Filing Number: 786270
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| Filing Accepted: 10/9/2024 |
| Last/Business Name
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BERLIN
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First Name |
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JUSTIN AND SARAH |
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| Street Address
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6677 NW 98TH DR |
| City, State Zip
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PARKLAND,
FL
33076
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| Email Address
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JUSTINBERLIN@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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BERLIN |
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First Name |
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JUSTIN AND SARAH |
| Policy # * |
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KIN-HO-FL-266305835 |
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Claim #* |
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HO-4890535 |
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Attorney is Applicable
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| Last Name* |
HANCOCK
First Name *
KELLY
Initial
M
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| Street Address* |
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12 SE 7TH STREET, SUITE 701 |
| City, State Zip* |
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FORT LAUDERDALE
,
FL
33301
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| Email Address * |
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HANCOCKBERLIN@GMAIL.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):*
JACQUI BERTREM
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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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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Claim Delay
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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)(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)(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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
The above Claimants (also hereinafter, the “Insureds”) purchased insurance policy number KIN-HO-FL-266305835 (the “Policy”) from Kin Interinsurance Network Insurance Company (hereinafter, “Insurance Company”). The Policy insured inter alia the Insureds’ property and contents located at or near 6677 NW 98 Drive, Parkland, Florida 33076 (the “Property”). The Policy was in full force and effect, with premiums paid, when, on or about May 20, 2024 and continuing on through June 11, 2024 and thereafter, the Insureds suffered damage and loss at the Property as a result of wind gusts and/or falling debris from a storm. The type of loss and damage suffered is covered by the Policy, and the Insureds made a claim for the loss under the Policy. The Insurance Company was required to properly adjust the claim and indemnify the Insureds under the Policy terms by issuing payment and performing other duties. The Insurance Company assigned claim number HO-4890535 to the claim, but failed or refused to properly adjust and pay the claim in accordance with the Policy terms. The Insurance Company failed to send a field adjuster or any other adjuster to the Property. The Insurance Company did not perform a good faith or competent inspection of the loss and wrongfully denied the claim, contrary to the coverages afforded by the Policy terms.
In a letter dated July 8, 2024, the Insurance Company purports a full denial of the claim, stating “your claim is not covered by your insurance policy” and “we must respectfully deny coverage for your damages”. However, the Insurance Company via its own actions has acknowledged some coverage, and has paid a total of $5,228 under its policy of insurance. A total of $3,228 was paid to Cinergy Restoration and $2,000 was paid directly to the Insureds as a partial payment for the loss. Now, the Insurance Company refuses to acknowledge the full extent of the covered damages and refuses to issue full and proper payment reflecting what is owed for the Insureds’ losses. The Insurance Company obtained a report from an outcome-oriented vendor with a history of misdeeds that contained miscalculations based on factually incorrect wind speeds, and used that to assert an unsupported and improper full and/or partial denial of coverage. The Insurance Company asserted numerous inapplicable exclusions, including claiming that the Insureds' roof was actually only suffering from wear and tear and age related depreciation, when in fact by its own report indicates on “05/20/24: High resolution radar data and/or ground reports indicate that wind gusts of 60-70 mph occurred from a general West/Southwesterly direction at the insured location on this date.” The Insurance Company also fails to acknowledge the covered loss from falling objects due to the storm, when once again as documented in its own report, there was a large palm frond and multiple coconuts that battered the roof and caused peril created openings.
The Insureds were forced to hire forensic engineers to correct the miscalculations and factually unsupported opinions of the vendor hired by the Insurance Company. Forensic Engineering study dated September 3, 2024 by Jeremey Brown, MS, P.E., CGC of Interactive Engineering proves that the vendor applies inapplicable Testing Application Standard, non-existent uplift movement formulas, and factually incorrect wind speed values. In its expert conclusion, Interactive Engineering determined that the “storm on May 20, 2024 caused damage to the roof surface and subsequently the water ingress through the building envelope” and given that over 25% of the roof is irreparable “a full roof replacement be completed to address the observed wind damage.”
The proper scope and costs of the damage and loss have already been provided to the Insurance Company by the Insureds. The Insurance Company has been provided with documentation, access to the Property, and has had everything needed to properly evaluate and pay the claim, however it refuses to do so. The Insurance Company has failed to perform pursuant to the Policy terms and litigation has become necessary to force the Insurance Company to honor its obligations. Please note that the foregoing is a recitation of acts and omissions of the Insurance Company as known or available on the date of filing of this Notice. The Insureds hereby reserve the right to present additional facts upon discovery of same.
Additional Information:
As the web portal for the filing of Section 624.155 notices has a limited space to provide text input, this document serves as a supplement to the Insureds’ Fla. Stat. § 624.155 Civil Remedy Notice.
The Insurance Company has violated Florida Statutes, Section 624.155 (1) (b) (1):
1. Not attempting in good faith to settle cases when under all the circumstances, could and should have done so, had it acted fairly and honestly towards its insured and with due regards for his/her interest.
And Florida Statutes, Section 626.9541:
(i) Unfair claim settlement practices:
(3) Committing or performing with such frequency as to indicate a general business practice any of the following:
(a) Failing to adopt and implement standards for the proper investigation of claims;
(c) Failing to acknowledge and act promptly upon communications with respect to claims;
(d) Denying claims without conducting reasonable investigations based upon available information;
(f) 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;
(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary;
Please be advised that you have sixty (60) days from the date of receipt of this notice by you and the Department of Insurance within which to cure its violations by fulling covering this claim. We hereby demand that you tender current damages calculated at $99,405.27 immediately. Please make payable to the Trust Account of Hancock & Berlin, PA f/b/o Justin & Sarah Berlin. We hope to amicably resolve this matter with you without the need for further action; however, if we do not receive a response within the timeframe to cure and in conjunction with the Notice of Intent to Litigate pursuant to Fla. Stat. § 627.70152 filed on the same date aforesaid, we will move forward with the filing of a lawsuit without further notice. In the meantime, should you have any questions or concerns, please do not hesitate to contact us. Nothing herein should be interpreted as a waiver of any kind.
