Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 788876

Filing Accepted: 10/27/2024

Print Filing

Complainant

Last/Business Name *

HILINSKI

First Name

DAVID AND CAROLE

Street Address *

837 TULIP LN

City, State Zip *

SANIBEL, FL 33957

Email Address *

INSURED@MCDONALDBARNHILL.COM

Complainant Type: *

Insured

Last/Business Name*		HILINSKI		First Name		DAVID AND CAROLE
Policy # *		HCPC-HW2-448603-8		Claim #*		925110

Attorney

Attorney is Applicable

Last Name*	GONTRUM First Name * RYAN Initial L
Street Address*		505 S. MAGNOLIA AVENUE
City, State Zip*		TAMPA , FL 33606
Email Address *		TAL@MCDONALDBARNHILL.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 12944

Name of individual responsible for violation (if any):* KENNETH ROBINSON A AND BO JULIAN
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Denial
	Claim Delay
	Unsatisfactory Settlement Offer
	Unfair Trade Practice

* Statutory provision(s) which the insurer allegedly violated.

	624.155(1)(b)(1)		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.
	626.9541(1)(i)(3)(a)		Failing to adopt and implement standards for the proper investigation of claims.
	626.9541(1)(i)(3)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.
	626.9541(1)(i)(3)(e)		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.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

***ADDITIONAL STATUTORY PROVISIONS ALLEGED TO HAVE BEEN VIOLATED AS FOLLOWS:*** §624.155 (5) No punitive damages shall be awarded under this section unless the acts giving rise to the violation occur with such frequency as to indicate a general business practice and these acts are: (a) Willful, wanton, and malicious; (b) In reckless disregard for the rights of any insured; or (c) In reckless disregard for the rights of a beneficiary under a life insurance contract; (8) The damages recoverable pursuant to this section shall include those damages which are a reasonably foreseeable result of a specified violation of this section by the authorized insurer and may include an award or judgment in an amount that exceeds the policy limits. ***Specific policy language that is relevant to the violation*** Homeowners Choice Property & Casualty Insurance Company, Inc. (HCI) failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, Homeowners failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections specifically cited herein, any endorsements or changes to said sections are relevant to the Insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered.

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

David and Carole Hilinski’s claim results from wind and water damage from Hurricane Ian, which occurred on or about September 28, 2022, to their property located at 837 Tulip Ln., Sanibel, FL 33957. The property was insured under policy number HCPC-HW2-448603-8. The heavy winds from the storm caused significant damage to the roof and exterior, as well as the boatlift of the property. The claim was reported to Homeowners Choice Property & Casualty Insurance Company Inc. (“HCI”) and was assigned claim number 925110. Homeowners assigned Kenneth Robinson as the desk adjuster and Bo Julian as the field adjuster for the claim. Mr. Julian inspected the property and prepared an estimate which significantly under scoped and underpriced the damage to the property. For example, the estimate failed to include anything for the boat lift and provided only minimal repairs to the exterior stucco. This estimate totaled $33,032.91, and after deductible and depreciation resulted in payment of just $17,553.53 for the loss. Mr. and Mrs. Hilinski hired Stellar Public Adjusting Services (“Stellar”) to represent their interests in the claim. Stellar completed an inspection and produced an estimate which found $99,216.17 worth of damages. Stellar sent their estimate along with photos and other requested documentation to HCI and requested payment. Unfortunately, there is no proof the carrier ever actually considered the other information sent by Stellar or did anything further to adjust the claim. HCI’s course of action has continuously delayed the claim while the Insured’s costs continue to rise. In Florida, the work of adjusting insurance claims engages the public trust. HCI has breached this duty in the adjustment of this loss by failing to timely communicate with the Insureds, delaying the claim, and not considering documentation that shows additional indemnity is owed to the Insureds. HCI has failed to create and implement adequate guidelines for proper investigation of claims handling and for training and supervision of employees and representatives which have resulted in some of the statutory violations set forth above. HCI charged Mr. and Mrs. Hilinski a substantial premium for these coverages but has refused to tender proper payment when under all circumstances it could have and should have done so had it acted fairly and honestly. Additionally, it appears this is done companywide. The Insureds have been forced to consider legal counsel to protect their interests. Therefore, to cure the defects outlined in this Civil Remedy Notice, HCI must: 1. Immediately tender all insurance monies due to the Insured for the loss; 2. Act fairly and honestly towards the Insured and with due regard for his interests in attempting to settle the claim; 3. Pay statutory interest on the amount of unpaid contractual damages from the date the claim was reported; 4. Cease and desist all present and future bad faith actions with regard to the Insured’s claim; Failure to cure all defects during the 60-day safe harbor period may result in additional extra-contractual damages.

Comments

User Id		Date Added		Comment
Legal@hcpci.com		12-23-2024		This is Homeowners Choice Property & Casualty Insurance Company’s (“HCPCI”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed on behalf of David and Carole Hilinski (“Insured”). HCPCI reviewed this CRN and conducted a thorough review of the subject claim (“claim”) and confirmed it handled the claim properly. Regarding an aspect of the claim, HCPCI issued payments for it on the information available to HCPCI and the circumstances at the time of such payments. Ultimately, HCPCI handled the claim in accordance with the policy and all statutory and regulatory requirements. HCPCI denies each allegation of bad faith and improper conduct in the CRN. At all times, HCPCI acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. Furthermore, the CRN fails to adequately describe the alleged violations and fails to provide sufficient information to have created an opportunity for the alleged violations to be corrected (although no violations exist). Instead of complying with Florida Statutes, Section 624.155, the Insured’s attorney in the CRN contained an inaccurate recitation of the facts, failed to reference specific, relevant insurance policy language; cited irrelevant statutes; failed to offer a valid cure, and relied on inaccurate and conclusory statements. The Insured’s laundry list of inapplicable statutes is insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). The CRN cannot serve as the basis of a bad-faith action against HCPCI. Finally, upon request by the Department of Financial Services, HCPCI will provide to the Department of Financial Services detailed correspondence HCPCI provided to the Insured regarding HCPCI’s obligations for the claim under the insurance contract and the facts of the claim.

Acknowledgement
*	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.

DFS-10-363
Rev. 10/14/2008