional $200,000. For condominium and homeowners’ association claims the cap will be the lesser of policy limits or $200,000 multiplied by the number of units in the association. No claim will be paid in excess of this cap.

It’s also important to note that FIGA’s coverage is limited to claims that were covered under the insolvent insurer’s policy. This means that if a policyholder had a claim that was not covered under their policy at the time the insurer became insolvent, FIGA may not cover that claim.

FIGA’s coverage is subject to certain deductibles and offsets. This means that FIGA may reduce the amount of compensation it pays to a policyholder by deducting any amounts the policyholder received from other sources, such as other insurance policies or other benefits.

While FIGA provides important protection and financial assistance to Florida residents, policyholders should be aware of its limitations. These limitations could impact a policyholder’s ability to receive full compensation for a claim in the event of an insurance company’s insolvency.

It’s important for policyholders to review their insurance policies carefully and consider purchasing additional coverage if they have concerns about FIGA’s limitations.

Filing a Claim with FIGA

To report a new claim or reopen an existing claim previously handled by an insolvent company, you will need to provide the following information based on the type of claim request:

  • Policyholder’s name
  • Claimant’s name (if not the policyholder)
  • Policy number
  • Claim number (Reopen only)
  • Date of loss
  • Brief description of the loss
  • Requestor’s best contact information (email & phone)
  • If other than policyholder reporting, please attach a letter of representation or the assignment of benefits contract
  • For loss assessment claims, please attach the Board Assessment Letter along with the breakdown of the assessment charges being billed to the policyholder

Step 1: Gather All the Necessary Documents

Gather all the necessary documents related to your claim, including your policy documents, any receipts, estimates, invoices and other supporting documentation. You may need to provide this information to FIGA when filing your claim.

Step 2: Fill Out the Claim Form with FIGA

Complete the FIGA claim form, which you can obtain from FIGA’s website or by contacting FIGA directly. Fill out the form accurately and provide all the necessary information related to your claim.

The Florida Insurance Guaranty Association email account nclaim@agfgroup.org is an email that will allow you to provide documents in PDF, Word, and Excel.   You can mail documents to P. O. Box 14249, Tallahassee, FL 32317 or fax them to 850-523-1888.

Step 3: Submit Your Claim Form

Once you have filled out the claim form, submit it to FIGA with your supporting documentation. You can do this either online, by mail, or by fax. Make sure to keep a copy of the claim form for your records.

Step 4: Check the Claims Deadline

You will need to make sure you time report your claim to FIGA and file the claim forms within the claim filing deadlines. You can check the claims deadlines on FIGA’s website or by clicking here.

Step 5: Stay on Top of Your Claim and Ask for Updates

FIGA will review your claim and advise if they need additional information or documentation. You will also be notified if your claim has been approved or denied. If your claim is approved, FIGA will work to pay out your claim as soon as possible. However, to ensure your claim is getting the attention it needs follow up with FIGA every 10 days and ask for a status update.

It’s important to note that the claims process with FIGA can take some time. Additionally, you should review your insurance policy carefully to understand the coverage provided by FIGA and any limitations or deductibles that may apply. If you have any questions or concerns about the claims process with FIGA, you can contact FIGA directly for assistance.

Claim Filing Deadlines

If you need to file a claim with the Florida Insurance Guaranty Association (FIGA), it’s important to be aware of the claim filing deadlines. These deadlines are established by Florida law and are designed to ensure that claims are filed in a timely manner.

For claims related to property and casualty insurance, the claim filing deadline with FIGA is generally within 2 years from the date the insurer was declared insolvent. This means that you have up to 2 years from the date the insurer becomes insolvent to file your claim with FIGA.

For claims related to medical malpractice insurance, the claim filing deadline is generally within 4 years from the date of the malpractice incident. It’s important to note that these are general guidelines and there may be exceptions depending on the specific circumstances of your claim. For example, if you are a minor or under a legal disability, you may have additional time to file your claim.

If you have questions about FIGA or the claim filing deadlines review the Frequently Asked Questions on FIGA’s website or contact an attorney at Murray Law Group for assistance.

Can An Attorney Help If I Have a Claim Dispute with FIGA?

Yes, if you have a dispute with the Florida Insurance Guaranty Association (FIGA) related to a property insurance claim, you may want to consider hiring a property insurance claim attorney to assist you.

A property insurance claim attorney can help you understand your rights and options under Florida law, as well as the terms of your insurance policy and FIGA’s coverage limitations. They can also help you navigate the claims process with FIGA and advocate on your behalf to ensure that you receive the maximum compensation available under the law.

If you have a dispute with FIGA, it’s important to act quickly and seek legal assistance as soon as possible. There may be strict deadlines and procedures that you need to follow in order to preserve your rights and protect your interests.

To find a property insurance claim attorney in Florida, you can search online or contact your state bar association for a referral. It’s important to choose an attorney who has experience in property insurance claims and is familiar with FIGA and its procedures. 

Free Claim Review with our Expert Insurance Attorneys

FIGA has been providing financial protection for Florida insurance policyholders for the last 50 years. If you have a policy with a provider that becomes insolvent, you must submit a claim with FIGA. At Murray Law Group, our knowledgeable insurance dispute attorneys can help you navigate the procedure and advocate for your rights with FIGA. Contact us today for more information and a free claims review.