Filing Number: 788671
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| Filing Accepted: 10/24/2024 |
| Last/Business Name
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WARNOCK
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First Name |
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JONATHAN BURNHAM AND CATHERINE |
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| Street Address
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175 GREENBRIAR LANE |
| City, State Zip
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SANTA ROSA BEACH,
FL
32459
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| Email Address
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CWARNOCK52@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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WARNOCK |
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First Name |
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JONATHAN BURNHAM AND CATHERINE |
| Policy # * |
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P016449872 |
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Claim #* |
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255925 |
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Attorney is Applicable
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| Last Name* |
ROSS
First Name *
VANESSA
Initial
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| Street Address* |
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1800 2ND STREET, SUITE 892 |
| City, State Zip* |
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SARASOTA
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FLORIDA
34236
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| Email Address * |
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ESERVICE@ROSSLEGALFL.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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SECURITY FIRST 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 10117 |
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| Name of individual responsible for violation (if any):*
MOLLY WHITTINGTON (#W731418), AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY SECURITY FIRST INSURANCE COMPANY INVOLVED IN THE CLAIM.
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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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Claim Denial
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Claim Delay
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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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| 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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Dwelling Coverage provisions
We cover:
1. The dwelling on the "residence premises" used mainly as your private residence, including attached structures and attached wall-to-wall carpeting if damage to the dwelling is caused by a covered loss; and
2. 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."
Perils Insured Against
We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property. We do not insure, however, for loss:
1. Involving collapse, including any of the following conditions of property or any part of the property, whether above or below the ground:
a. An abrupt falling down or caving in;
b. Loss of structural integrity, including separation of parts of the property or property in danger of falling down or caving in; or
c. Any spalling, crumbling, settling, cracking, shifting, bulging, racking, sagging, bowing, bending, leaning, shrinkage or expansion, or any other age or maintenance related issues, as such condition relates to a. or b. above.
except as provided in 8. Collapse under Section I – Additional Coverages;
2. Caused by: a. Freezing of a plumbing, heating, air conditioning or automatic fire protective sprinkler system or of a household appliance, or by discharge, leakage or overflow from within the system or appliance caused by freezing. (1) Maintain heat in the building; or
(2) Shut off the water supply and drain the system and appliances of water;
b. Freezing, thawing, pressure or weight of water or ice, whether driven by wind or not, to a: (1) Fence, pavement, patio or swimming pool;
(2) Foundation, retaining wall, or bulkhead; or
(3) Pier, wharf or dock;
c. Theft in or to a dwelling under construction, or of materials and supplies for use in the construction until the dwelling is finished and occupied;
d. Vandalism and malicious mischief, if the dwelling has been “vacant” or “unoccupied” for more than 30 days immediately before the loss. A dwelling being constructed is not considered “vacant” or “unoccupied”;
e. Accidental discharge or overflow of water or steam, unless loss to property covered under Coverage A or B results from an accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance on the “residence premises”.
This exclusion applies only while the dwelling is “vacant”, “unoccupied” or being constructed, unless you have used reasonable care to:
Loss to property covered under Coverage A or B that results from an accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance on the "residence premises" includes the cost to tear out and repair only that part or portion of a building or other structure covered under Coverage A or B, on the "residence premises", necessary to access the system or appliance.
(1) The cost that we will pay for the tear out and repair of the part or portion of the building or other structure covered under Coverage A or B as specified above is limited to only that part or portion of the covered building or other structure which is necessary to provide access to the part or portion of the system or appliance that caused the covered loss, whether the system or appliance, or any part or portion of the system or appliance, is repairable or not.
(2) In no event will we pay for the repair or replacement of the system or appliance that caused the covered loss.
For purposes of this provision, a plumbing system or household appliance does not include:
(1) A sump, sump pump, irrigation system, or related equipment; or
(2) A roof drain, gutter, down spout, or similar fixtures or equipment.
Loss Payment
We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be paid upon the earliest of the following: a. 20 days after we receive your written proof of loss and reach a written executed agreement of settlement with you according to the terms of the written agreement; or
b. 60 days after we receive your written proof of loss and:
(1) There is an entry of a final judgment or, in the case of an appeal from such judgment, within SFI FL HO3 03 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 20 of 31
c. Within 90 days after we receive written notice of an initial claim, “reopened claim” or “supplemental claim” from you, we will pay or deny such claim or a portion of the claim unless the failure to pay such claim or portion of claim is caused by factors beyond our control which reasonably prevent such payment.
60 days from and after the affirmance of the same by the appellate court; or
(2) There is a written executed mediation settlement agreement with you according to the terms of the written mediation settlement; or
Loss Settlement
Covered property losses are settled as follows: a. Property of the following types: (1) Personal property;
(2) Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings; and
(3) Structures that are not buildings;
at actual cash value at the time of loss but not more than the amount required to repair or replace
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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.
In Florida, the work of adjusting insurance claims engages the public trust. Security First Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of Catherine Warnock and Jonathan Burnham (“INSURED”) claim of loss. Security First Insurance Company’s mailing address is 1001 Broadway Avenue, Ormond Beach, FL 32174.
INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages.
INSURER has failed to promptly settle the INSURED’S insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED’S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy.
This claim involves the INSUREDS’ property located at 175 Greenbriar Lane, Santa Rosa Beach, FL 32459 which sustained significant damage from water on or about June 30, 2024. The INSUREDS immediately reported the loss to INSURER and allowed for inspection.
The INSUREDS suffered damage to the interior of the property. INSURER inspected the property and denied coverage for the claim..
The INSUREDS retained Noble Public Adjusting. to assist with determining the amount of damage sustained to the property. Noble prepared an estimate in the amount of $87,149.00. The INSUREDS also incurred $9,523.68 of additional living expenses to vacate the property due to the presence of mold until the same could be remediated. The total damage is $96,672.68. The INSUREDS are owed insurance benefits in order to return the property to pre-loss condition.
Therefore, demand is hereby made as follows:
Estimate $96,672.68
Less Prior Payments $0
Less Deductible $2,500.00
TOTAL $94,172.68
The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. 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 upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty.
The INSURED was, and still is, forced to expend out of pocket monies to submit her insurance claim, e.g., retaining an attorney and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them.
INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155.
Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must:
(1) Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future;
(2) INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees with regard to these claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully;
(3) INSURER must tender to the INSURED $94,172.68 as set forth above; and,
(4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim.
Attachments: Estimate, receipts and proposed complaint
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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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