Filing Number: 786097
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| Filing Accepted: 10/8/2024 |
| Last/Business Name
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SPIES
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First Name |
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KIM AND CHRISTOFFEL |
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| Street Address
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2516 SW 14TH AVE. APT 402 |
| City, State Zip
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FORT LAUDERDALE,
FL
33315-22
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| Email Address
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SWOLFE@MYLEGALWOLFE.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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SPIES |
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First Name |
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KIM AND CHRISTOFFEL |
| Policy # * |
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KIN-CO-FL-223366857 |
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Claim #* |
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HO-3266281 |
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Attorney is Applicable
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| Last Name* |
WOLFE
First Name *
SCHAROME
Initial
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| Street Address* |
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7380 SAND LAKE RD. SUITE 500 |
| City, State Zip* |
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ORLANDO
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FLORIDA
32819
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| Email Address * |
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SWOLFE@MYLEGALWOLFE.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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KIN INTERINSURANCE NETWORK
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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 16603 |
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| Name of individual responsible for violation (if any):*
GREGG WEST AND RAELENE BENCIVENGA OF KIN INTERINSURANCE NETWORK.
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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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Unsatisfactory Settlement Offer
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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)(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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| 626.9541(1)(i)(3)(g) |
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Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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| 626.9541(1)(i)(3)(h) |
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Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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| 626.9541(1)(i)(4) |
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Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
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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.
COVERAGE A – Dwelling
We cover:
1. The alterations, appliances, fixtures and improvements which are part of the building contained within the "residence premises";
2. Items of real property which pertain exclusively to the "residence premises";
3. Property which is your insurance responsibility under a corporation or association of property owners agreement; or
4. Structures owned solely by you, other than the "residence premises," at the location of the "residence premises."
COVERAGE C – Personal Property
We cover personal property owned or used by an "insured" while it is anywhere in the world. At your request, we will cover personal property owned by:
1. Others while the property is on the part of the "residence premises" occupied by an "insured";
2. A guest or a "residence employee," while the property is in any residence occupied by an "insured."
Our limit of liability for personal property usually located at an "insured's" residence, other than the "residence premises," is 10% of the limit of liability for Coverage C, or $1000, whichever is greater.
Personal property in a newly acquired principal residence is not subject to this limitation for the 30 days from the time you begin to move the property there.
5. Property Removed. We insure covered property against direct loss from any cause while being removed from a premises endangered by a Peril Insured Against and for no more than 30 days while removed. This coverage does not change the limit of liability that applies to the property being removed.
COVERAGE D – Loss Of Use
We will pay the additional expenses you incur, but no more than the limit of liability shown for Coverage D in the Declarations for the following:
1. Additional living expenses incurred by you so that your household can maintain its normal standard of living when a loss to covered property or the building containing the property covered under this policy makes that part of the “residence premises” where you reside not fit to live in.
2. Reasonable Emergency Measures.
a. We will pay up to the greater of 1% of your Coverage A limit of liability or $3,000 for the reasonable cost incurred by you for necessary measures taken solely to protect covered property from further damage, when the damage or loss is caused by a Peril Insured Against.
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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.
Kin InterInsurance Network (Insurer) issued a residential condominium insurance policy to Kim Spies & Christoffel Spies (Insureds), who paid premiums for the coverages afforded therein. Policy number KIN-CO-FL-223366857 (the “policy”) provided insurance coverage for the property located at 2516 SW 14th Ave. APT 402, Fort Lauderdale, FL 33315-2247, within The Grove at River Oaks community, for covered perils insured against, including storm damage.
On or about October 1, 2023, during a local storm proceeding for three (3) days, the subject property suffered damages from a covered peril insured against (“the loss”). Damages include but were not limited to the ceiling and wall treatments, cabinetry, flooring and personal property. This is separate but in addition to the common elements of the association. The damage was also reported to The Grove at River Oaks Association.
Not only did water pour into the ceiling of the Insureds’ unit, but the Insureds’ neighbors were also reporting water through the 3rd floor of 405, into the 2nd floor of the unit 405 kitchen, as well as the roof of unit 401. Robert T. Cherry of Cherry Roofing, retained by the Association, issued opinions on the cause and origin of the Insureds’ property damage, including wind, wind driven rain, collapse, and water intrusion. The Insureds then timely reported the loss to the Insurer.
It is believed that Kin assigned Field Adjuster, Gregg West, on or about October 3, 2023. He inspected the loss on October 5, 2023, and coverage was opened based on his estimate of damages drafted October 11, 2023 totaling $3,062.04 RCV. This reportedly included the kitchen, living room, stairs, and one closet.
In addition to contacting the Association and the Insurer, the Insureds reached out to Gary Rosen, Ph.D. LEED AP, as the only Florida mold contractor approved by DBPR to provide FLA mold contractor license examination and training. On October 12, 2023, Pro-Lab also issued a report identifying unusual mold spore counts in the kitchen and bedroom closet for both Hyphae and Penicillium Aspergillus.
The cost to repair the subject property was then estimated at $96,509.87 ACV according to AGG Properties LLC a Florida licensed HAAG Certified Inspector. The price estimated by Mr. West, for the Insurer, is insufficient and his estimate was incomplete as it failed to include an additional bedroom damaged or any mold remediation.
On January 25, 2024, the Insureds were made aware that Raelene Bencivenga, of the Insurer, was closing its investigation without further payment. This was without further inspection by any contractors or engineers for the Insured unit, let alone anyone to evaluate the mold claim presented. The Insureds also had a rental agreement that has now been affected by the failure of KIN to properly make them whole, with loss of rents from BRD Construction, Inc.
On September 24, 2024 a supplemental demand was made for the damages in the amount of $96,509.87 with a delineated estimate and attachments. No response was received. The Insureds have now also begun repairs at the property as they continue efforts to mitigate their damages and protect the property as best as they are able without the assistance of their benefits. The Insureds are prejudiced by the failure of the Insurer to properly handle their claim and timely respond to them.
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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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