Filing Number: 785237
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| Filing Accepted: 10/1/2024 |
| Last/Business Name
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ARIANA WATTLEY
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First Name |
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| Street Address
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1150 HUDSON HARBOR LANE |
| City, State Zip
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POINCIANA,
FL
34759
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| Email Address
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IAHANNVI30@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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ARIANA WATTLEY |
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First Name |
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| Policy # * |
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7709HR026586 |
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Claim #* |
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334361-GN |
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Attorney is Applicable
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| Last Name* |
LEONARDIS
First Name *
RICHARD
Initial
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| Street Address* |
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925 S. FEDERAL HWY |
| City, State Zip* |
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BOCA RATON
,
FL
33432
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| Email Address * |
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RLEONARDIS@KPATTORNEY.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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NATIONWIDE PROPERTY AND 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 37877 |
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| Name of individual responsible for violation (if any):*
WAYNE SMITH II
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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 Delay
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Unfair Trade Practice
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Unsatisfactory Settlement Offer
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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)(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)(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.
Loss settlement provision
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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.
The carrier was put on notice of the insured’s storm damage claim. The carrier initially attempted to low-ball the claim. Subsequently, the insured provided the carrier with a completed roof replacement invoice in the amount of $38,594.70 needed to restore the property back to its pre-loss condition. Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered deficient payments in the amounts of only $3,239.86 and $2,938.47, leaving a remainder in the amount of $32,416.37 to be paid in order to cure the breach, less any applicable policy deductible. The insured has complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insured. About seven hundred ninety-five days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insured’s property and has not taken any meaningful ensuing action.
It is clear that the carrier is not treating the insured with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insured; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insured’s interests; refusing to pay the full amount owed to the insured despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insured, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days.
All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $38,594.70, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier.
Please do not hesitate to contact the undersigned at (561)-892-9760 if you have any questions or concerns.
Sincerely,
Richard Leonardis
Attorney at Law
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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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