Civil Remedy Notice of Insurer Violations
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Filing Number:     585158
Filing Accepted:  9/24/2021
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Complainant
Last/Business Name *  
FLORIDA PREMIER ROOFING, LLC   First Name  
Street Address * C/O 9000 REGENCY SQUARE BLVD SUITE 201
City, State Zip * JACKSONVILLE, FL 32211
Email Address * PATRICK.ZERR@EQUITABLEADJUSTMENTS.COM
Complainant Type: * Third Party
Insured
Last/Business Name*   JOHNSON   First Name   PATRICIA
Policy # * HCPCH0336340110 Claim #* 913461
Attorney
Attorney is Applicable
Last Name* JAMES First Name * NICHOLAS Initial
Street Address* 9000 REGENCY SQUARE BLVD SUITE 201
City, State Zip* JACKSONVILLE , FLORIDA 32211
Email Address * NICK.JAMES@EQUITABLEADJUSTMENTS.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
NAIC Company Code 12944
 
Name of individual responsible for violation (if any):* STEPHANIE BOLLERUD AND ALL SUPERVISORS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* 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.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
* Specific policy language that is relevant to the violation.
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POLICY TO BE PORVIDED
 
* Facts and circumstances giving rise to the violation.
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On or about 4/11/2021, the Insured, Patricia Johnson, suffered property damage at their property located at 5812 Seagrape Drive , Fort Pierce, FL 34982. The property suffered extensive damage to the roof. Homeowners Choice Property and Casualty Insurance Company (hereinafter Homeowners Choice) issued an insurance policy for the Insured’s property, Policy Number HCPCH0336340110, which was in full force and effect on the date of the loss. The loss was the result of a significant windstorm. Shortly following the loss, the Insured contracted with Florida Premier Roofing, LLC (hereinafter “FLPR”) to provide remediation and/or construction services to mitigate the loss and restore the property to its pre-loss condition. In order to expedite the process the Insured executed an assignment of benefits contract with FLPR, assigning the post-loss benefits owed under the policy to FLPR in exchange for its services. The assignment is deemed valid as the Insured is a named insured under the homeowners’ insurance policy and it was the intent of FLPR and Insured that the right to pursue a claim against Homeowners Choice for payment be transferred to FLPR. FLPR timely notified Homeowners Choice of the damages sustained to the property and contemporaneously provided a report of the cost of repairs amounting to $29,178.89. Despite demand for payment, Homeowners Choice has failed or refused to pay full value for services rendered by FLPR to protect and return property to pre-loss conditions. Homeowners Choice’s refusal to reimburse FLPR adequately for contracted services provided and otherwise make FLPR whole, constitutes a breach of contract. As a result of Homeowners Choice’s aforementioned breach of contract, it has become necessary for FLPR to retain the services of counsel. Homeowners Choice has engaged in a customary business practice and a deliberate course of conduct to hinder resolution of its claims until they enter litigation. It has become a pattern of practice for Homeowners Choice to not settle claims when it has the ability to do so, and these dilatory tactics serve no purpose other than to increase profits. Homeowners Choice has violated the following statutory provisions: §642.155(1)(b)(1) - Not attempting in good faith to settle claims when, under all circumstances, it could and should have done so, had it acted fairly and honestly towards its insured and with due regards for her or his interests; §624.155(1)(b)(3) – Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlement under other provisions of the insurance policy coverage; §626.9541(1)(i)(2) – A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy; §626.9541(1)(i)(3) – Committing or performing with such frequency as to indicate a general business practice any of the following: (a) Failing to adopt and implement standards for the proper investigation of claims; (b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (c) Failing to acknowledge and act promptly upon communications with respect to claims; (d) Denying claims without conducting reasonable investigations based upon available information; (e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured with 30 days after proof-of- loss statements have been completed; (f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement; (g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim; (h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. To remedy this Civil Remedy Notice and to cure the conduct giving rise to the violations described herein, Homeowners Choice must immediately: (i) tender the full remaining payment to FLPR for its services rendered; (ii) make payment of any pre-judgment interest owed under Florida law, including §627.70131(5)(a), which is accruing daily; (iii) make payment for the additional expense incurred by the FLPR in hiring an attorney; and (iv) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this Supplemental Claim. The aforementioned payments should be tendered to FLPR’s attorneys at Equitable Adjustments, Inc., 9000 Regency Square Blvd., Ste. 201, Jacksonville, Florida 32211.
Comments
User Id Date Added Comment
Legal@hcpci.com 11-22-2021 This is Homeowners Choice Property & Casualty Insurance Company’s (“HCPCI”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by Nicholas James on behalf of Florida Premier Roofing, LLC assignee of Patricia Johnson (“Insured”). After reviewing the CRN, HCPCI conducted a thorough review of the subject claim (“claim”) and confirmed it has handled the claim properly. Overall, HCPCI has handled the claim in accordance with the subject insurance contract and all statutory and regulatory requirements. HCPCI denies each allegation of bad faith and improper conduct in the CRN. At all times, HCPCI has acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. However, the CRN is deficient. Generally, CRNs must set forth with specificity relevant insurance contract language, statutory provisions and facts and circumstances to provide insurers with a meaningful opportunity to cure statutory violations alleged in CRNs. Here, instead of complying, the CRN cites statutes that are not relevant, does not identify specific insurance contract provisions, and does not provide factual support for statutory violations alleged in the CRN. Further, Florida Premier Roofing, LLC does not have standing to have filed the CRN. For instance, HCPCI has never provided insurance to Florida Premier Roofing, LLC and moreover, Florida Premier Roofing, LLC has no cause of action against HCPCI for extra-contractual damages or otherwise under Florida law. Finally, upon request by the Department of Financial Services, HCPCI will provide to the Department of Financial Services detailed correspondence HCPCI provided to the Insured regarding HCPCI’s obligations for the claim under the insurance contract and the facts of the claim.
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.

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