Filing Number: 784733
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| Filing Accepted: 9/27/2024 |
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RIVERSIDE GRILL
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First Name |
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GATOR'S |
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4255 PENINSULA POINT |
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SANFORD,
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32771
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EPWINT@AOL.COM |
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Insured |
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RIVERSIDE GRILL |
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First Name |
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GATOR'S |
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LBW556593R2 |
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Claim #* |
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2201726 |
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Attorney is Applicable
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| Last Name* |
O'NEIL
First Name *
JONATHAN
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203 FORT WADE ROAD, SUITE 260 |
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PONTE VEDRA
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FLORIDA
32081
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JONATHAN@WOOLSEYMORCOM.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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UNDERWRITERS AT LLOYD'S, LONDON
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NAIC Company Code |
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| Name of individual responsible for violation (if any):*
STYMETRA HOLBROOK PAUL SANDERSON SCOTT SCHRAMM
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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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Claim Delay
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Other
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Wrongful claim denial
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Unfair Trade Practice
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Other
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Unfair claim settlement practices
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Other
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Unreasonable investigation
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Other
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Failure to act on claim
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Other
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Failure to conduct a reasonable investigation based on available information
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Other
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Failure to maintain proper complaint handling procedures
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Other
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Misrepresenting the insurance policy provisions to the insured
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Other
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Misrepresenting Florida statutory provisions to the insured
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Other
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Misrepresenting facts to the insured
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Other
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Failure to acknowledge and act promptly upon communications with respect to claims
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Other
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Denying claims without conducting reasonable investigations based upon available information
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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)(2) |
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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.
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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)(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)(3)(e) |
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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.
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| 626.9541(1)(i)(3)(f) |
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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.
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| 626.9541(1)(i)(3)(g) |
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Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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| 626.9541(1)(i)(3)(h) |
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Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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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.
BUILDING AND PERSONAL PROPERTY COVERAGE FORM
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.
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4. Additional Coverages
a. Debris Removal (1) Subject to Paragraphs (3) and (4), we will pay your expense to remove debris of Covered Property caused by or resulting from a Covered Cause of Loss that occurs during the policy period. The expenses will be paid only if they are reported to us in writing within 180 days of the date of direct physical loss or damage. (2) Debris Removal does not apply to costs to: (a) Extract "pollutants" from land or water; or (b) Remove, restore or replace polluted land or water. (3) Subject to the exceptions in Paragraph (4), the following provisions apply: (a) The most we will pay for the total of direct physical loss or damage plus debris removal expense is the Limit of Insurance applicable to the Covered Property that has sustained loss or damage. (b) Subject to (a) above, the amount we will pay for debris removal expense is limited to 25% of the sum of the deductible plus the amount that we pay for direct physical loss or damage to the Covered Property that has sustained loss or damage. (4) We will pay up to an additional $10,000for debris removal expense, for each location, in any one occurrence of physical loss or damage to Covered Property, if one or both of the following circumstances apply: (a) The total of the actual debris removal expense plus the amount we pay for direct physical loss or damage exceeds the Limit of Insurance on the Covered Property that has sustained loss or damage. (b) The actual debris removal expense exceeds 25% of the sum of the deductible plus the amount that we pay for direct physical loss or damage to the Covered Property that has sustained loss or damage. Therefore, if (4) (a) and/or (4) (b) apply, our total payment for direct physical loss or damage and debris removal expense may reach but will never exceed the Limit of Insurance on the Covered Property that has sustained loss or damage, plus $10,000.
b. Preservation Of Property If it is necessary to move Covered Property from the described premises to preserve it from loss or damage by a Covered Cause of Loss, we will pay for any direct physical loss or damage to that property: (1) While it is being moved or while temporarily stored at another location; and (2) Required by local ordinance. No Deductible applies to this Additional Coverage.
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e. Increased Cost Of Construction (1) This Additional Coverage applies only to buildings to which the Replacement Cost Optional Coverage applies. (2) In the event of damage by a Covered Cause of Loss to a building that is Covered Property, we will pay the increased costs incurred to comply with enforcement of an ordinance or law in the course of repair, rebuilding or replacement of damaged parts of that property, subject to the limitations stated in e. (3) through e.(9) of this Additional Coverage. (3) The ordinance or law referred to in e. (2) of this Additional Coverage is an ordinance or law that regulates the construction or repair of buildings or establishes zoning or land use requirements at the described premises, and is in force at the time of loss.
