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Request for mediation - Florida Department of Financial Services 2026

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Definition and Meaning

The "Request for Mediation - Florida Department of Financial Services" is a formal document used by individuals or entities seeking to resolve disputes concerning automobile insurance claims in Florida. The form is designed to facilitate communication between the claimant and the insurer, promoting an environment conducive to reaching a mutually agreeable resolution through mediation. This approach aims to avoid lengthy legal procedures by providing a structured yet flexible platform for dialogue.

Steps to Complete the Request for Mediation

  1. Personal Information: Begin by providing your full name, address, contact information, and insurance policy details. Ensure all information is accurate to avoid processing delays.

  2. Claim Details: Include specifics about the insurance claim, such as the claim number, date of the incident, and a detailed description of the circumstances surrounding the claim. This section should accurately reflect all material facts.

  3. Dispute Description: Lay out the core issues in dispute, emphasizing areas where there is disagreement with the insurer’s assessment or decision. Providing clear and concise descriptions helps mediators understand your perspective.

  4. Supporting Documentation: Attach all relevant documents supporting your claim and the dispute. This can include correspondence with the insurer, photographs of the incident, and repair estimates.

  5. Signature and Date: Conclude by signing and dating the form, confirming that all information provided is true and accurate to the best of your knowledge.

Eligibility Criteria

  • Policy Holder: You must be a policyholder with an active automobile insurance policy within the state of Florida.

  • Coverage Dispute: The dispute must pertain to coverage issues related to property damage or personal injury claims.

  • Insurer Notification: Before filing for mediation, there should be a documented attempt to resolve the issue directly with the insurance company.

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Important Terms Related to Mediation

  • Mediation: A non-binding negotiation process with the assistance of a neutral third-party mediator to help resolve disputes.

  • Claimant: The individual or entity filing the request for mediation, usually the insured party.

  • Insurer: The insurance company providing the automobile insurance coverage in question.

Legal Use of the Request for Mediation

The form is legally recognized in Florida for mediating disputes related to automobile insurance claims, focusing on property damage and personal injury. Mediation is underpinned by state law to ensure fair practice and is aimed at achieving settlement without litigation. All parties in mediation must act in good faith during proceedings.

State-Specific Rules for Mediation

Florida mandates specific procedural rules for mediation under the Department of Financial Services. These stipulations include the formal appointment of a mediator, adherence to scheduling protocols, and a commitment to confidentiality throughout the process. Additionally, Florida law requires that a mediation request be initiated within a specific timeframe following a claim dispute.

Examples of Mediation Usage

  • Automobile Accidents: A claimant whose vehicle was damaged in an accident uses the mediation process to negotiate the repair costs after an initial offer from the insurer falls short of estimates.

  • Personal Injury Disputes: In cases where an insurer disputes the severity or treatment costs related to injuries from an accident, mediation provides a platform for discussing these discrepancies.

Required Documents

  • Insurance Policy Copy: A complete copy of the relevant insurance policy covering the incident.

  • Claim Correspondence: All communication between the claimant and insurer regarding the claim.

  • Incident Reports: Police reports, if applicable, detailing the incident.

  • Damage Estimates: Documentation from auto repair shops or medical records substantiating the claim amount.

Form Submission Methods

  • Online Submission: You can submit the form electronically via the Florida Department of Financial Services portal, which streamlines processing and feedback.

  • Mail Submission: Alternatively, print and fill out the form, then send it via postal mail to the designated department address.

  • In-Person Delivery: Submit the form directly at a local Department of Financial Services office, ensuring all required documents accompany the submission.

Selecting the appropriate submission method can impact processing times, with online submissions generally being the fastest.

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Mediation is a flexible dispute resolution process in which an impartial third party facilitates negotiations between parties to help them devise their own, mutually acceptable solutions. The mediator will ask questions, reframe issues, assist the parties to understand each other, and help identify solutions.
Initiating Mediation or Sinkhole Neutral Evaluation Online Request: Request Assistance. Telephone: Consumer Helpline 1-877-MY-FL-CFO (1-877-693-5236) Out of State Callers: (850) 413-5818. Email: Mediation@MyFloridaCFO.com or NeutralEvaluation@MyFloridaCFO.com.
Unless otherwise stipulated by the parties, each party, 10 days prior to appearing at a mediation conference, must file with the court and serve all parties a written notice identifying the person or persons who will appear at the mediation conference as a party representative or as an insurance carrier representative,
A mediation statement should distill the issues in the case. Less is always more. Start with a single paragraph identifying the parties and summarizing the claims. Provide a concise summary of the key facts without the gory details, as objectively as possible.
That is, how do we get people to agree to mediate? No one can be forced to attend a mediation session after all. Mediation is completely voluntary. In other words, both sides have to want to be there.

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Related links

Fla. Admin. Code Ann. R. 69J-166.002 | State Regulations

1. By the Policyholder. A policyholder may request mediation by submitting a completed Form DFS-I1-1669, Request for Commercial Residential Insurance MediationRead more

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Consumer Assistance Portal

The Division of Consumer Services will assist you with your insurance questions and concerns, as well as open a formal complaint. Request AssistanceRead more

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