Civil Remedy Notice of Insurer Violations
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Filing Number:     790885
Filing Accepted:  11/7/2024
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Complainant
Last/Business Name *  
LABORDE   First Name   MARIE
Street Address * 1107 NE 18TH AVE.
City, State Zip * CAPE CORAL, FL 33909
Email Address * MARIELABORDE20@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   LABORDE   First Name   MARIE
Policy # * KIN-DP-FL-237858227 Claim #* HO-0007633
Attorney
Attorney is Applicable
Last Name* MAHONEY First Name * JOHN Initial
Street Address* 4290 WOODBINE RD.
City, State Zip* PACE , FLORIDA 32571
Email Address * JMAHONEY@ARLAWLLC.NET
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   KIN INTERINSURANCE NETWORK
NAIC Company Code 16603
 
Name of individual responsible for violation (if any):* TAMMY TURNER AND OTHER ASSIGNED INSURANCE ADJUSTERS
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)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

POLICY PROVISIONS VIOLATED: The insurance company is in breach of the Coverage sections of the subject policy KIN-DP-FL-237858227. ADMINISTRATIVE CODE SECTIONS VIOLATED: 69B-220.201(3)(b) – An adjuster shall treat all claimants equally. 69B-220.201(3)(b)2. – An adjuster shall adjust all claims strictly in accordance with the insurance contract. 69B-220.201(3)(c) – An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insureds. 69B-220.201(3)(d) – An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. 69B-220.201(3)(o) – An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This notice is given in order to perfect the right of the insureds, Marie and Rika Laborde (“insureds”), to pursue the civil remedy authorized by Fla. Stat. §624.155 against their insurer, Kin Interinsurance Network (“the insurance company”). The insurance company has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the claim of loss of its insured and has failed to pay for covered damages in breach of the insurance policy. This claim arises from covered damages sustained by the insured from Hurricane Ian that occurred on or about September 28, 2022. On or about that date, the insured property suffered substantial wind and hurricane damage because of Hurricane Ian. The insurance company was timely notified of the loss and assigned claim number HO-0007633. The insureds sought the assistance of an attorney and obtained a damage/repair estimate for damages across all coverages. The carrier opened coverage under the policy. The carrier paid some amounts but those were insufficient to indemnify the loss. The insureds disagreed and timely supplemented. The insureds provided an estimate and other information to the insurance company. The insurance company failed to properly pay the insureds for all their covered losses under Coverage A, Coverage B, Coverage C, Coverage D, and other available coverages. To date, despite acknowledging coverage for the loss and notwithstanding the insureds pleas otherwise, the insurance company has failed and refused to pay all insurance benefits due and owing under the policy and has failed and refused to restore the insureds property to pre-loss condition. The insurance company’s valuation of the loss did not begin to approach a necessary amount to repair the property to pre-loss condition. The insureds requested the insurance company to pay the full amount of money needed to address their covered losses. After attempts to obtain a fair claim settlement failed, the insureds were left with no choice but to hire an attorney to pursue the insurance company for its breach of the insurance policy in failing to pay the full policy value of the loss. Implicit within every insurance policy is a duty of good faith and fair dealing. However, the insurance company has failed to comply with those obligations in connection with this claim. Instead, the insurance company has looked for ways to avoid paying the claim in full and these actions have been to the detriment of the insureds. The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim the representatives on behalf of the insurance company have approached this investigation in a manner prejudicial to the insureds. The insurance company used either untrained or improperly trained adjusters in connection with this claim. The insurance company should have been adjusting the loss with the insureds but instead, it was looking for ways not to pay the claim in full. If the insurance company handles all the claims in this way, then it is improperly handling all claims. The insurance company’s conduct has been reckless and unfair to the insureds. The concept of insurance is that insurance is the insurers’ granting of 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 specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the insureds may mitigate their damages and be placed back into the position they were in prior to the loss as quickly as possible. The insurance company has breached this duty. The insurance company should have acted fairly and honestly towards the Insureds. Instead, the insurance company refused and/or failed to settle the insurance claim when under all circumstances it could have. This is wrongful conduct. Further, the insureds contend that the insurance company’s adjusters and/or representatives financially benefitted from such wrongful conduct. Therefore, to cure the defects outlined in this Civil Remedy Notice, the insurance company must: create and implement adequate guidelines for proper investigation and evaluation as to claims handling and for the training and supervision of employees. This would have helped the insurance company avoid the statutory violations set forth above and may help the insurance company prevent such violations from occurring in the future. In addition, the insurance company must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims. The insurance company should also offer appropriate training and supervision of employees with regard to these types of claims to ensure the insurance company’s claims handling procedures are adequate to prevent the unfair and wrongful treatment that the Insureds experienced here. To remedy the above issues the insurance company must act fairly and honestly towards the insureds and with due regard for their best interests in attempting to settle the insureds claim. The insurance company must immediately tender all insurance benefits due and owing to the insureds under the policy pursuant to the relevant policy provisions provided therein. The necessary remedy payments would also include all interest due and owing under applicable Florida Statutes and all attorney’s fees and costs incurred by the insureds because of the bad faith conduct of the insurance company. Stated another way, the insurance company must pay the insureds the fair value of their insurance claim. This remedy would reasonably place the insured back to the pre-loss condition that is contemplated in their policy and would resolve the outstanding disputes.
Comments
User Id Date Added Comment
kristen.henderson@kin.com 12-31-2024 While Kin Interinsurance Network believes that the Civil Remedy Notice fails to comply with the requirements of Florida Statute §624.155 and Florida Case law, it has responded to the Notice in writing to John Mahoney, Esq on 12/31/2024. Pursuant to F.S. 624.155(3)(d), please accept this notice on the disposition of the alleged violations contained in the Civil Remedy Notice occurred on 12/12/2024.
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.

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