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CAUSES OF LOSS – SPECIAL FORM
A. Covered Causes Of Loss
When Special is shown in the Declarations, Covered Causes of Loss means Risks Of Direct Physical Loss unless the loss is: 1. Excluded in Section B., Exclusions; or 2. Limited in Section C., Limitations; that follow.
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[I]f an excluded cause of loss that is listed in 3.a. through 3.c. results in a Covered Cause of Loss, we will pay for the loss or damage caused by that Covered Cause of Loss.
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E. Additional Coverage – Limited Coverage For "Fungus", Wet Rot, Dry Rot And Bacteria
1. The coverage described in E.2. and E.6. only applies when the "fungus", wet or dry rot or bacteria are the result of one or more of the following causes that occur during the policy period and only if all reasonable means were used to save and preserve the property from further damage at the time of and after that occurrence: a. A "specified cause of loss" other than fire or lightning; or b. Flood, if the Flood Coverage Endorsement applies to the affected premises. This Additional Coverage does not apply to lawns, trees, shrubs or plants which are part of a vegetated roof. 2. We will pay for loss or damage by "fungus", wet or dry rot or bacteria. As used in this Limited Coverage, the term loss or damage means: a. Direct physical loss or damage to Covered Property caused by "fungus", wet or dry rot or bacteria, including the cost of removal of the "fungus", wet or dry rot or bacteria; b. The cost to tear out and replace any part of the building or other property as needed to gain access to the "fungus", wet or dry rot or bacteria; and c. The cost of testing performed after removal, repair, replacement or restoration of the damaged property is completed, provided there is a reason to believe that "fungus", wet or dry rot or bacteria are present. 3. The coverage described under E.2. of this Limited Coverage is limited to $15,000. Regardless of the number of claims, this limit is the most we will pay for the total of all loss or damage arising out of all occurrences of "specified causes of loss" (other than fire or lightning) and Flood which take place in a 12- month period (starting with the beginning of the present annual policy period). With respect to a particular occurrence of loss which results in "fungus", wet or dry rot or bacteria, we will not pay more than a total of $15,000 even if the "fungus", wet or dry rot or bacteria continue to be present or active, or recur, in a later policy period.
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BUSINESS INCOME (AND EXTRA EXPENSE) COVERAGE FORM
A. Coverage
1. Business Income
We will pay for the actual loss of Business Income you sustain due to the necessary "suspension" of your "operations" during the "period of restoration". The "suspension" must be caused by direct physical loss of or damage to property at premises which are described in the Declarations and for which a Business Income Limit Of Insurance is shown in the Declarations. The loss or damage must be caused by or result from a Covered Cause of Loss. With respect to loss of or damage to personal property in the open or personal property in a vehicle, the described premises include the area within 100 feet of such premises.
2. Extra Expense
We will pay Extra Expense (other than the expense to repair or replace property) to: (1) Avoid or minimize the "suspension" of business and to continue operations at the described premises or at replacement premises or temporary locations, including relocation expenses and costs to equip and operate the replacement location or temporary location. (2) Minimize the "suspension" of business if you cannot continue "operations". We will also pay Extra Expense to repair or replace property, but only to the extent it reduces the amount of loss that otherwise would have been payable under this Coverage Form.
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Also refer to:
Coverage A provision, coverage B provision, coverage C provision, coverage D provision, all additional coverages provisions, all coverages provided by endorsement or rider, the declarations page, loss payment or settlement provision, duties in event of loss policy provision, all terms and conditions of section I of the insurance policy, the insurance policy definitions section, the insurance policy‘s exclusion of coverage provisions, all insurance policy provisions that provide coverage to the insured property, and all policy provisions.
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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.
Underwriters at Lloyd’s, London (syndicate list for B0142AA2200357: LIB 4472, BRT 2987, BRT 2988, MMX 2010, AUW 609, WBC 5886, SAM 727, and KII 1618)
624.155(1)(a)(1) – violating 626.9541(1)(i)
626.9541(1)(a)(1) -- misrepresenting the terms of an insurance policy.
626.9541(1)(i) -- unfair claim settlement practices.
