Filing Number: 790607
|
| Filing Accepted: 11/6/2024 |
| Last/Business Name
*
|
|
|
MORANG
|
|
First Name |
|
STEPHANIE |
|
| Street Address
*
|
|
168 NORTH CORY DRIVE |
| City, State Zip
*
|
|
EDGEWATER,
FL
32141
|
| Email Address
*
|
|
STEPHANIELMORANG@GMAIL.COM |
| Complainant Type:
*
|
|
Insured |
|
| Last/Business Name* |
|
MORANG |
|
First Name |
|
STEPHANIE |
| Policy # * |
|
P000088103 |
|
Claim #* |
|
252404 |
|
Attorney is Applicable
|
| Last Name* |
ABAD
First Name *
FRANCISCO
Initial
I
|
| Street Address* |
|
1700 NW 64TH ST #460 |
| City, State Zip* |
|
FORT LAUDERDALE
,
FLORIDA
33309
|
| Email Address * |
|
FABAD@SCHILLINGSILVERS.COM |
|
|
| Insurer Type
*
|
|
Authorized Insurer
Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
SECURITY FIRST INSURANCE COMPANY
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code 10117 |
|
|
| Name of individual responsible for violation (if any):*
LOUIE LENOIR
|
| Type of Insurance
*
Residential Property & Casualty
|
|
|
| Reason for Notice
*
|
|
Unfair Trade Practice
|
|
Claim Denial
|
|
|
*
Statutory provision(s) which the insurer allegedly violated.
|
|
|
| 626.9541(1)(i)(3)(b) |
|
Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
|
|
*
Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
SECTION I CONDITIONS
2. Your Duties After Loss.
The first paragraph of 2. Your Duties After Loss is deleted and replaced by the following:
In case of a loss to covered property, we have no duty to provide coverage under this policy to an “insured”, or to an “assignee”, if the failure of you, an “insured” seeking coverage, an “assignee”, or a representative of any of these to comply with the following duties is prejudicial to us:
2.a.(2) is deleted and replaced by the following:
(2) Any claim or “reopened claim”, as those terms are defined in Florida Statute 627.70132, is barred unless notice of the claim was given to us in accordance with the terms of the policy within 2 years after the date of loss. Any “supplemental claim”, as that term is defined in Florida Statute 627.70132 is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 3 years after the date of loss.
|
| |
*
Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Stephanie Morang and Mistry Strother (f/k/a Misty Morang) (“Insureds”) purchased an insurance policy (“Policy”) from Security First Insurance Company. Security First issued a Policy bearing policy number P000088103, with policy period of July 27, 2022, to July 27, 2023, for the property located at 168 North Cory Drive, Edgewater, Florida 32141 (“Property”). On September 28, 2022, the Property sustained a substantial loss due to Hurricane Ian. Security First received notice of the claim and assigned claim number 252404 (the “Claim”).
On December 7, 2023, a Security First field adjuster and a certified roofer from Southeast Roofing inspected the Property (together known as the “inspectors”). The inspectors observed creased shingles on the roof and leaking. The inspectors recommended that the main roof be replaced. The inspection further revealed ceiling stains in the living room, front bedroom, back bedroom, and garage. Despite these findings, Security First stated that hey were prejudiced by the Insureds’ alleged failure to promptly report the claim. Upon information and belief, the claim was reported on November 30, 2023, which is less than two (2) years after the date of loss. At the time the loss occurred, the Insureds were to report the claim within 2 years after the date of loss. Similarly, Fla. Stat. 627.70132’s applicability at the time of the date of loss stated that notice must be given to the insurer within 2 years after the date of loss. The denial letter also states that “[t]he reported date of loss exceeds the notice requirement pursuant to Fl. Statute 627.70132. This Florida Statute requires that all claims be reported before the expiration of one year from the date of loss.”
For years, Florida Statute Section 627.70132 applied only to windstorm and hurricane claims, and it required that a claim “for loss or damage caused by the peril of windstorm or hurricane is barred unless notice of the claim, supplemental claim, or reopened claim was given to the insurer in accordance with the terms of the policy within 3 years after the hurricane first made landfall or the windstorm caused the covered damage.” See Florida Statute Section 627.70132 (2020). Then, effective July 1, 2021, the Statute was amended to apply to all claims, not just windstorm or hurricane. Furthermore, the timeframe for reporting an initial or reopened claim was reduced to 2 years, while still allowing 3 years for supplemental claims. See Florida Statute Section 627.70132 (2021).
