Filing Number: 784587
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| Filing Accepted: 9/26/2024 |
| Last/Business Name
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H&M TREASURE COAST LLC
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First Name |
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| Street Address
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1971 SW BILTMORE STREET |
| City, State Zip
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PORT ST LUCIE,
FL
34984
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| Email Address
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QAMERWAHAJ@YAHOO.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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H&M TREASURE COAST LLC |
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First Name |
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| Policy # * |
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CPS7535719 |
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Claim #* |
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02124014 |
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Attorney is Applicable
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| Last Name* |
FRIEDMAN
First Name *
MICHAEL
Initial
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| Street Address* |
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1001 YAMATO ROAD, SUITE 311 |
| City, State Zip* |
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BOCA RATON
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FLORIDA
33431
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| Email Address * |
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MFRIEDMAN@FRIEDMANLEGALFL.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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SCOTTSDALE 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 41297 |
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| Name of individual responsible for violation (if any):*
SHAWN GADDY, FERNANDO DA SILVA
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| Type of Insurance
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Commercial Property & Casualty
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| Reason for Notice
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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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| 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)(j) |
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Altering or amending an insurance adjuster’s report without:
(I) Providing a detailed explanation as to why any change that has the effect of reducing the estimate of the loss was made; and
(II) Including on the report or as an addendum to the report a detailed list of all changes made to the report and the identity of the person who ordered each change; or
(III) Retaining all versions of the report, and including within each such version, for each change made within such version of the report, the identity of each person who made or ordered such change;
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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.
A. Coverage
We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss.
d. We will initially pay at least the actual
cash value of the insured loss, less any
applicable deductible.
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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.
H&M Treasure Coast purchased a property insurance policy, Policy No. CPS7535719, from Scottsdale Insurance Company, to cover the Property located at 1971 SW Biltmore Street, Port Saint Lucie, FL 34984. On about November 10, 2022, the Property was damaged by a hurricane. H&M Treasure Coast contacted their insurer, Scottsdale Insurance Company, to report the claim, which was assigned as Claim No. 02124014. Scottsdale sent an adjuster to inspect the Property, and the inspector found that the damage totaled $30,029.44 ACV/$30,503.90 RCV and “recommend[ed] payment to the Insured in the RCV amount of $26,503.90.” Scottsdale received this report, estimate, and recommendation but – without telling the adjuster – decided to alter or amend the estimate to “zero it out” so that the estimate reflected $0 due and owing to the insured. To compound on its errors, after sending an engineer to the Property, Scottsdale altered or amended the estimate once more to delete line items set forth by the adjuster and to amend prices recommended to be due and owing to the insured. Scottsdale has not provided any explanation, let alone a detailed explanation, as to why any change was made and failed to include a report or addendum to the report which detailed a list of all changes or the identity of the person who made the change. At the time of his deposition, the field adjuster had no knowledge that his estimate was ever changed and no knowledge as to who changed it or why. Further, despite later opening coverage on this claim, Scottsdale refuses to provide an amount that would restore the property to its pre-loss condition and has instead issued an underpayment that is based on a repair protocol that alters how the original property was constructed and does not replace the damage with “like and kind” materials.
This notice is given to perfect the right to pursue the violations set forth in this civil remedy notice within the given cure period. Therefore, to cure the defects outlined in this civil remedy notice, Scottsdale must pay for the damages outlined in the invoices and estimates provided to Scottsdale and claimed to restore the property to its pre-loss condition, in the principal amount of $203,935.99.
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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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