Filing Number: 791305
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| Filing Accepted: 11/11/2024 |
| Last/Business Name
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| Street Address
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19492 NW 11TH ST |
| City, State Zip
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PEMBROKE PINES,
FL
33029
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| Email Address
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INSURED@MCDONALDBARNHILL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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WALKER |
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First Name |
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ERIC |
| Policy # * |
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SJ31114269 |
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Claim #* |
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SL24201595 |
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Attorney is Applicable
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| Last Name* |
GONTRUM
First Name *
RYAN
Initial
L
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| Street Address* |
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505 S. MAGNOLIA AVENUE |
| City, State Zip* |
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TAMPA
,
FL
33606
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| Email Address * |
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TAL@MCDONALDBARNHILL.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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SLIDE 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 17227 |
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| Name of individual responsible for violation (if any):*
CHELSA GRIFFIN AND ANTHONY PAGUANDAS
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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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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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| 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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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(1)(B)(1) Any person may bring a civil action against an insurer when such person is damaged:
By the commission of any of the following acts by the insurer:
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 towards its insured and with due regard for his interests;
2. 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.
§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.
§626.9541(i) Unfair Claim Settlement Practices
2. Committing or performing with such frequency as to indicate a general business practice any of the following:
§626.9541(1)(i)3a Failing to adopt and implement standards for the proper investigation of claims.
***Specific policy language that is relevant to the violation***
Slide Insurance Company (“Slide”) failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, Slide 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.
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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.
Eric Walker’s claim results from water damage due to a plumbing supply line failure on or about March 12, 2024, to his property located at 19492 NW 11th St., Pembroke Pines, FL 33029. The plumbing failure resulted in water pouring into the kitchen, damaging cabinets, floors, and drywall in multiple rooms of the dwelling. The property was insured under policy number SJ31114269. The claim was reported to Slide Insurance Company (“Slide”) and was assigned the claim number SL24201595. The carrier assigned Chelsa Griffin as the desk adjuster, and Anthony Paguandas as the field adjuster to the claim. Mr. Paguandas performed a perfunctory inspection and prepared an estimate totaling $27,000.58, which not only underscoped the damage, but also classified many necessary repairs under limited matching endorsement coverage. For example, despite the widespread damage to the kitchen cabinets, the estimate included the detaching and resetting of the kitchen appliances as matching repairs. Based on this estimate, Slide issued two checks totaling just $16,625.52 in a failed attempt to indemnify the Insured for his unfortunate loss. Unsurprisingly, the funds issued are insufficient to restore Mr. Walker’s property back to its pre-loss condition.
Mr. Walker hired Stellar Public Adjusting Services LLC. (“Stellar”) to represent his interests in the claim. Stellar inspected the property and found $162,867.28 worth of damages to the dwelling. Stellar sent their estimate, photos, and other documentation to Slide and requested supplemental payment. However, slide refused to issue additional payment, or even send another individual to reinspect. Stellar and Mr. Walker also requested appraisal to resolve the claim, but Slide refused to proceed with appraisal either. There is no evidence that Slide considered the documentation provided by Stellar or did anything to further adjust the claim. Slide’s course of action has continuously delayed indemnification while the Insureds’ costs continue to rise.
In Florida, the work of adjusting insurance claims engages the public trust. Slide has breached this duty in the adjustment of this loss by refusing to provide proper indemnity, unnecessarily delaying resolution of the claim, and failing to take into consideration documentation provided to them which would support further compensation. Slide 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.
Slide charged Mr. Walker a substantial premium for these coverages but has refused to tender sufficient payment when under all circumstances it should have done so, had they acted fairly and honestly. As a result, the Insureds have been forced to retain legal counsel to protect their interests.
Therefore, to cure the defects outlined in this Civil Remedy Notice, Slide 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.
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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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