Facts of the case:
Underwriters at Lloyd’s, London (syndicate list for B0142AA2200357: LIB 4472, BRT 2987, BRT 2988, MMX 2010, AUW 609, WBC 5886, SAM 727, and KII 1618) (hereinafter “UNDERWRITERS”) has committed the following in handling the insured’s claim: 1) failure to pay benefits owed; 2) failure to act in due diligence and good faith to resolve claims; 3) placing the financial interest of the insurer before that of the policy holder and claimant; 4) failure to properly train, evaluate, and manage adjusters retained to represent the policies and procedures of UNDERWRITERS; 5) looking for ways to delay benefit payments and otherwise “low ball” or “stone wall” claims; 6) looking for ways to deny the insured’s claim; 7) looking for ways to reduce recovery to the insured; 8) failure to perform a reasonable investigation; 9) misrepresenting Florida statutory provisions to its insured; 10) misrepresenting insurance policy provisions to the insured; 11) UNDERWRITERS has failed and refused to acknowledge coverage and promptly pay the benefits due and owed to the insured; 12) the reasons for this may be attributed to improper training, supervision, and/or motivation of outside adjusters and claims supervisors to promptly and fairly adjust and pay full benefits available to the insured. The insurer may have failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because a proper investigation and full and prompt payment for the loss is not occurring.
In Florida, the work of adjusting insurance claims engages the public trust. UNDERWRITERS has breached this duty by its adjustment of the insured’s claim of loss. UNDERWRITERS has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in violations as set forth above. UNDERWRITERS has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. Despite the insured’s timely notification to UNDERWRITERS of their insurance claim, UNDERWRITERS has failed and refused to acknowledge the covered loss and pay all amounts due and owing to the insured under the policy of insurance. UNDERWRITERS has failed to promptly settle the insured’s insurance claim, when the obligation to settle the claim had become reasonably clear, under one portion of the insurance, in order to influence settlements under other portions of the insurance policy coverage. Despite the insured’s pleas otherwise, UNDERWRITERS has failed and refused to acknowledge its obligation to tender all insurance proceed monies due and owing the insured or assist the insured in mitigation of the damages.
In exchange for a premium paid by the insured, UNDERWRITERS issued the subject insurance policy which provided coverage for the insured property from April 15, 2022 through April 15, 2023 for “Risks Of Direct Physical Loss unless the loss is: 1. Excluded in Section B., Exclusions; or 2. Limited in Section C., Limitations.” As such, the subject all-risk Policy contains coverage for all direct physical losses to the insured property unless the loss is specifically and unambiguously excluded from coverage by the Policy. On or about September 28, 2022, the insured property suffered a windstorm loss (Hurricane Ian), and the insured immediately submitted a claim to UNDERWRITERS for property damage, i.e., storm, wind, rain, and water intrusion damage throughout the insured property. Hence, the insured suffered a substantial loss regarding the real property and continue to suffer such loss. Having suffered such substantial damage, the insured promptly notified UNDERWRITERS of the loss in an effort to mitigate the current damage and prevent the exacerbation of any additional losses. The desired result did not follow. UNDERWRITERS since being presented the Insured’s claim has misrepresented policy provisions to avoid paying the insured what they are owed under the policy. Ultimately, UNDERWRITERS has failed and refused to properly settle the insured’s claim in good faith. The insured has requested that UNDERWRITERS conduct an investigation, admit coverage, and pay damages; UNDERWRITERS has failed and refused to do so. In short, UNDERWRITERS has failed to handle its insured’s claim in good faith in violation of Fla. Stat. 624.155(1)(b)(1), 624.155(1)(b)(3), and 626.9541(1)(i).
Based upon UNDERWRITERS’s investigation and property inspection, which confirmed windstorm damages, UNDERWRITERS nevertheless sent correspondence to the insured dated November 21, 2022 (signed by UNDERWRITERS’s adjuster, Stymetra Holbrook) confirming partial coverage, under-scoping, underpaying, denying the remainder, and issuing payment for only $37,087.03 ($26,369.90 BPP & $10,717.13 food spoilage). In regard to insurance contracts, a specific refusal to pay a claim is the breach which triggers the cause of action. Allstate Ins. Co. v. Kaklamanos, 843 So. 2d 885, 892 (Fla. 2003); Donovan v. State Farm Fire and Cas. Co., 574 So. 2d 285, 286 (Fla. 2nd DCA 1991) (finding that a breach of contract takes place at the moment the insurance company refuses to pay a claim). Therefore, UNDERWRITERS breached the Policy. Moreover, UNDERWRITERS’s argued exclusions and/or limitations to coverage are devoid of anti-concurrent causation language. Thus, “coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause.” Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694, 699 (Fla. 2016). In addition, under the Policy, any ensuing loss to property not excluded or excepted in this policy is covered. Hence, there are a myriad of coverages under the Policy that would provide coverage for the loss. Nevertheless, UNDERWRITERS failed and refused to acknowledge the covered loss and pay all amounts due and owing for the loss. Therefore, UNDERWRITERS breached the Policy. Thereafter, the insured submit documents and records in support of its claim for building, business personal property, and business income loss as a result of the windstorm and requested UNDERWRITERS to reconsider its coverage determination. Nevertheless, UNDERWRITERS failed and refused to acknowledge the covered loss and pay all amounts due and owing for the loss. Therefore, UNDERWRITERS breached the Policy.
