Fewer Citizens policyholders, yes, but will they
have a better shot at winning a claims dispute?
The state-backed insurer
expects to have slightly more than half a million policyholders
by the end of the year. The policy roster has plunged 63% from
the 1.4 million-policy peak in |
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Article Courtesy of The Palm Beach Post
By Anne Geggis
Published September 23, 2025
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The number of property owners covered by the state’s
insurer of last resort has dropped dramatically — but options for
resolving disputes between Citizens Property Insurance Corp.’s and its
customers over what’s owed when a claim occurs recently got a boost.
The state-backed insurer expects to have slightly more than half a
million policyholders by the end of the year. The policy roster has
plunged 63% from the 1.4 million-policy peak in September 2023, when the
state’s insurance market wobbled in the aftermath of 10 private insurers
going insolvent between 2019 and 2023.
That means that it's less likely that all Florida insurance
policyholders will be tapped to shore up Citizens in the event of a
catastrophic hurricane, as happened after a conga line of storms pounded
the state during the 2004 and 2005 seasons.
But hidden in the bullish picture is a battle over an unresolved
byproduct of Florida's tort reform efforts this decade.
Namely, how to create a healthy property insurance market and still
provide a channel for customers to challenge claims settlements they
feel do not reflect the cost of the damage they have suffered, either by
a broken pipe or a hurricane. As Florida enters the most active portion
of the 2025 hurricane season, it is no small controversy.
And Citizens and its remaining 500,000-plus customers are only the
latest to face this vexing, and potentially costly, challenge.
How tort reform boosted insurance market, raised legal challenge issue
Fears of a property insurance meltdown that could have paralyzed
Florida's real estate industry — and the potentially crushing liability
that Citizens was carrying — spurred special legislative sessions to
prevent a crisis.
During those sessions in 2022 and 2023, specifically, lawmakers enacted
judicial system changes they believed necessary to curtail excessive —
and some even say fraudulent — lawsuits they and insurance industry
voices said were taking a toll on the private market in addition to the
state’s climatological and geographical vulnerability to hurricanes.
Today, state officials say those reforms are doing the job. But lawyers
and consumer advocates remain concerned that customers will ultimately
get fleeced twice — first by still nation-leading pricey insurance
premiums and then by claims checks that will leave them paying more than
they should have to in repairing damage.
The changes hobbled policyholders' ability to sue over claims disputes
with their insurer. That is because attorney fees are no longer
automatically added to a settlement as they formerly were, decreasing
attorney incentive to take the cases. It is especially the case when the
disputed amount is on the smaller side but a big expense for a
household: $10,000 or so.
Years later, Citizens has depopulated — the term for shifting policies
from its books to private insurers — to the tune of 1 million customers.
A major reason this has been possible, the company, state officials and
insurance industry representatives have said, is because the legal
reforms have lured new private insurers into Florida. On Sept. 18, the
Office of Insurance Regulation announced two new property insurers have
stepped into the market — the 15th and 16th new insurers since the legal
changes were made.
“This is all great news,” Jeremy Pope, Citizens’ chief administrative
officer, told a Citizens’ committee Sept. 17.
But one of those legal changes that Citizens wanted — and sees as
crucial in reducing its litigation costs — is facing its undoing.
Part of the effort to tamp down costs
In 2023, the Florida Legislature granted Citizens the right to send
claims disputes to a special court run by the state Division of
Administrative Hearings, often referred to as DOAH.
There, judges, paid by salaries that Citizens funds, act as arbitrators
in Citizens’ disputes. The insurer's board of governors approved a $19.3
million contract with DOAH to pay the administrative costs of these
claims hearings through 2027.
In those proceedings, however, policyholders who get in front of the
judge almost always lose — 90% of the policyholder claims against
Citizens that reached the arbitration judge were denied, giving Citizens
the right to legal fees from the claimant.
Now, though, the procedure is on hold, as a Hillsborough County judge
has found that a Hurricane Ian victim has a substantial chance of
success on the merits of his case. The judge's ruling found that the
DOAH arbitration procedure should not go forward in the case of Martin
Alvarez, or any other Citizens' policyholder, because of the violation
of constitutional rights it presents.
Judge Melissa M. Polo issued an injunction against the administrative
court hearings in these cases. The plaintiff's attorney argues that this
quasi-judicial procedure unfairly violates a policyholder’s right to a
fair trial. More lawsuits seeking to void the arbitration have followed.
Citizens, however, has appealed the injunction against the DOAH
arbitration hearings and continues to refer cases to the administrative
procedure since that Aug. 2 injunction. It plans to increase the number
cases going to the arbitration hearings to 3,800 a year, according to
public documents first reported by the Sun Sentinel and ProPublica.
Faster, cheaper, but is it fair?
The DOAH arbitration hearings allow disputes to be resolved much faster,
said Michael Peltier, spokesperson for Citizens. It usually takes less
than 90 days, compared to an average of two years in civil court, he
said.
“The DOAH process, which has been operating for 50 years, offers a fair
and efficient venue for settling disputed claims and the statute that
specifically authorizes Citizens to use DOAH is constitutional,” Peltier
said. “For policyholders, the process allows disputed claims to be
resolved in a matter of months instead of waiting nearly two years under
the state court system.”
The Hillsborough judge's injunction, however, is seen as a victory by
plaintiff attorneys who see Citizens’ 90% success rate in the
administrative hearings as evidence of a deck stacked against the
policyholder with a legitimate claim.
“It’s shocking,” Harold Levy, founder and managing partner of HL Law
Group in Fort Lauderdale, said of the one case he's seen where a
policyholder was able to get a favorable decision in the administrative
court, compared to the number he's seen withdrawn or settled.
“When you look at it, practically speaking, you have a very, very
advanced timeframe. Things have to happen very quickly," Levy added.
"You're spending a lot of money up front and timeframes that are very
onerous, and you're going in front of judges who we feel are very
strongly on the side of Citizens.”
The chances and the odds
About 1,500 Citizens' policyholder cases have gone to the administrative
procedure since the practice was started in 2024, as of a count dated
July 2025. Citizens can invoke the procedure after the insurer receives
notice of a policyholder's intent to sue.
Peltier says that 90% of that initial group sent to the administrative
procedure settle before it gets to the judge. And 1-in-4 are settled for
an average of $30,000, he said.
“When we see evidence that supports a finding that the claim is covered,
we give the policyholder the benefit of the doubt and pay the claim,”
Peltier said. “I would argue that that is a major reason our success
rate is so high when those last few cases make their way to final
hearing.”
Another 50% of the cases are settled by Citizens with a $250 to $300
payment. And another 11% of the cases have been withdrawn, Peltier said.
In the Tampa case, however, paperwork from another administrative claim
hearing illustrates the high stakes even when a jury trial is not
involved. In one West Palm Beach case, a CItizens' policyholder withdrew
her claim on the hearing date. Still, the policyholder was ordered to
pay Citizens’ court costs: $45,000.
Arguments for injunction are due in the District Court of Appeal next
month.
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