Filing Number: 787694
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| Filing Accepted: 10/21/2024 |
| Last/Business Name
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PENNINGTON
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First Name |
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SYDNEY |
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| Street Address
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6251 WEST GLORY HILL STREET |
| City, State Zip
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BEVERLY HILLS,
FL
34465
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| Email Address
*
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INTAKE2@THEKRFIRM.COM |
| Complainant Type:
*
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Insured |
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| Last/Business Name* |
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PENNINGTON |
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First Name |
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SYDNEY |
| Policy # * |
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79-NS-0098-5 |
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Claim #* |
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59-69R0-67M |
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Attorney is Applicable
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| Last Name* |
KADIR
First Name *
ALI
Initial
A.
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| Street Address* |
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986 DOUGLAS AVE, STE. 102 |
| City, State Zip* |
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ALTAMONTE SPRINGS
,
FL
32714
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| Email Address * |
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INTAKE2@THEKRFIRM.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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STATE FARM FLORIDA 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 10739 |
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| Name of individual responsible for violation (if any):*
LAURA A. RYAN, CRYSTAL A. SMITH, SHELLY LAIRD, JACK WARD, PETE (LAST NAME OF CRYSTAL SMITH’S MANAGING SUPERVISOR UNKNOWN), MONTE (LAST NAME UNKNOWN), KAREN (LAST NAME UNKNOWN), AND ALL STATE FARM CLAIMS ADJUSTERS, EMPLOYEES, REPRESENTATIVES, AGENTS,
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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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Other
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Misrepresentation
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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)(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 will pay for accidental direct physical loss to the property described in Coverage A, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy.
. . . .
COVERAGE B – PERSONAL PROPERTY
We will pay for accidental direct physical loss to the property described in Coverage B caused by the following perils, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy.
. . . .
1. Fire or lightning.”
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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.
Sydney Pennington is a homeowner insured with a policy issued by State Farm Florida Insurance Company (“State Farm”). The insured property or home is located at 6251 West Glory Hill Street, Beverly Hills, Florida 34465.
In June of 2024, a fire caused extensive damage to Ms. Pennington’s home. Ms. Pennington timely reported an insurance claim for this damage to State Farm and fully cooperated with all requests for inspections. She provided all requested documentation, if any, and complied with all post loss policy conditions.
After reporting the claim, State Farm retained an unqualified and biased field adjuster who has a financial relationship with State Farm. This field adjuster inspected Ms. Pennington’s home in an apparent effort to minimize State Farm’s losses instead of adjusting the claim in good faith in due regard for Ms. Pennington’s interests.
Despite State Farm finding coverage for her claim, it significantly undervalued Ms. Pennington’s claim at only $67,415.99. Due to such, Ms. Pennington has not been able to permanently repair her home. Indeed, invoices for smoke and fire remediation, textile and electronic cleaning, ALE, storage, appliances, as well as a list of personal property contents and an estimate for repair of all damages were prepared on behalf of Ms. Pennington totaling $230,240.86 and were submitted to State Farm; well above the amount from State Farm.
Based on these facts, it is clear State Farm unreasonably denied full coverage for Ms. Pennington’s claim in bad faith through its extremely low and unreasonable undervaluation of her claim. Had State Farm conducted a reasonable investigation based upon the available information, it would have been evident that affording greater coverage and issuing a substantially higher payment is warranted. Instead, it failed to adopt and implement standards for proper claim investigation as well as misrepresented pertinent policy provisions/facts rather than act fairly and/or honestly with Ms. Pennington in due regard for her interests. State Farm also delayed the claim and failed to timely respond to communications. This has become a common business practice of State Farm.
Florida Statute § 624.02 defines insurance as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. State Farm has breached this duty by refusing to properly and timely adjust the loss.
As a result, Ms. Pennington will have no choice but to retain the undersigned counsel to file a lawsuit against State Farm.
State Farm has more than enough information and is still refusing to accept coverage for this claim. This continued and repeated reckless claim delay and denial of coverage will result in a significant punitive damage award if a bad faith lawsuit is filed.
State Farm can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Ms. Pennington based on her $230,240.86 estimates and invoices.
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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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