Filing Number: 786242
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| Filing Accepted: 10/9/2024 |
| Last/Business Name
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BLAGOEV
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First Name |
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PETAR & LOUISE |
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| Street Address
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1012 SAN MATEO DR. |
| City, State Zip
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PUNTA GORDA,
FL
33950
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| Email Address
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LABLAGOEV@COMCAST.NET |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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BLAGOEV |
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First Name |
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PETAR & LOUISE |
| Policy # * |
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SJ30085974 |
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Claim #* |
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SL22206266 |
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Attorney is Applicable
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| Last Name* |
CIANI
First Name *
NICHOLAS
Initial
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| Street Address* |
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1529 NE 17 TER |
| City, State Zip* |
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FORT LAUDERDALE
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FLORIDA
33304
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| Email Address * |
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MANAGER@CIANI.LAW |
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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):*
NAOMI RUITER, ELLERY HARRIS-BALL, JOHN HUFF, CINDY BRAUD, DELYNSI CHE, TIARA GIBBS, AMBER MCCRARY, JEFF GRAHAM, KIM SHEEHEY, TERRANCE SWANSON
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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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| 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)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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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)(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.
Specific policy language that is believed to be relevant to the violations includes, but is not necessarily limited to, the following:
Also, please keep in mind that not all violations of Florida Bad Faith Statutes necessarily implicate policy provisions.
See Subject Policy:
SLIDE INSURANCE COMPANY
Policy No.: SJ30085974
Coverage A - Dwelling $613,751
Coverage B - Other Structures $12,275
SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure against risk of direct physical loss to property described in Coverages A and B
Coverage A – Dwelling 1. We cover: a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and b. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises
B. Coverage B – Other Structures 1. We cover other structures on the "residence premises" set apart from the dwelling by clear space. This includes structures connected to the dwelling by only a fence, utility line, or similar connection
H. Our Option If we give you written notice within 30 days after we receive your signed, sworn proof of loss, we may repair or replace any part of the damaged property with material or property of like kind and quality
For an additional premium, we insure aluminum framed screened enclosures for direct physical loss due to hurricane. This endorsement does not increase the limit of liability for Coverage A or Coverage B. The most we will pay to replace an aluminum framed screened enclosure is the limit of liability indicated for screened enclosures in the policy declarations
Covered property losses are settled at replacement cost without deduction for depreciation at the time of loss, but no more than the amount required to repair or replace and no more than the limit of liability indicated for screened enclosures in the policy declarations
SIC HO HE 02 22 -Screened Enclosure - Hurricane $19,764
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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.
This notice is given to SLIDE INSURANCE COMPANY (hereafter “INSURER”) to perfect PETAR & LOUISE BLAGOEV (hereafter “Insured(s)”) right to pursue the civil remedy authorized by Fla. Stat. s. 624.155.
This complaint is made on behalf of Insured(s). In consideration of the premium paid to it by the Insured(s), SLIDE INSURANCE COMPANY issued a Residential Property Insurance Policy bearing Policy No.: SJ30085974 (hereafter “Policy”).
On or around September 28, 2022, while the Policy was in full force and effect, the Insured(s) suffered a direct physical loss at the insured property located at 1012 SAN MATEO DR., PUNTA GORDA, FLORIDA 33950 (hereafter “Property”) due to WIND.
The claim was reported to SLIDE INSURANCE COMPANY on or around September 30, 2022. SLIDE INSURANCE COMPANY assigned Claim No. SL22206266 to the loss. The areas of the home that were damaged included personal property, the boat lift, exterior fixtures, gutters, soffit and fascia, exterior walls, pool enclosure, roofing system, several interior rooms, and the garage. These areas have been specifically documented with photographs and estimates and provided to SLIDE INSURANCE COMPANY prior to filing any Notice of Intent or litigation.
To date, SLIDE INSURANCE COMPANY has failed to fully indemnify PETAR & LOUISE BLAGOEV and SLIDE INSURANCE COMPANY has violated several bad faith statutes, with impunity. Some of these bad faith practices amounts to a general business practice.
Hurricane Ian devastated the area surrounding the Insureds Property on September 28, 2022. Two days later the Blagoevs filed their own claim with Slide. They did not enlist the help of a Public Adjuster or attorney and at the time assumed they could deal directly with Slide.
For background, the Blagoevs have owned the Property since 1997 and fully replaced their roof after Hurricane Charlie in 2005. They were insured previously by St. Johns, which was subsequently bought out by Slide, who assumed the Policy.
Once the Blagoevs filed the claim, Slide began implementing one of their general bad faith practices, which included reassigning the claim to a new adjuster every few weeks. This is a tactic oft used by insurers to delay the adjustment of the claim and by extension delay making payments on the claim. In this instance, Slide engaged ten separate individuals to adjust this claim before a Notice of Intent or litigation was filed. The names of those individuals are: Naomi Ruiter; Ellery Harris-Ball; John Huff; Cindy Braud; Delynsi Che; Tiara Gibbs; Amber McCrary; Jeff Graham; Kim Sheehey; Terrance Swanson. This list includes seven different Desk Adjusters, two field adjusters, and one alleged roofer. Nearly every time the Blagoevs called Slide to discuss their claim, Slide had assigned a new adjuster. The Blagoevs would have to explain everything all over again while the new adjuster got up to speed on the file. This was not only frustrating, but caused significant delay and confusion in the claims process. Eventually the Blagoevs were forced to hire help and engaged the services of a Public Adjuster, Oakmont Public Adjusting in May 2023. This bad faith practice of continuously reassigning the claim has been used many times by Slide and other insurers and is the quintessential example of failing to adopt and implement standards for the proper investigation of claims in violation of 626.9541(1)(i)(3)(a). You’ll often hear insurers and agents complain about public adjusters, but you’ll never hear the stories where insurers drive their customers directly into a public adjuster’s arms by dealing with them in bad faith, which is exactly what happened to the Blagoevs.