On December 5, 2022, UNDERWRITERS sent correspondence to the insured (signed by UNDERWRITERS’s adjuster, Stymetra Holbrook) confirming partial coverage, under-scoping, underpaying, denying the remainder, and issuing payment for only $2,406.78 (supplement for BPP). On August 11, 2023, UNDERWRITERS sent correspondence to the insured (signed by UNDERWRITERS’s adjuster, Paul Sanderson) confirming partial coverage, under-scoping, underpaying, denying the remainder, and issuing payment for only $11.,209.00 (loss of business income). On October 27, 2023, UNDERWRITERS sent correspondence to the insured (signed by UNDERWRITERS’s adjuster, Paul Sanderson) and summarily reaffirmed its coverage determination.
Concerned with the accuracy of UNDERWRITERS’s coverage determination and partial denial, and given the extensive nature of the physical damage, the insured retained a consulting licensed contractor, Tom Gannon, with LSC Construction Consultants, LLC (“LSC”), to perform an investigation and damage evaluation in accordance with industry standards and Florida law. Based on his investigation, Mr. Gannon concluded that a windstorm on or about September 28, 2022 (Hurricane Ian), including wind, caused damage to the exterior of the insured property (particularly the roof warranting replacement), including openings, which allowed wind and rain to intrude causing additional damage. Moreover, Mr. Gannon determined that at least $104,597.43 worth of building repairs would be required to return the property to its pre-loss condition as a result of the windstorm loss. Moreover, the insured sustained at least $29,162.69 in Business Personal Property damage, sustained at least $11,000.00 in food spoilage, and incurred at least $162,615.00 in business income loss as a result of the windstorm. Hence, the insured has sustained at least $307,375.12. Furthermore, the insured has incurred at least $51,242.24 in repair expenses to date with outstanding damage and repairs remaining. Nevertheless, UNDERWRITERS failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, UNDERWRITERS breached the Policy.
On September 27, 2024, the insured sent correspondence to UNDERWRITERS enclosing the LSC report, the Business Personal Property support, and the Business Income support outlining the cause, scope, and cost of the loss along with other supporting documents, the Notice of Intent to Initiate Litigation, and requested UNDERWRITERS to reconsider its coverage denial. To date, UNDERWRITERS has failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, UNDERWRITERS breached the Policy.
As such, UNDERWRITERS’s coverage denial is a blatant misrepresentation of the available coverages under the Policy in direct violation of Fla. Stats. 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), 626.9541(1)(a)(1), and 626.9541(1)(i)(2) and is nothing more than a mere pretext to wrongfully deny and delay this claim. As a result, UNDERWRITERS has materially misrepresented the coverages under the subject policy to the insured for the purpose and with the intent of effecting settlement of the insured’s claim on less favorable terms than those provided in, and contemplated by, the subject policy in direct violation of Fla. Stat. § 626.9541(1)(i)(2). Further, UNDERWRITERS is in violation of Florida statutes §§ 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), and 626.9541(1)(a)(1) by misrepresenting pertinent facts and insurance policy provisions relating to coverages at issue; and also in violation of Fla. Stat. 626.9541(1)(i)(3)(d) by denying the insured’s claim without conducting a reasonable investigation based upon available information.
In summary, the insured’s loss is clearly covered by the terms of the policy of insurance with UNDERWRITERS. However, UNDERWRITERS chose to deny coverage for the insured’s loss. Despite clear evidence that the damage was covered and caused by a covered peril, the claim was denied. To date, UNDERWRITERS continues to deny the insured and its insured full indemnity for the claim. While UNDERWRITERS refuses to honor this claim, a jury in Seminole County will likely do what UNDERWRITERS has refused; exercise the benefit of doubt in favor of the insured in finding full coverage for this loss. Indeed, the insured will undoubtedly meet the burden of proof at trial, under the UNDERWRITERS all-risk policy, to show that, while UNDERWRITERS provided insurance coverage, damage occurred to the insured property. See Jones v. Federated Nat'l Ins. Co., 235 So. 3d 936, 942 (Fla. 4th DCA 2018). With the data presented within the UNDERWRITERS’s investigation and LSC’s investigation, UNDERWRITERS’s burden to demonstrate by the greater weight of the evidence that all the physical damage to the insured property was caused solely by excluded perils under the policy and not in combination with a covered peril has not and cannot be met. See Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694 (Fla. 2016). Despite clear indicators of covered damage, UNDERWRITERS nevertheless inexplicably denied the insured’s claim.
