Why homeowners are losing 90% of cases against Florida’s biggest insurer

Florida’s home insurance crisis has left more than half a million homeowners with no choice but to rely on the state’s insurer of last resort.

As private companies have fled the market and premiums have skyrocketed, Citizens Property Insurance Corporation has become the only remaining option for many.

But when policyholders challenge denied claims, Citizens wins more than 90% of the time in a little-known legal process that sidesteps traditional courts, where its win rate drops to around 55%, as first reported by ProPublica and the Sun Sentinel.

The disparity reveals a troubling pattern in an already fragile market—one where homeowners are being pushed into a system where the odds are overwhelmingly stacked against them.

The new ‘courtroom’ homeowners rarely chose

In spring 2023, amid a deepening insurance crisis, Florida lawmakers passed a measure giving Citizens the power to reroute disputes with policyholders away from traditional courts and into the Division of Administrative Hearings (DOAH). The move was part of a broader legislative push backed by Citizens to make it easier for the not-for-profit, state-backed insurer to raise rates and reduce its legal exposure as climate-fueled disasters mounted.

It was a time of historic losses. Florida saw four billion-dollar weather disasters in 2022, which doubled to eight in 2023, and then spiked to 11 in 2024, according to data from the National Oceanic and Atmospheric Administration.

Those three years alone account for nearly 40% of all billion-dollar disasters in state history going back to 1980. As insurers became insolvent or left the market, more than 1.4 million homeowners were pushed on to Citizens, the state’s “insurer of last resort.”

But the new legal channel raised alarms early on. During floor debate, then-state Rep. Erin Grall called the provision “very broad” and warned it would harm policyholders, according to ProPublica. 

State Rep. Hillary Cassel, a former insurance attorney, went further, arguing that DOAH hearings strip homeowners of their right to a jury trial, limit discovery, and tilt the balance of power toward the insurer. 

“I do take issue with allowing these cases to go into an administrative hearing process and being denied a right to a trial by jury that is the foundation of our American justice system,” she said in what now feels like a prophetic testimony on the House floor. 

“I’ve heard the former executive director of Citizens comment that they are willing to pay to hire these administrative judges to handle these cases on behalf of Citizens which I believe creates a conflict of interest,” she added.

Unlike circuit court, DOAH hearings are presided over by administrative judges, offer no jury, and can severely limit the scope of evidence homeowners are allowed to present. Once a case is routed to DOAH, homeowners can’t simply walk away—they’re bound to the process, which critics argue favors the very entity that lobbied to create it.

And as Cassel’s testimony suggested, Citizens pays the salaries of the judges that act as arbitrators in the disputes by design.

The state created the DOAH in the mid-1970s to help resolve legal disputes involving government agencies and ensure fairness in the process, an article from the Florida Bar journal explains. Government entities always cover the cost of using DOAH, so taxpayers don’t have to pay out of pocket, a presentation from Citizens clarifies.

A funding proposal from the company suggests that it plans to send more than 3,800 cases to arbitration per year, allotting over $19 million to fund its contract with the DOAH through 2027—a nearly 10 times bump to the $2 million board-approved package for 2023 and 2024.

The numbers don’t lie

Since gaining the power to route disputes into the Division of Administrative Hearings, a presentation from Citizens states that only 1% of claims have been routed to DOAH hearings—all of which are a matter of public record. But the results are striking.

The insurer has prevailed in over 90% of the cases it has taken to DOAH, according to ProPublica’s investigation. That’s a staggering advantage compared with its 55% win rate in circuit court trials, where homeowners have access to juries, broader discovery, and stronger legal protections.

And when cases settle at DOAH, they tend to settle for far less. Half of all settlements result in payouts of $500 or less, and nearly 4 out of 5 cases (78%) never make it to a final ruling, ProPublica’s investigation found.

Critics say the limited legal leverage pushes many homeowners to take whatever they can get—even if it doesn’t come close to covering the cost of repairs. And what was once pitched as a faster, simpler process has become, for many, a one-sided system where the odds are stacked.

The human toll

Those outcomes are costing homeowners more than just claims money they may have been entitled to.

After finding water pooling in their Fort Lauderdale kitchen, Peter and Linda Kilfoil filed a claim with their insurance carrier, Citizens, to cover the $40,000 of necessary repairs. The insurer denied it, blaming long-term leakage not covered under their policy. 

Hoping to challenge the denial, the couple sued—but their case was routed to DOAH, where an administrative judge barred them from deposing the Citizens adjuster. Their attorney says that move deprived them of a critical chance to investigate why the claim was denied in the first place.

At the same time, Peter was battling both prostate and skin cancer, enduring hospitalizations. Facing mounting stress from the dispute and his worsening health, the couple made the painful decision to settle the case for just $500 in February. Peter died six months later, in August.

Theirs is just one story. After a pipe burst beneath his living room and a roof leak shorted his AC—causing mold to spread—Jeffery McShane faced an estimated $200,000 in repairs. But Citizens denied his claim too, citing policy exclusions. Fearing that pressing the case could result in an even lower payout (or none at all) he settled at DOAH for just $5,000.

After the storm, a new battle

But policyholders may be reaching a turning point.

After Hurricane Milton tore through his Tampa neighborhood in 2024, Martin Alvarez filed a claim with Citizens to repair the damage. When he disputed the insurer’s settlement offer, his case was rerouted to DOAH, but Alvarez fought back. And in August 2025, a Hillsborough County judge sided with him, issuing an injunction that paused Citizens’ use of the DOAH process statewide, the Sun Sentinel reports.

In her ruling, Judge Melissa Polo said Alvarez had a “substantial likelihood” of proving that the system violates policyholders’ constitutional right to a fair trial. She described DOAH as “structurally biased,” citing restrictions on discovery, lack of judicial review, and a pattern of awarding legal fees to Citizens—even when homeowners drop their claims.

But Citizens isn’t backing down.

CEO Tim Cerio has framed the backlash as a politically motivated campaign to unwind the legal reforms that, in his words, “brought Florida’s insurance market back from the brink.”

At a board meeting this month, Cerio accused trial attorneys of driving up premiums through “fraudulent litigation” and dismissed critics of DOAH as simply angry over lost legal fees. He defended the process as fast, fair, and efficient—pointing to data showing that 37% of DOAH cases result in the company reversing their initial claims decision and paying out to customers, and underlining the fact that as a not-for-profit, Citizens has no incentive to deny claims.

The state, too, is touting results. Since its 2023 peak of 1.4 million policyholders, Citizens has shed 63% of its book, with projections of just over 500,000 policies by year-end. Sixteen new private insurers have entered the market since the reforms took effect.

But for those who remain with Citizens—the homeowners with the least market choice and the most exposure to disaster—it may be little comfort.