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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 above Claimants (also hereinafter, the “Insureds”) purchased insurance policy number KIN-HO-FL-266305835 (the “Policy”) from Kin Interinsurance Network Insurance Company (hereinafter, “Insurance Company”). The Policy insured inter alia the Insureds’ property and contents located at or near 6677 NW 98 Drive, Parkland, Florida 33076 (the “Property”). The Policy was in full force and effect, with premiums paid, when, on or about May 20, 2024 and continuing on through June 11, 2024 and thereafter, the Insureds suffered damage and loss at the Property as a result of wind gusts and/or falling debris from a storm. The type of loss and damage suffered is covered by the Policy, and the Insureds made a claim for the loss under the Policy. The Insurance Company was required to properly adjust the claim and indemnify the Insureds under the Policy terms by issuing payment and performing other duties. The Insurance Company assigned claim number HO-4890535 to the claim, but failed or refused to properly adjust and pay the claim in accordance with the Policy terms. The Insurance Company failed to send a field adjuster or any other adjuster to the Property. The Insurance Company did not perform a good faith or competent inspection of the loss and wrongfully denied the claim, contrary to the coverages afforded by the Policy terms.
In a letter dated July 8, 2024, the Insurance Company purports a full denial of the claim, stating “your claim is not covered by your insurance policy” and “we must respectfully deny coverage for your damages”. However, the Insurance Company via its own actions has acknowledged some coverage, and has paid a total of $5,228 under its policy of insurance. A total of $3,228 was paid to Cinergy Restoration and $2,000 was paid directly to the Insureds as a partial payment for the loss. Now, the Insurance Company refuses to acknowledge the full extent of the covered damages and refuses to issue full and proper payment reflecting what is owed for the Insureds’ losses. The Insurance Company obtained a report from an outcome-oriented vendor with a history of misdeeds that contained miscalculations based on factually incorrect wind speeds, and used that to assert an unsupported and improper full and/or partial denial of coverage. The Insurance Company asserted numerous inapplicable exclusions, including claiming that the Insureds' roof was actually only suffering from wear and tear and age related depreciation, when in fact by its own report indicates on “05/20/24: High resolution radar data and/or ground reports indicate that wind gusts of 60-70 mph occurred from a general West/Southwesterly direction at the insured location on this date.” The Insurance Company also fails to acknowledge the covered loss from falling objects due to the storm, when once again as documented in its own report, there was a large palm frond and multiple coconuts that battered the roof and caused peril created openings.
The Insureds were forced to hire forensic engineers to correct the miscalculations and factually unsupported opinions of the vendor hired by the Insurance Company. Forensic Engineering study dated September 3, 2024 by Jeremey Brown, MS, P.E., CGC of Interactive Engineering proves that the vendor applies inapplicable Testing Application Standard, non-existent uplift movement formulas, and factually incorrect wind speed values. In its expert conclusion, Interactive Engineering determined that the “storm on May 20, 2024 caused damage to the roof surface and subsequently the water ingress through the building envelope” and given that over 25% of the roof is irreparable “a full roof replacement be completed to address the observed wind damage.”
The proper scope and costs of the damage and loss have already been provided to the Insurance Company by the Insureds. The Insurance Company has been provided with documentation, access to the Property, and has had everything needed to properly evaluate and pay the claim, however it refuses to do so. The Insurance Company has failed to perform pursuant to the Policy terms and litigation has become necessary to force the Insurance Company to honor its obligations. Please note that the foregoing is a recitation of acts and omissions of the Insurance Company as known or available on the date of filing of this Notice. The Insureds hereby reserve the right to present additional facts upon discovery of same.
Additional Information:
As the web portal for the filing of Section 624.155 notices has a limited space to provide text input, this document serves as a supplement to the Insureds’ Fla. Stat. § 624.155 Civil Remedy Notice.
The Insurance Company has violated Florida Statutes, Section 624.155 (1) (b) (1):
1. Not attempting in good faith to settle cases when under all the circumstances, could and should have done so, had it acted fairly and honestly towards its insured and with due regards for his/her interest.
And Florida Statutes, Section 626.9541:
(i) Unfair claim settlement practices:
(3) Committing or performing with such frequency as to indicate a general business practice any of the following:
(a) Failing to adopt and implement standards for the proper investigation of claims;
(c) Failing to acknowledge and act promptly upon communications with respect to claims;
(d) Denying claims without conducting reasonable investigations based upon available information;
(f) 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;
(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary;
Please be advised that you have sixty (60) days from the date of receipt of this notice by you and the Department of Insurance within which to cure its violations by fulling covering this claim. We hereby demand that you tender current damages calculated at $99,405.27 immediately. Please make payable to the Trust Account of Hancock & Berlin, PA f/b/o Justin & Sarah Berlin. We hope to amicably resolve this matter with you without the need for further action; however, if we do not receive a response within the timeframe to cure and in conjunction with the Notice of Intent to Litigate pursuant to Fla. Stat. § 627.70152 filed on the same date aforesaid, we will move forward with the filing of a lawsuit without further notice. In the meantime, should you have any questions or concerns, please do not hesitate to contact us. Nothing herein should be interpreted as a waiver of any kind.
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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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