Filing Number: 588631
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| Filing Accepted: 10/13/2021 |
| Last/Business Name
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APEX ROOFING & RESTORATION LLC A/A/O TANA HESS
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First Name |
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| Street Address
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5515 RAVEN CT. |
| City, State Zip
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TAMPA,
FL
33625
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| Email Address
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WITHHELD |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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APEX ROOFING & RESTORATION LLC A/A/O TANA HESS |
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First Name |
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| Policy # * |
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1501-2102-6419 |
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Claim #* |
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FL21-0133265 |
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Attorney is Applicable
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| Last Name* |
MITRA
First Name *
MITUN
Initial
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| Street Address* |
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501 E. LAS OLAS BLVD SUITE 200/300 |
| City, State Zip* |
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FORT LAUDERDALE
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FL
33301
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| Email Address * |
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MITUN@KWGLEGAL.COM |
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| Insurer Type
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Authorized Insurer
Unauthorized Insurer
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| Insurer Name |
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| Insurer Name* |
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UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
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| Insurer Name* |
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| Street Address* |
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| City, State Zip* |
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,
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NAIC Company Code 10861 |
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| Name of individual responsible for violation (if any):*
UNKNOWN
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| Type of Insurance
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Residential Property & Casualty
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| Reason for Notice
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Claim Delay
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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Statutory provision(s) which the insurer allegedly violated.
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| 624.155(1)(b)(1) |
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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.
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| 624.155(1)(b)(3) |
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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.
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| 626.9541(1)(i)(3)(a) |
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Failing to adopt and implement standards for the proper investigation of claims.
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| 626.9541(1)(i)(3)(b) |
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Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
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| 626.9541(1)(i)(3)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Loss settlement provision
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Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
The carrier has not attempted in good faith to settle the
claimant’s claim when, under all the circumstances, it could and should have done so, had it acted
fairly and honestly toward its claimant and with due regard for its interests. The carrier has done
everything possible to delay the claim and refuses to provide any sort of status of the claim.
Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that
burden upon the insured. This was made clear by the appellate court and the Florida Supreme
Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005)(“The Legislature has clearly
chosen to impose on the insurance companies a duty to use good faith and fair dealing in
processing and litigating the claims of their insureds…”).
The carrier was immediately put on notice of the claimant’s claim. Subsequently, the
claimant submitted a loss package in the amount of $28,640.18 less any applicable deductible
needed to restore the property back to its pre-loss condition to the carrier. Thereafter, the claimant
attempted to follow-up with the carrier multiple times in regard to the status of the claim and has
been ignored by the carrier. The claimant has complied with all of the carrier’s requests to date
and the carrier has still failed to treat this claim with good faith. More than ninety-two (92) days
have passed since the original date of loss. The carrier has still refused to pay the fully covered
amount owed under the policy. The carrier is aware of the full loss package and has not taken any
meaningful ensuing action.
It is clear that the carrier is not treating the claimant with good faith claims conduct; failing
to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly
and fairly to provide full and prompt indemnity to the claimant; failing to implement proper
standards for the adjustment and investigation of claims and placing the company’s interests
before the claimant’s interests; not training, supervising or managing adjusters properly so that
prompt and full payments are made; refusing to pay the full amount owed to the insureds despite
the fact that the damages are covered under the policy; looking for ways to delay full recovery orKatranis, Wald & Garner, PLLC
501 E. Las Olas Blvd Suite 200/300, Fort Lauderdale, FL 33301
Telephone: (754) 231-8107 | Service@KWGLegal.com
any recovery to the insureds; and refusing to provide coverage for the claimant’s loss in a timely
manner. The Carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1),
624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(d), and Fla. Stat.
§627.7152(9)(b) making a carrier’s response to a 10-day letter with a pre-suit settlement offer,
request for mediation, or demand for appraisal mandatory.
Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1)
Pay the complete covered loss in the amount of $28,640.18 less any applicable deductible; 2) Pay
the claimant’s attorneys’ fees and costs as they have been forced to retain counsel; and 3) Pay the
statutory interest on the amount of unpaid damages from the date of loss to the date payment is
finally made. A copy of this letter and filed form submitted to the FDFS has been printed out and
mailed.
Please do not hesitate to contact the undersigned or Dalila Munoz at (754) 231-8107 if you
have any questions or concerns.
Sincerely,
Mitun Mitra
Mitun Mitra, Esquire
Attorney at Law
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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.
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DFS-10-363
Rev. 10/14/2008
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