Civil Remedy Notice of Insurer Violations
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Filing Number:     649770
Filing Accepted:  10/3/2022
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Complainant
Last/Business Name *  
TRUONG   First Name   HUE
Street Address * 11057 RIVER TRENT COURT
City, State Zip * LEHIGH ACRES, FL 33971
Email Address * ALI@THEKRFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   TRUONG   First Name   HUE
Policy # * HOH607711 Claim #* H87647
Attorney
Attorney is Applicable
Last Name* KADIR First Name * ALI Initial A.
Street Address* 986 DOUGLAS AVE, STE. 102
City, State Zip* ALTAMONTE SPRINGS , FL 32714
Email Address * ALI@THEKRFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 14407
 
Name of individual responsible for violation (if any):* MELANIE CARRENO, KYLE DAVIS, RENO EGUIA, LAUREN SHAWN BAGGERLY, AND ALL HERITAGE CLAIMS ADJUSTERS, EMPLOYEES, REPRESENTATIVES, AGENTS, VENDORS, AND/OR ENGINEERS WHO HANDLED THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Misrepresentation
* 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)(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.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

“We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property.”
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Hue Truong is a homeowner insured with an all-risks policy issued by Heritage Property & Casualty Insurance Company (“Heritage”). The insured property or home is located at 11057 River Trent Court, Lehigh Acres, Florida 33971. In January of 2022, a wind and rainstorm caused extensive damage to Mr. Truong’s home. Mr. Truong timely reported an insurance claim for this damage to Heritage and fully cooperated with all requests for inspections. He provided all requested documentation, if any, and complied with all post loss policy conditions. After reporting the claim, Heritage retained an unqualified and biased field adjuster who has a financial relationship with Heritage. This field adjuster inspected Mr. Truong’s home in an apparent effort to minimize Heritage’s losses instead of adjusting the claim in good faith in due regard for Mr. Truong’s interests. Despite Heritage finding coverage for his claim, it significantly undervalued Mr. Truong’s claim at only $18,000. Because this amount was an offer pre-mediation, Heritage did not issue any payment to Mr. Truong. Due to such, Mr. Truong has not been able to permanently repair his home. Indeed, an estimate for repair of all damages with respect to his claim was prepared on behalf of Mr. Truong for $23,086.44 and was submitted to Heritage; well above the amount from Heritage. Based on these facts, it is clear Heritage unreasonably denied full coverage for Mr. Truong’s claim in bad faith through its extremely low and unreasonable valuation of his claim. Heritage undervalued and failed to make any payment regarding his claim without conducting a reasonable investigation based upon the available information. It misrepresented pertinent policy provisions and facts, and did not act fairly and honestly with Mr. Truong in due regard for his interests. Heritage also failed to adopt and implement standards for the proper investigation of his claim. This has become a common business practice of Heritage. Florida Statute § 624.02 defines insurance as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. Heritage has breached this duty by refusing to properly and timely adjust the loss. As a result, Mr. Truong had no choice but to retain the undersigned counsel and file a lawsuit against Heritage. Heritage has more than enough information and is still refusing to accept coverage for this claim. This continued and repeated reckless claim delay and denial of coverage will result in a significant punitive damage award if a bad faith lawsuit is filed. Heritage can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Mr. Truong based on his $23,086.44 estimate.
Comments
User Id Date Added Comment
ncarlisle@heritagepci.com 11-18-2022 November 18, 2022 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Hue Truong Insured: Hue Truong Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 649770 filed on October 3, 2022 Claim No: H87647 Policy No.: HOH607711 Dear Madam and/or Sir: Please allow this correspondence to serve as Heritage Property & Casualty Insurance Company’s (“Heritage”) official response to the Civil Remedy Notice of Insurer Violation (“Notice”), Filing Number 649770, filed by Hue Truong on behalf of Heritage’s insured Hue Truong and accepted by the department on October 3, 2022. Without waiving Heritage’s arguments that the subject Civil Remedy Notice is legally insufficient and non-compliant with Florida law, Heritage has performed its obligations under the insurance policy. The Notice contains a list of violations which are alleged to have been committed by Heritage. In fact, none of the listed violations/allegations have occurred and Heritage categorically denies any violations of §624.155 and §626.9541, Fla. Stat., as well as any and all other statutes/regulations/codes/rules and allegations of wrongdoing rising to a level of a general business practice. The subject Civil Remedy Notice lists whole sections of the insurance policy without any specificity as to the allegations of wrongdoing by Heritage and therefore is legally insufficient. In addition, Heritage denies any and all allegations of any kind referenced in the Civil Remedy Notice. Sincerely, /s/ David Barrera David Barrera, Esq. Claims Counsel Heritage Property & Casualty Insurance Co. CRN Response
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