Filing Number: 785186
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| Filing Accepted: 10/1/2024 |
| Last/Business Name
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ASRR SUZER 8955 LLC
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First Name |
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| Street Address
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8955 COLLINS AVENUE |
| City, State Zip
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SURFSIDE,
FL
33154
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| Email Address
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SR@SAPIRCORP.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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ASRR SUZER 8955 LLC |
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First Name |
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| Policy # * |
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GA16CGL2110721C |
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Claim #* |
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CGL371416 |
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Attorney is Applicable
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| Last Name* |
MOORE
First Name *
MEGHAN
Initial
C
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| Street Address* |
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2255 GLADES ROAD, SUITE 324A |
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BOCA RATON
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FLORIDA
33431
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| Email Address * |
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MEGHAN.MOORE@FLASTERGREENBERG.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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NAVIGATORS SPECIALTY INSURANCE COMPANY
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| Insurer Name* |
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| Street Address* |
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,
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NAIC Company Code 36056 |
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| Name of individual responsible for violation (if any):*
CHUCK DAVIS
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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 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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| 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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Navigators Specialty Insurance Company (“Navigators”) issued a liability insurance policy, Policy Number GA16CGL2110721C, effective December 23, 2016, as part of a consolidated insurance program (the “Policy”), to SC 8955 LLC p/k/a ASRR Suzer 8955 LLC (“Insured” or “ASRR”) in connection with the construction of a project located at 8955 Collins Avenue, Surfside, Florida 33154 (the “Project”).
The Policy has liability limits of $2,000,000 Each Occurrence; $2,000,000 General Aggregate, $2,000,000 Products/Completed Operations Aggregate; $2,000,000 Personal Injury/Advertising; and $50,000 Fire Legal Liability (Any One Fire).
The Policy states in relevant part:
SECTION I – COVERAGES
COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" and settle any claim or "suit" that may result. But:
(1) The amount we will pay for damages is limited as described in Section III – Limits Of Insurance; and
(2) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C.
No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments - Coverages A and B.
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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.
According to the Florida Office of Insurance Regulation, Navigators’ address is One Hartford Plaza, Hartford, CT 06155-0001. This notice is given by the Insured in order to perfect the right to pursue the civil remedy authorized by Fla. Sta. Section 624.155
The facts and circumstances giving rise to this violation follows:
Navigators issued a liability insurance policy, Policy Number GA16CGL2110721C, effective December 23, 2016, as part of a consolidated insurance program (the “Policy”), to ASRR in connection with the construction of a project located at 8955 Collins Avenue, Surfside, Florida 33154 (the “Project”).
Following completion of the Project, the Insured received several complaints and demands from 8955 Collins Condominium Association, Inc. (the “Association”) and individual unit owners at the Project about moisture related damages resulting from alleged construction deficiencies (the “Defect Claims”).
The Insured notified Navigators and tendered the Defect Claims to Navigators for defense and indemnity. The Insured sought and obtained the Insurer’s permission to pay for certain mitigation and remediation work in units 401, 801, and 802 (“Mitigation Work”) in connection with the defense of the Defect Claims and to submit the invoices to the Insurer for reimbursement. To date, Navigators has failed to pay for covered Mitigation Work necessary to minimize resulting damages and bolster the defense of the Developer.
Specifically, the Insured submitted invoices, including $298,348.20 for Mitigation Work to Navigators for reimbursement (“Reimbursement Claim”). Thereafter, Navigators made multiple misrepresentations, disclaimed coverage on baseless grounds, and refused to reimburse these expenses. This constitutes a violation of Florida Statute Sections 626.9541(1)(i)(3)(b) (misrepresenting facts pertinent to the coverages at issue) and 626.9541(1)(i)(3)(d) (denying claims without conducting reasonable investigations based upon available information).
