Filing Number: 785464
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| Filing Accepted: 10/2/2024 |
| Last/Business Name
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911 MOLD TESTING LLC
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First Name |
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| Street Address
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9600 NW 25TH ST |
| City, State Zip
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MIAMI,
FL
33172
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| Email Address
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INFO@911MOLDTESTING.COM |
| Complainant Type:
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Third Party |
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| Last/Business Name* |
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NADIA BROOKNER AND JACK BROOKNER |
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First Name |
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| Policy # * |
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CIC00247145390A |
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Claim #* |
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2471453033 |
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Attorney is Applicable
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| Last Name* |
GONZALEZ ESQ.
First Name *
ROBERT F.
Initial
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| Street Address* |
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8950 SW 74TH CT., STE 2267 |
| City, State Zip* |
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MIAMI
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FLORIDA
33152
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| Email Address * |
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INTAKE@FLINSLAW.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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USAA 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 25968 |
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| Name of individual responsible for violation (if any):*
UNKNOWN
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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 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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| 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)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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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.
Section 1 - Perlis Insured Against Section 1 - Property Coverages 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.
Page 1 of 1On September 27, 2022, Nadia Brookner and Jack Brookner suffered a loss due to covered perilscontemplated under the Policy; and timely reported the damage to Defendant. Nadia Brooknerand Jack Brookner contracted 911 Mold Testing LLC in order to perform TARP, DRYOUT,RETARP services to the Insureddirectly relating to the loss. In exchange for 911 Mold TestingLLC's services Nadia Brookner and Jack Brookner executed an assignment of benefits. On orabout February 13, 2024, 911 Mold Testing LLC provided USAA CASUALTY INSURANCECOMPANY with notice of the Assignment of Benefits. Within the statutory period, 911 MoldTesting LLC provide USAA CASUALTY INSURANCE COMPANY with a copy of its invoice,assignment agreement, demand for payment of insurance benefits and supporting documentation.During the investigation of the claim, USAA CASUALTY INSURANCE COMPANY sent anunqualified person to make determinations of causation of damage in violations of 626.9541(1)(i)(3)(d). After completing its deficient investigation USAA CASUALTY INSURANCECOMPANY should have provided coverage for the loss. USAA CASUALTY INSURANCECOMPANY has unduly delayed full payment and coverage over the claim in violation of theinsurance contract and has done so in a manner which violates multiple Florida Statutes.Furthermore, USAA CASUALTY INSURANCE COMPANY failed to promptly provide areasonable explanation in writing to the insured of the basis in the insurance policy, in relation tothe facts or applicable law, for denial of a claim or for the offer of a compromise settlement.The failure to issue payment when there was no applicable exclusion for the type of service orclaim in relation to the covered claim is a violation of 624.155(1)(b)(1) and 624.155(1)(b)(3).USAA CASUALTY INSURANCE COMPANY has been provided sufficient evidence tosupport coverage for the subject claim and services. Despite making numerous payments in thepast for these types of services which were performed in relation to valid insurance claims,USAA CASUALTY INSURANCE COMPANY has subsequently made it a business practice todeny these services irrespective of the facts for each claim in direct violation of 626.9541(1)(i)(3)(a) and 626.9541(1)(i)(3)(b).USAA CASUALTY INSURANCE COMPANY has repeatedly and continuously acted in badfaith in this matter and others like it. Despite the fact that these services are directly related tocovered losses and not excluded under the policy of insurance, USAA CASUALTYINSURANCE COMPANY refuses to pay insurance benefits for same. In order to cure USAACASUALTY INSURANCE COMPANY’s continuous acts of bad faith, USAA CASUALTYINSURANCE COMPANY must issue payment for the invoiced amount of $ 21,997.14 andwhich has a current balance of $ 12,037.91; as well as, statutory interest. In addition, USAACASUALTY INSURANCE COMPANY must cease its unfair trade practice of citing toirrelevant policy provisions in order to misrepresent the coverages afforded under its policies ofinsurance.PDC24-000823
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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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