Let’s back up to around September 2022 when the claim was opened. Initially, a company called Strategic Roofing was sent to the Blagoevs property to perform an inspection. The company is known for participating in the Slide preferred vendor program, but Slide’s official position is that it has no knowledge of Strategic Roofing being at the Blagoev’s property. According to the Blagoevs, this company inspected their property and said a roof replacement was warranted. This is obviously something the Blagoevs couldn’t possibly make up, so the fact that Slide is denying all knowledge of this inspection could only lead to the conclusion that Strategic Roofing wasn’t supposed to tell the Blagoevs their roof needed to be replaced. Not only is this another failure of Slide to adopt and implement standards for the proper investigation of claims, but it is also a misrepresentation of facts with the intent to resolve the Blagoevs claim on less favorable terms. Thus, Slide violated 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), and 626.9541(1)(i)(2).
We also need to discuss a couple specific aspects of the claimed damages, i.e., the pool cage and the dock/boat lift damages. As to the pool cage, Slide opened coverage for those damages to the tune of around $5,500. In deposition, Slide clarified that the $5,500 was intended to cover a full pool cage replacement, and yet that money doesn’t come anywhere close to the actual cost of a pool cage replacement. The Blagoevs submitted four independent valuations of the pool cage replacement from companies called Andrews Roofing, Scribbs, Screens Over Marco, and Fabri-Tech. These are companies that actually perform the work, not just an adjuster coming up with an unsubstantiated $5,500 to do the work. Those four estimates are anywhere from $17,000 to $45,000. This goes well beyond a mere difference of opinion as Slide has underpaid these covered damages by more than three times. To be sure, the Blagoevs’ Policy has a separate coverage for the pool cage of $19,764 to be paid out under replacement cost value. That Polic language is cited above in this CRN. All of this information was provided to Slide before any Notice of Intent or Litigation was initiated, but Slide chose not to attempt to settle this portion of the claim in good faith in violation of 624.155(1)(b)(1). Further, this amounts to a misrepresentation from Slide by standing on its unsubstantiated estimate of $5,500. This was a violation of 626.9541.(1)(i)(2). Considering there is no genuine dispute of material fact that Slide underpaid the pool cage, Slide is in violation of 626.9541(1)(i)(4) for failing to pay the adequate amount within 90 days of the Blagoevs opening the claim.
As to the dock/boat lift damages, this was a portion of the Blagoevs claim that was simply never adjusted, despite the Blagoevs providing Slide with all the necessary information prior to any Notice of Intent or litigation being initiated. The Blagoevs provided invoices from companies called Parr Marine and Livingston Electric for the wind damage to their dock/boat lift along with photographs of the damages taken by the Public Adjuster, which specific annotations pointing out the damage. Slide confirmed under oath that it received all of this information prior to receiving a Notice of Intent, that the Blagoevs Policy covers for wind damage to the dock/boat lift, and that Slide simply never adjusted these damages. This is yet another failure to adopt and implement standards for the proper investigation of claims in violation of 626.9541(1)(i)(3)(a). This also amounts to a functional denial of these damages without providing an explanation in violation of 626.9541(1)(i)(3)(f) and a denial without engaging in a reasonable investigation based on available information in violation of 626.9541(1)(i)(3)(d). Finally, Slide is also in violation of 626.9541(1)(i)(4) for failing to pay these invoices within 90 days of the Blagoevs either opening the claim or providing this information for Slide’s review, whichever is greater.
In order to cure the defects outlined in this Civil Remedy Notice, the Insured(s) invite(s) SLIDE INSURANCE COMPANY to:
Create and implement adequate guidelines for the proper investigation and evaluation of claims, including claims handling, training and supervision of employees and agents, which will avoid future statutory violations as set forth above; and
Immediately tender all insurance benefits due and owing to the Insured(s) under the Policy to return the property to pre-loss condition, including all interest due and owing under applicable Florida Statutes and all reasonable attorneys’ fees pursuant to Fla. Stat. §626.428, which is to be determined by a court of law at a later date.
The Insured(s) has/have previously submitted to SLIDE INSURANCE COMPANY an estimate totaling $323,077.42 actual cash value damages. The Insured(s) invite(s) SLIDE INSURANCE COMPANY to use these figures in determining a proper indemnity amount, even though it is not necessary for the Insured(s) to list a specific cure amount herein. See Lugassy v. United Property & Cas. Ins. Co., 2022 Fla. App. LEXIS 8143 (Fla. 4th DCA 2022).
Any indemnity amounts would be in addition to, not including, attorney’s fees.
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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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