Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 550861

Filing Accepted: 4/3/2021

Print Filing

Complainant

Last/Business Name *

ARMSTRONG

First Name

ROBERT

Street Address *

11182 GOLDEN SILENCE DR.

City, State Zip *

RIVERVIEW, FL 33579

Email Address *

RARMSTRONG718@GMAIL.COM

Complainant Type: *

Insured

Last/Business Name*		ARMSTRONG		First Name		ROBERT
Policy # *		8073626317		Claim #*		01000040860

Attorney

Attorney is Applicable

Last Name*	KRAPF First Name * GRANT Initial W.
Street Address*		2790 SUNSET POINT ROAD
City, State Zip*		CLEARWATER , FLORIDA 33759
Email Address *		GRANT@KRAPFLEGAL.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		FIRST PROTECTIVE INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10897

Name of individual responsible for violation (if any):* AUSTIN COTTER, CHARLOTTE STARR, AND ANY OTHER INDIVIDUAL FROM FIRST PROTECTIVE INSURANCE COMPANY D/B/A FRONTLINE INSURANCE COMPANY WHO WAS INVOLVED IN THE CLAIM AND UNKNOWN TO CLAIMANT, AND FIRST PROTECTIVE INSURANCE COMPANY D/B/A FRONTLINE INSURANCE
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Unfair Trade Practice
	Claim Delay
	Other : Not treating the policyholder with good faith claims conduct
	Other : Placing the company’s financial interests before the policyholder’s interests
	Other : Looking for ways to deny full recovery to the Insureds
	Other : Failing to implement proper standards for the adjustment and investigation of claims
	Other : Looking for ways to delay full recovery to the Insureds
	Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made,
	Other : Misrepresenting the terms of the insurance policy

* Statutory provision(s) which the insurer allegedly violated.

	624.155(1)(b)(1)		Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
	626.9541(1)(i)(3)(a)		Failing to adopt and implement standards for the proper investigation of claims.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Reference to specific policy language… The violations alleged are statutorily based and do not rely on any specific policy language.

