Filing Number: 676693
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| Filing Accepted: 2/21/2023 |
| Last/Business Name
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| Street Address
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6694 HOULTON CIR |
| City, State Zip
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LAKE WORTH,
FL
33467
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| Email Address
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AROLLINS@ITSABOUTJUSTICE.LAW |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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PIERRE |
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First Name |
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JEAN |
| Policy # * |
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HOH302326 |
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Claim #* |
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H32957 |
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Attorney is Applicable
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| Last Name* |
ROLLINS
First Name *
ANDREW
Initial
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| Street Address* |
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350 NORTH LAKE DESTINY ROAD |
| City, State Zip* |
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MAITLAND
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FLORIDA
32751
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| Email Address * |
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AROLLINS@ITSABOUTJUSTICE.LAW |
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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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HERITAGE 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 14407 |
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| Name of individual responsible for violation (if any):*
NA
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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 Denial
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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)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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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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| 626.9541(1)(i)(4) |
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Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
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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.
Based on information and belief, the following policy provisions apply to this Civil Remedy Notice:
Section 1 – Perils Insureds Against – Coverage A- Dwelling and Coverage B – Other Structures
Section 1 – Property Coverages – Coverage A - Dwelling and Coverage B – Other Structures
Section 1 – Conditions - Loss Payment
Section 1 – Conditions - Loss Settlement
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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.
On or about September 10, 2017, Jean Pierre, suffered a wind event at his home located at 6694 HOULTON CIR LAKE WORTH FL 33467 8736. As many who suffered damage as a result of Hurricane Irma, the insureds were not aware of the damage until a licensed roofer inspected the property and found the damage.
On or about September 10, 2017, Jean Pierre (“Insured”) suffered significant damage to their home located at 7141 Lockwood Rd, Lake Worth, FL 33467 caused by a windstorm Hurricane Irma. Prior to the loss, Heritage Property & Casualty Insurance Company (“HERITAGE”) issued a homeowner’s insurance policy (policy no. HOH302326) for the Insureds’ home. The policy was in full force and effect on the date of loss and affords coverage for A windstorm hurricane damage.
The insured was a named insured on the policy. Upon learning of the damage, the insured promptly notified Heritage of the loss, to which Heritage assigned Claim Number H32957. The insured notified Heritage on August 24,2020. Remarkably, despite being notified of the loss Heritage failed to complete any resemblance of an investigation. Heritage never even sent anyone to the property to inspect! In fact, Heritage issued its coverage letter and claimed that the insureds had failed to prove the damages were the result of Hurricane Irma. The letter states, “you did not provide prompt notice of physical damage that would have occurred from Hurricane Irma … You have not provided us any factual information at all that would support your claim.”
It is clear that HERITAGE has not acted honestly or fairly towards its Insureds. HERITAGE never even investigated and sent an adjuster to the property for this claim. As is the case this, it has become a general business practice of HERITAGE to not implement proper claims handling procedures, to not send a field adjuster out to a late reported hurricane Irma claim, and to not settle claims in good faith when under all circumstances it should have. HERITAGE regularly denies claims on cases that it never even inspected the property in order to avoid issuing full payment on losses that it knows are covered under the policy.
HERITAGE also routinely refuses to inspect the property and pay claims in full when it has the ability to do so, waits to see if its Insureds contest the coverage determination, as was necessary here. This has become a pattern and practice of HERITAGE and has occurred in several other claims including Claim No.: HP211090 and Claim No.: HP208532. HERITAGE has developed this deliberate strategy in order to deter its insureds from challenging its coverage determinations and hinder their ability to seek additional payment for monies owed under the policy. HERITAGE’s practice of not adjusting losses in good faith in accordance with section 627.70131, Florida Statues, unnecessarily delays resolution of its claims and leaves claimants with no choice but to incur further time and expense just to be fully indemnified pursuant to the terms of their contract with HERITAGE. HERITAGE has completely abdicated its duty to adjust and has put the onus on its insureds to spend thousands of dollars in litigation before HERITAGE is willing to issue benefits or make repairs that it knows are owed pursuant to the policy. HERITAGE’s pattern and practice of not sending a field adjuster to inspect the property, then deny the claim stating they don’t have enough information, is evidence that it does not act fairly or honestly towards the Insureds during its adjustment process and that it has failed to implement proper standards for the investigation and handling of its claims. It is unconscionable that HERITAGE would put its Insureds in dire financial straits rather than simply pay what it owes as is its contractual obligation.
In order to cure this Civil Remedy Notice, HERITAGE must immediately acknowledge in writing that Insureds’ estimate is reasonable in scope and tender all undisputed benefits owed. The written acknowledgment should be tendered to the Insureds’ attorney, Andrew Rollins, Esq. at 350 N. Lake Destiny Road, Maitland, FL 32751.
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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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