As of today, UNDERWRITERS has failed and refused to inform the insured of their rights under the policy of insurance and Florida statutes, has improperly delayed the insured’s claim, has wrongfully denied the insured’s claim, and has failed and refused to adequately indemnify the insured for the loss and defiantly continues to do so. Indeed, from the time of receiving the claim, UNDERWRITERS has purposely and maliciously delayed in adjusting the subject claim in an effort to either avoid paying the claim altogether or, at the very least, avoid paying the full extent of the loss. Notably, under Florida law, “[t]he filing of a lawsuit does not extinguish the insurer’s obligations under the policy to adjust and pay the claim.” Tristar Lodging, Inc. V. Arch Specialty Ins. Co., 434 F. Supp. 2d 1286, 1289 (M.D. Fla. 2006).
To date, the insured has made a good faith effort to comply with all of the requirements under the subject policy of insurance, and it is only fair that UNDERWRITERS do the same. Yet, that is not the case. The insured feels that the insured property is a valuable asset, and, by continuously delaying the proper handling of this claim, UNDERWRITERS is putting the insured property at risk. As a responsible property owner, the insured purchased insurance to protect the property, paid all of the premiums, and has kept up to date with the responsibilities under the policy. Yet, when the insured needed to rely on the insurance because of this unforeseen loss, UNDERWRITERS turned its back and delayed and wrongfully denied coverage that the insured is rightfully owed.
Ultimately, UNDERWRITERS has failed and refused to properly investigate the loss. The insured has requested that UNDERWRITERS admit coverage and pay damages, UNDERWRITERS has failed and refused to do so, and continues to refuse to fully indemnify the insured for the loss and pay the amounts necessary to properly repair the insured’s property, despite knowing it is required to do so. In short, UNDERWRITERS has failed to handle its insured’s claim in good faith.
In Florida, the work of adjusting insurance claims engages the public trust; UNDERWRITERS has breached this duty by its insufficient adjustment of the insured’s claim. UNDERWRITERS has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations set forth above. UNDERWRITERS has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages.
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 upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the insured may mitigate their damages to put them back into the position they were prior to loss as quickly as possible. UNDERWRITERS breached this duty.
The actions taken by UNDERWRITERS in the handling / adjustment of the insured’s claim were willful, wanton, and with complete disregard for the rights of its insured and occur with such a frequency as to indicate a general business practice and are in violation of Fla. Stat. 624.155 and 626.9541.
UNDERWRITERS’s actions amount to but are not limited to the following:
1. Claim delay
2. Wrongful claim denial
3. Unfair trade practice
4. Unfair claim settlement practices
5. Unreasonable investigation
6. Failure to act on claim
7. Failure to conduct a reasonable investigation based on available information
8. Failure to maintain proper complaint handling procedures
9. Misrepresenting the insurance policy provisions to the insured
10. Misrepresenting Florida statutory provisions to the insured
11. Misrepresenting facts to the insured
12. Failure to acknowledge and act promptly upon communications with respect to claims
13. Denying claims without conducting reasonable investigations based upon available information
14. 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.
15. 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.
16. Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
17. Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
18. Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 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 an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed.
Therefore, to cure the defects outlined in this civil remedy notice, UNDERWRITERS must:
(1): Admit full coverage for the insured’s loss; and
(2): Tender all insurance monies due and owing to the insured for the loss under the subject Policy;
A copy of this form submitted to the FDFS has been emailed and/or uploaded and also printed out and mailed to the following parties providing them notice of the filing of this civil remedy notice:
Underwriters at Lloyd’s, London (syndicate list for B0142AA2200357: LIB 4472, BRT 2987, BRT 2988, MMX 2010, AUW 609, WBC 5886, SAM 727, and KII 1618)
c/o Minuteman Adjusters
220 Kaufman Financial Center
30833 Northwestern Highway
Farmington Hills, MI 48334
minuteman@claimemail.com
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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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