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

First Protective Insurance Company d/b/a Frontline Insurance Company, (“Insurer”) has committed the following in handling the Insured’s claim: 1) failure to act in due diligence and good faith to resolve claims; 2) placing the financial interest of Insurer before that of the Policy Holder and Claimant; 3) looking for ways to deny benefit payments and otherwise “low ball” or “stone wall” claims; 4) not adjusting the claims promptly and fairly; 5) failing to implement proper standards for the adjustment and investigation of claims; 6) looking for ways to delay benefit payments; 7) conducting inadequate investigations; and 8) failing to provide an estimate that complies with Florida Building Code. The Claimant timely submitted a claim to the Insurer for the damage sustained to the above referenced insured property as a result of a windstorm and ensuing water damage. Upon the initial investigation, the Insurer’s adjuster failed to conduct an adequate and thorough investigation. As a result, it is apparent that the Insurer significantly underestimated the scope of the loss to the Claimant’s property; including replacement of the flooring throughout the home. The Insurer failed to allocate enough coverage to repair or replace this damage when it paid the Claimant $860.20 after application of the policy deductible. The Insurer’s “low-ball” payment would not restore the property to its pre-loss condition, which is the Insurer’s duty under the contract of insurance issued by it. Due to the extent of the damage to the living room and office, Claimant hired a public adjuster who provided an estimate for $39,526.91 in covered damages. It is very clear that the Insurer and its adjuster colluded to misrepresent the true scope of damage to the insured property and the true replacement cost of the damage. This was a backhanded attempt to avoid paying to restore damage of the covered peril and place the financial interest of the Insurer over that of the Claimant. The Insurer misrepresented the loss and issued a wrongful partial denial. The Insurer extended coverage for replacement of the roof, but its payment would not restore the property to its pre-loss condition because no the Insurer did not provide coverage for any interior damage. Regarding the interior water damage, the Insurer denied all coverage based on the rationale that the “water was coming up under the hardwood floors.” Interestingly, the Insurer made this determination without hiring an expert such as an engineer. The water damage sustained to the floorswas the result of water intrusions that entered the insured property through storm-created openings in the roof. Although the Insurer and Insured may be in dispute about how the damage was sustained, the Insurer knows or should know that when independent perils converge and no single cause can be considered the sole or proximate cause, it is appropriate to apply the concurring cause doctrine. Sebo v. Am. Home Assurance Co., 208 So. 3d 694, 697 (Fla. 2016). The concurring cause doctrine states that coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause. Id. at 698. A covered peril that meets with an uncovered peril may still provide for coverage under a policy when the covered peril triggered the events that eventually led to the loss. Id. at 697. Additionally, although there was interior water damage the adjuster did not use a water meter. A water meter can be purchased online from Amazon for around $40 before tax. The Insurer could purchase a water meter and assess thousands of properties with one meter. Instead, the Insurer would rather place its financial interests over those of the Claimant by failing to provide the adjuster with the necessary tools to correctly inspect the loss. As a result of the inadequate investigation and surrounding circumstances it is apparent that Insurer significantly underestimated the scope of the loss to the Claimant’s property. Insurer and its adjuster have colluded to misrepresent the true scope of damages to the insured property and the true replacement costs of the damages. This is an underhanded attempt to place the financial interest of Insurer over those of the Claimant, to delay the Claimant’s claim, and to delay the Claimant in restoring his property to its pre-loss condition. Finally, the Insurer failed to allocate and pay for overhead and profit, pursuant to Florida Statute 627.7011(3)(a). Where the Insureds are reasonably likely to need a general contractor for the repairs, Florida Statute 626.7011(3) does not permit an Insurer to withhold overhead and profit pending the actual repair, unless absent a showing by the Insureds that it was likely to need a general contractor for the repairs. Trinidad v. Fla. Peninsula ins. Co., 121 So. 3d 433, 435 (Fla. 2013). The Insurer has implemented policies and procedures that are designed to wrongfully withhold costs associated with restoring the insured property to its pre-loss condition. This is another underhanded attempt to place the financial interest of the Insurer over that of the Claimant. In short, the Insurer is not acting with due regard for the Claimant’s interest. In Florida, the work of adjusting insurance claims engages the public trust. The Insurer has breached this duty. The Insurer has significantly underestimated the replacement costs of Insured’s property to further frustrate and delay the Claimant’s claim. The Insurer’s actions amount to but are not limited to the following: 1. Claim delay 2. Claim denial 3. Not treating the Policyholder with good faith claims conduct 4. Looking for ways to reduce recovery to the Claimant 5. Looking for ways to deny recovery to the Claimant 6. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the Claimant 7. Failing to implement proper standards for the adjustment and investigation of claims 8. Not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company’s interests before the policyholder’s interests 9. Conducting inadequate investigations 10. Failing to comply with Florida Building Code Therefore, to cure the defects outlined in this civil remedy notice, the Insurer must: (1) Admit full coverage for the Insured’s loss. (2) Tender full benefits owed to the Insureds under the insurance contract. (3) Pay all attorney’s fees, costs, and interest. A copy of this form submitted to the FDFS has been sent via Electronic Mail to the following parties providing them notice of the filing of the civil remedy notice. Please email any response to this civil remedy notice to badfaith@krapflegal.com VIA Electronic Mail: First Protective Insurance company d/b/a/ Frontline Insurance Company P.O. Box 95804 Lake Mary, FL 32795 claims@flhi.com info@frontlineinsurance.com

Comments

User Id		Date Added		Comment
grant@krapflegal.com		06-01-2021		The details herein have been amicably resolved between the parties; therefore, we withdraw this Civil Remedy Notice.

Acknowledgement
*	The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes. Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

DFS-10-363
Rev. 10/14/2008