Filing Number: 786030
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| Filing Accepted: 10/7/2024 |
| Last/Business Name
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| Street Address
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538 RANGEWOOD DR SE |
| City, State Zip
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PALM BAY,
FL
32908
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| Email Address
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MACKEE2003@YAHOO.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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GEORGE |
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First Name |
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JUDITH |
| Policy # * |
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SJ30255370 |
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Claim #* |
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202408003759 |
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Attorney is Applicable
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| Last Name* |
ALTMAN
First Name *
ALEXIS
Initial
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| Street Address* |
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925 SOUTH FEDERAL HIGHWAY |
| City, State Zip* |
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BOCA RATON
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FLORIDA
33432
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| Email Address * |
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AALTMAN@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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SLIDE 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 17227 |
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| Name of individual responsible for violation (if any):*
JOHN JANES
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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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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Claim Denial
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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)(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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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
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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.
Slide Insurance Company(“carrier”) has not attempted in good faith to settle the insureds’ claim when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insureds and with due regard for their interests. The carrier has done everything possible to delay the claim and refuses to pay the complete covered loss amount due under the policy. Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that burden upon the insureds. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005) (“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insureds…”).
The carrier was put on notice of the insureds’ storm claim which caused substantial damage to the insureds’ property. Rather than conducting a good faith investigation into the claim as required under the law, the carrier wrongfully denied the claim on the misrepresentation that the damages to the roof were not from one event but several, and the water intrusion was due to a failed repair. Most concerning was that the desk adjuster John Janes was advised that the repair was done after the water started entering and in response to the water entering, but Mr. Janes advised that Slide would not change its decision even though it was based on a fraudulent premises. The insured provided the carrier with estimates as well as photographs of all the damages and an estimate in the amount of $49,129.36. The carrier continued to wrongfully deny the claim. The insureds have 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. The carrier is aware of damage sustained by the insureds’ property and has not taken any meaningful ensuing action.
Pursuant to Florida Statute §624.155(1)(b)(1), Slide has failed to settle the claim in good faith when it could and should have done so. The Insured reported the Loss and the Property was presented for inspection. The damage to the insured’s home was clearly caused by a covered peril under the Policy, but Slide intentionally and callously delayed the claim process and wrongfully denied the claim. Slide has not shown a good faith intention to pay what was owed but rather has underpaid the claim for financial gain and profit.
Pursuant to Florida Statute §626.9541(1)(i)(3)(a), Slide has a duty to adopt and implement standards for the proper investigation of claims. The carrier refused to investigate the claim properly and instead has sent unqualified individuals to inspect the property in an effort to deny claims for financial purposes.
Florida law mandates that insurers and adjusters do not mislead the Insured. Florida Insurance companies that fail to follow these Florida laws and regulations, designed to protect consumers, do not only breach their duties under the policy of insurance but do so in bad faith. In violation of Florida Statute §626.9541(1)(i)(3)(b), Slide intentionally misrepresented the available coverage under the policy and has misrepresented that the policy does not provide coverage for the loss and has misrepresented the cause of loss.
Furthermore, the Insured believes Slide repeatedly and as a standard business practice engages in this behavior to deprive its Insured of their rightful insurance proceeds when they experience a covered loss. Insured contends Slide has implemented a claims program and business practices that are tailored to increase its profits at the expense of benefits that are owed to its customers and that other Insured have been refused insurance proceeds due and owing under the policy in the same or similar circumstances, and some have been provided inadequate insurance monies under the same or similar facts or circumstances. This is wrongful conduct and directly violates the purpose of insurance coverage. Slide’s wrongful conduct and omissions include, but are not limited to: claim delay, not conducting a full and prompt investigation, not treating the policyholder with good faith claims conduct, looking for ways to reduce recovery to Insured; looking for ways to delay full recovery to Insured; holding back and failing to pay portions of claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the Insured; not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company’s interests before the policyholder’s interests; establishing severity control initiatives and otherwise establishing a culture of not fully and promptly paying claims following losses; and failing to pay the full amount of the Insured’s damage despite knowing it must do so.
Consequently, these actions have caused undo frustration and financial harm to the Insured. As a direct and proximate result of the poor handling of this Claim by Slide the Insured sustained extracontractual damages. Due to the bad faith actions of Slide, Insured was forced to engage the services of the Public Adjuster to attempt to recover the settlement to which they are rightfully entitled.
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 regard 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 $49,129.36, less any applicable policy deductible;
2.) Pay all mitigation invoices for emergency services;
3.) Pay the Insureds’ attorneys’ fees and costs as they have been forced to retain counsel;
4.) 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 or Stephanie Alexandre at (561)-892-9925 if you have any questions or concerns.
Sincerely,
Alexis Altman
Alexis Altman, Esq
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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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