Further, since the Defect Claims were made, Navigators has failed to provide an adequate defense to the Developer. For instance, while Navigators through Gunther Legal has provided a full and seamless defense to the general contractor and other consolidated insurance program enrollees, Navigators has only provided a partial and limited defense to the Developer. Specifically, Navigators has sought to avoid rather than incur expenses to fully investigate and defend the Developer, including by refusing to pay for covered Mitigation Work and by hindering the ability of counsel appointed by Navigators to incur fees and expenses in the defense of the Developer. Further, Navigators has misrepresented that property damaged by moisture and mold is not covered despite the fact that covered moisture damage plainly precedes any resulting mold damage. This violates Florida Statute Sections 626.9541(1)(i)(2) and 626.9541(1)(i)(3)(b).
Navigators presently has an opportunity to settle the Reimbursement Claim on behalf of its Insured by paying the amount owed for the Mitigation Work. Despite this, Navigators has refused to do so in violation of Fla. Stat. §§624.155(1)(b)(1) and 626.9541(1)(i)(3)(a). In doing so, Navigators has plainly placed its own financial interests above that of its Insured. Navigators’ conduct constitutes a breach of its duties and obligations under Florida law, as set forth above, and as further described below:
• Not attempting in good faith to settle claims when, under all the circumstances, Navigators could and should have done so, had it acted fairly and honestly toward its insured and with due regard for its Insured’s interests in violation of Fla. Stat. § 624.155(1)(b)(1) by refusing to pay Reimbursement Claim;
• Failing to adopt and implement standards for proper investigation of claims in violation of Fla. Stat. § 626.9541(1)(i)(3)(a) because had it done so, Navigators would not have misrepresented facts to its Insured and would not have wrongfully denied coverage to its Insured for the Reimbursement Claim;
• Failing to acknowledge and act promptly upon communications with respect to claims because Navigators repeatedly ignored the Insured’s communications and now wrongfully refuses to pay the Reimbursement Claim (Fla. Stat. § 626.9541(1)(i)(3)(c));
• Misrepresenting pertinent facts and insurance policy provisions relating to coverages at issue in violation of Fla. Stat. §§ 626.9541(1)(i)(2) and 626.9541(1)(i)(3)(b) by reversing its agreement to pay for certain expenses and misrepresenting that it has no obligation to pay the Reimbursement Claim.
To date, Navigators has not provided a reasonable explanation in writing for its failure to pay the Reimbursement Claim. This constitutes a violation of §626.9541(1)(i)(3)(e) and further demonstrates (along with the conduct complained of above) that Navigators has failed to adopt and implement standards for the proper investigation of claims in violation of §626.9541(1)(i)(3)(a).
Navigators has a duty to affirm or deny full or partial coverage for the loss and to provide a reasonable explanation for its decision. It has yet to do so. Such conduct violates Fla. Stat. §§626.9541(1)(i)(3)(e) and (f).
An insurer has an obligation to fully and fairly investigate and promptly pay valid claims in good faith. As described above, Navigators has breached this duty in violation of Fla. Stat. §626.9541(1)(i)(3)(a).
In sum, Navigators has not attempted in good faith to adjust or settle the claim when, under the circumstances, it could and should have done so, had it acted fairly and honestly towards the Insured and with due regard for her interests in violation of Fla. Stat. §624.155(1)(b)(1).
To date, Navigators has paid only a fraction of what it owes to the Developer for investigative, remediation, and mitigation expenses incurred by the Developer, which constitutes a breach of the policy. As a result, the Insured has suffered and continues to suffer damages.
To cure its numerous statutory violations, Navigators must acknowledge coverage for the amounts owed under the policy and reimburse the Developer for the covered Mitigation Work.
This Notice pertains solely to the Mitigation Work that is the subject of the Developer’s written agreement with the Association to pay certain expenses that have been incurred in units 401, 801, and 802. The Developer denies all other claims made against it in connection with alleged construction deficiencies at the Project.
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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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