Filing Number: 791480
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| Filing Accepted: 11/11/2024 |
| Last/Business Name
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GOULD
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First Name |
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STERLING |
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| Street Address
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190 GARDEN AVE NW |
| City, State Zip
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PORT CHARLOTTE,
FL
33952
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| Email Address
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MORECREDIBLE@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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GOULD |
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First Name |
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STERLING |
| Policy # * |
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KIN-HO-FL-110440594 |
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Claim #* |
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HO-4530356 |
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Attorney is Applicable
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| Last Name* |
CANKAYA
First Name *
DENIZ
Initial
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| Street Address* |
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101 NE 3RD AVE, SUITE 1500 |
| City, State Zip* |
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FORT LAUDERDALE
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FLORIDA
33301
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| Email Address * |
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DENIZ@CANKAYA-LAW.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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KIN INTERINSURANCE NETWORK
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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 16603 |
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| Name of individual responsible for violation (if any):*
CORAL MCMINN
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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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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)(h) |
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Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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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.
SECTION I – CONDITIONS
17. What Law Governs
This policy and any performance there under shall
be construed with and governed by the laws of the
State of Florida.
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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.
An insurance company has a duty to create/establish and implement guidelines for the proper and thorough adjustment, investigation, and evaluation of a loss and claim. In this regard, the carrier has a duty to explain the insured’s policy during the adjustment of the loss, as well as conduct a full, thorough, proper, and fair investigation and evaluation of the claim. The carrier has a duty to provide its policyholder(s) with every benefit of the doubt and attempt to find coverage under the policy, rather than find a way to exclude and/or limit coverage and benefits. The carrier's obligation to comply with these duties and obligations, among many others, continues even if an insured is required to file suit against the carrier in order to protect the insured's rights and to obtain the proper indemnification due and owing under the policy.
The carrier in this claim, Kin Interinsurance Network (hereinafter “Kin”), has chosen to ignore and violate the above. As is detailed herein, the Carrier has breached its duties in the adjustment and investigation of the claim and has clearly failed to supervise and train its employees and retained adjusters, resulting in the statutory violations set forth herein.
More specifically, Kin has communicated in private with its Insured about a claim despite knowing the Insured was represented by legal counsel on the matter.
On or about November 7, 2024, Kin adjuster Coral McMinn conducted a recorded statement for claim HO-4586772 during which the adjuster devoted almost the entire time to questioning and asking the Insured about their hurricane Ian claim. Kin’s adjuster asked extensive questions regarding the Ian claim, the damages associated with it, repairs performed, repairs outstanding, and more. Kin has been on notice of the fact that the Insured has legal counsel on their Hurricane Ian claim since at least July 18, 2023, when the Insured’s counsel electronically served a Fla. Stat. 627.70152 Notice of Intent to Initiate Litigation on Kin. Indeed, the claim has been in litigation since September of 2023. In fact, the Insured was scheduled to sit for deposition on the Hurricane Ian claim the week following this recorded statement.
This constitutes a major violation of Florida law, as well as of Kin’s ethical obligations as an insurance company. To circumvent legal counsel of one of its Insureds, that it has full knowledge of, for the purposes of engaging in an unsupervised and unlimited fact finding expedition is nothing short of scandalous.
These communications were also evidenced in writing prior to the recorded statement on November 1, 2024, when Kin’s adjuster wrote directly to the Insured, without including Insured’s counsel, requesting information regarding their Hurricane Ian claim.
"Good afternoon,
We require additional information to determine coverage. Specifically we require:
• An agreed time to complete a recorded statement. My availability is below. All times are displayed in Eastern time.
• Any home inspection/prepurchase reports.
• Repair documents from your Hurricane Ian claim.
• Solar panel documentation.
• Fence documents following repairs made after Hurricane Ian.
• Documentation from the mitigation company for the Hurricane Milton damage."
Fla. Admin. Code R. 69B-220.201 states in relevant part as follows:
(3) Code of Ethics. The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster's own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters:
(c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured.
(g) An adjuster shall not negotiate or effect settlement directly or indirectly with any third-party claimant represented by an attorney, if the adjuster has knowledge of such representation, except with the consent of the attorney. For purposes of this subsection, the term "third-party claimant" does not include the insured or the insured's resident relatives.
Kin is in clear violation of the above. Thousands of Kin’s insureds in Florida, and in particular on the west coast of Florida, suffered immense damage as a result of Hurricane Ian. Many of those insureds were in litigation with Kin regarding those damages when Hurricanes Helene and Milton struck Florida approximately two years later. As those Insureds’ homes were damaged once again, they were forced to file new claims. At this point it is believed that Kin, as a regular business practice, is communicating with and conducting recorded statements of its Insureds on represented matters without the knowledge of their legal counsel. Presumably this is being done to bypass the protections that legal counsel affords its insureds. Without counsel present, Kin is free to probe, intimidate, and interrogate its Insureds however it likes for the purpose of gaining and manipulating information which it can then weaponize to limit and deny payouts.
This is a blatant affront to the public policy considerations in place to ensure that the homeowners of Florida are treated fairly. Insurance carriers must not be permitted to carry on with this sort of bad faith conduct which violates core tenets of our legal system and the basic ethical considerations which all insurance companies are held to.
In order for Kin to cure this civil remedy notice, Kin must
(1) Create and implement adequate guidelines for proper investigation and evaluation of claims;
(2) Create and implement adequate guidelines for the training and of the Carrier’s employees and representatives, which will avoid future statutory violations such as the ones set forth above;
(3) Act fairly and honestly towards the Insureds, with due regard for the Insured’s interests and their legal representation as the Carrier attempts to settle the Claim;
(4) Immediately produce to the Insured’s attorney any and all transcripts, audio and video recordings, notes, materials, documents, and files which were created during the course of communications with the Insured outside the presence of their legal counsel;
(5) Immediately, and under no circumstances no later than sixty days from the date of this Civil Remedy Notice, tender full payment required to place the insured back into a pre-loss condition, and additionally acknowledge and agree to the insured’s entitlement to statutory attorney’s fees pursuant to Fla. Stat. 627.428.
Should Kin fail to comply with the demands set forth in this Civil Remedy Notice, Kin must prepare to pay the full cost of its failure to rightfully indemnify the Insured, including all future damages that come about as a result of Kin’s failure to comply with the demands set forth in this Civil Remedy Notice.
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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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