Filing Number: 785139
|
| Filing Accepted: 10/1/2024 |
| Last/Business Name
*
|
|
|
FROEHLICH
|
|
First Name |
|
TOBY AND JACQUELYN |
|
| Street Address
*
|
|
10009 ORCHID RIDGE LANE |
| City, State Zip
*
|
|
BONITA SPRINGS,
FL
34135
|
| Email Address
*
|
|
TOBYF@WPPERIE.COM |
| Complainant Type:
*
|
|
Insured |
|
| Last/Business Name* |
|
FROEHLICH |
|
First Name |
|
TOBY AND JACQUELYN |
| Policy # * |
|
SJ30344707 |
|
Claim #* |
|
2024 0600 0900 |
|
Attorney is Applicable
|
| Last Name* |
MARKER
First Name *
SHAUN
Initial
J
|
| Street Address* |
|
ONE NORTH CLEMATIS STREET, SUITE 510 |
| City, State Zip* |
|
WEST PALM BEACH
,
FL
33401
|
| Email Address * |
|
SMARKER@MERLINLAWGROUP.COM |
|
|
| Insurer Type
*
|
|
Authorized Insurer
Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
SLIDE INSURANCE COMPANY
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code 17227 |
|
|
| Name of individual responsible for violation (if any):*
OFFICERS, SUPERVISORS, AND OR MANAGEMENT OF SLIDE INSURANCE COMPANY, AS WELL AS ALL CLAIMS REPRESENTATIVES, ADJUSTERS, LOSS CONSULTANTS, ENGINEERS AND EXPERTS, AND GRINDLEY WILLIAMS ENGINEERING, JAMES MOORE, AND KENNETH PARSONS.
|
| Type of Insurance
*
Residential Property & Casualty
|
|
|
| Reason for Notice
*
|
|
Claim Delay
|
|
Claim Denial
|
|
Unfair Trade Practice
|
|
|
*
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)(2) |
|
Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
|
| 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)(2) |
|
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.
|
| 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)(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.
|
|
*
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 coverage provisions; additional coverages; duties in event of loss policy provisions; all terms and conditions of Section I of the insurance policy; the insurance policy's definition section; the insurance policy's exclusion of coverage provisions; loss payment policy provision; loss settlement provision; the declarations page; we will adjust all losses with you.
|
| |
*
Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
In Florida, the work of adjusting insurance claims engages the public trust. Slide Insurance Company (“Slide”) has breached this duty by its handling of the Insureds’, Toby and Jacquelyn Froehlich’s Claim of Loss (Claim Number 202406000900; D.O.L. 09/28/2022).
Slide has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insureds’ insurance claim for damages.
On or about September 28, 2022, the Insureds submitted a claim to Slide Insurance for damages sustained as a result of Hurricane Ian.
We have identified the following instances of bad faith conduct on the part of your company:
• Purposefully minimizing the value of the claim by using biased estimating software/pricing and low-balling the cost of repairs. Specifically, estimation and repair costs have been purposefully devalued to the benefit of the insurance company despite knowledge that these costs are woefully deficient.
• Refusing to pay for necessary repairs and attempting to coerce us into accepting a lower settlement amount by failing to properly consider all applicable statutes and building code requirements both at the state and local level.
• Implementing a claim handling process geared solely to the minimization of damages. This scheme is meant solely to benefit the carrier while hindering the Insureds from obtaining just compensation for the loss.
• Failing to adopt and implement standards for the proper investigation of the claim; failing to conduct a proper investigation of all wind damage to the property, including all wind damage to the roof.
• Hiring a biased engineer to inspect the property and generate a report that minimizes the actual damages that have occurred to the subject property as a result of wind from Hurricane Ian, including all damages to the roof.
• Hiring a biased engineer to determine that there were damages to the roof unrelated to Hurricane Ian so as to deny payment to the Insureds. More specifically, thermal expansion and contraction, wear and tear from foot traffic and normal aging, and installation-related issues.
• Failure to conduct an adequate and complete inspection of the outdoor kitchen roof, which would have revealed obvious and apparent damage from Hurricane Ian.
• Failing to conduct an adequate and complete inspection of the subject property, specifically the roof.
• Misrepresenting to the Insureds that the existing roof system is repairable. See correspondence dated August 16, 2024 from Slide to Insureds.
• Failure to timely and adequately issue payment to Insureds.
• Failure to account for and acknowledge that the Boral concrete tiles installed on the subject property are discontinued and do not have an active State of Florida Notice of Acceptance.
• Failure to acknowledge and account for all fractured tiles, right/left corner fractures, and point load fractures that are a result of wind from Hurricane Ian.
These actions on the part of your company are unacceptable, and are in violation of our insurance policy and the duty of good faith and fair dealing that Slide Insurance owes to its policyholders. Based on conduct to date, these practices occur with such frequency as to constitute a general claims handling process/business practice imbedded within the company’s management of Hurricane Ian claims.
To date, notwithstanding the Insureds’ pleas otherwise, Slide has continued to refuse to acknowledge its obligation to tender all insurance proceed monies due and owing the Insureds or assist the Insureds in mitigation of the damages.
The insurer has failed and refused to acknowledge coverage and restore the Insureds to their pre-loss condition. Slide has sufficient information upon which to evaluate the Insureds’ claim for damages, and certainly has been provided with an independent means by which to determine the amount of loss.
The Insureds have otherwise fully complied with the insurer's requests for post-loss compliance. Slide has not properly paid all of the covered damages. These actions by Slide occur with such frequency to indicate a general business practice of the company.
The Insureds have complied with the policy of insurance and Florida law, Slide Insurance continues to wrongfully refuse to tender the insurance proceeds that are due and owing the Insureds. The concept of insurance is the granting of timely and prompt indemnity or security against a contingent loss. Florida Statutes section 624.02 defines "insurance" as a contract whereby one undertakes to indemnify another or pay 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 Insureds may be put back into the position they were in prior to the loss as quickly as possible. Slide Insurance breached this duty.
The Insureds were and still are forced to expend out of pocket monies to submit the insurance claim to force Slide to honor its obligations under the insurance policy to pay all the insurance proceeds due and owing them. Slide has clearly displayed bad faith in its handling, processing, and wrongful delay and wrongful denial of this claim. The Insureds merely request that Slide "adjust the loss" with them in accordance with the policy of insurance for which Slide has accepted a premium, and in accordance with Florida law. Slide’s conduct has been reckless and unfair to its Insureds and has caused and continues to cause additional damages.
We demand that Slide immediately take steps to rectify the situation and handle this claim in a fair and appropriate manner. This includes providing full and fair compensation for the damages incurred and for any additional costs and expenses incurred as a result of Slide’s bad faith conduct, including but not limited to, fees and costs related to the retention of personnel/counsel required to challenge Slide’s improper handling of this claim. [As of this moment, the damages found and evaluated by the insured(s) value at minimum $257,259.88, and we request payment in that sum as a curative measure to the conduct described herein.]
|
|
*
|
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.
|
DFS-10-363
Rev. 10/14/2008
|