On December 16, 2022, the Statute was amended yet again, narrowing the timeframe for reporting even further. Now, the Statute provides that initial and reopened claims must be reported within 1 year of the date of the loss, and supplemental claims must be reported within 18 months. See Florida Statute Section 627.70132 (2022). Section 23, ch. 2023-172, provides that “[c]hapter 2022-271, Laws of Florida, shall not be construed to impair any right under an insurance contract in effect on or before the effective date of that chapter law. To the extent that chapter 2022-271, Laws of Florida, affects a right under an insurance contract, that chapter law applies to an insurance contract issued or renewed after the applicable effective date provided by the chapter law. This section is intended to clarify existing law and is remedial in nature.”
Here, the subject Policy had a valid policy period of July 27, 2022, through July 27, 2023, and the reported date of loss is September 28, 2022. In fact, the subject Policy provides, in part, that “[i]n the case of a windstorm or ‘Hurricane loss,’ you must give us notice of the initial claim, ‘supplemental claim’ or ‘reopened claim’ within three years after the hurricane first made landfall or the windstorm caused the covered damage.” See Policy, attached as Exhibit “B” to Defendant’s Motion to Dismiss. More importantly, and more concerning, Security First completely ignores a portion of the Office of Insurance Regulation’s Filing Number 22-050476 out of its denial letters or motions filed in discovery. This Filing expresses a refusal to approve Security First’s endorsement to use the new law in existing policies. The Filing, dated January 17, 2023, express tates that the new form/law is APPROVED for use in new business (new policies) starting on February 1, 2023, and renewals starting on February 1, 2023. Therefore, the 1-year requirement of the new statute does not apply to this the subject claim.
It is clear that Security First found covered damage to the Property but looked for any possible alternative to not deny the claim and not make a payment under this valid claim. Contrary to the terms of the Policy and applicable Florida law, Security First performed a subpar investigation of the claim to the detriment of the Insureds. Due to Security First’s gross mismanagement of the claim, the failure to properly investigate the loss and adjust this loss in good faith, the Insureds continues to suffer damages.
By stating the above detailed facts, it is clear that Security First has violated the following Florida Statutes:
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue;
Security First misrepresented the terms of the Policy; specifically, Security First stated that the Insureds were barred from coverage as they failed to report the claim within 1 year when, in reality, the Insureds had 2 years after the date of loss to report the claim. Here, the claim was reported within 2 years of the date of loss and Security First was able to properly identify the damages reported through 2 inspectors.
Based on the above, it is irrefutable evidence that Security First knowingly and intentionally, performs sub-part investigations into its claim in order to further disadvantage the Insureds. The financial detriment caused to the Insured is a direct result of Security First’s reckless investigation. Upon information and belief, the aforementioned action complained of, among others, was made by Security First so often as to constitute a general business practice, evidencing a motive to enhance Security First’s profits, and designed to cause a detrimental effect to its policyholders.
The above clearly depicts that Security First adjusted this claim in bad faith and that Security First is in direct violation of Unfair Claims Practices, by knowingly misinterpreting the Policy to the insured.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Security First fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, Security First must: Create and implement adequate guidelines for proper investigation and evaluation as to claims handling and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and to avoid this from occurring in the future; Security First 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 types of claims to ensure Security First’s claims handling procedures with regard to these types of losses are adequate; Security First must act fairly and honestly towards the Insureds with due regard for their best interests in attempting to settle the claim; Security First must immediately tender all insurance benefits due and owing to the Insureds under the Policy pursuant to the relevant policy provisions provided therein that would reasonably place the property back to its pre-loss condition, including, but not limited to all interest due and owing under applicable Florida Statutes. The Insureds expect Security First to respond to this CRN stating that it does not comply with Florida Statutes and Security First will ignore the specific allegations herein and fail to refute them with any factual basis. Security First must immediately tender all insurance benefits in the amount of $67,297.95. This represents the balance of all damages, exclusive of attorney’s fees and costs.
The Insured still hopes that this claim can be resolved amicably. Failure to cure the defects as described herein will result in additional extra-contractual damages.
Should Security First fail to cure the violations set forth in this Civil Remedy Notice within the cure period, Insured reserves the right to seek restitution through litigation.
|
|
*
|
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
|