Filing Number: 791546
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| Filing Accepted: 11/12/2024 |
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FERNANDEZ
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First Name |
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DANILO |
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| Street Address
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1069 5TH AVE NE |
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LARGO,
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33770
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| Email Address
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MAIL@BENNETT.LEGAL |
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Insured |
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| Last/Business Name* |
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FERNANDEZ |
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First Name |
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DANILO |
| Policy # * |
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P0000106859 |
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Claim #* |
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201147 |
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Attorney is Applicable
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| Last Name* |
BENNETT
First Name *
RYAN
Initial
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PO BOX 159 |
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PARRISH
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34219
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RYAN@BENNETT.LEGAL |
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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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SECURITY FIRST INSURANCE COMPANY
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| Insurer Name* |
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,
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NAIC Company Code 10117 |
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| Name of individual responsible for violation (if any):*
STEVE WATSON, ADRIAN MICIANO, TARA SHORT
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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)(2) |
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A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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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)(b) |
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Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
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| 626.9541(1)(i)(3)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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| 626.9541(1)(i)(3)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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| 626.9541(1)(i)(3)(f) |
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Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
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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.
FLORIDA ADMINISTRATIVE CODE SECTIONS VIOLATED: 69B-220.201(3)(B) AN ADJUSTER SHALL TREAT ALL CLAIMANTS EQUALLY. AN ADJUSTER SHALL NOT PROVIDE FAVORED TREATMENT TO ANY CLAIMANT. 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 INSURED. 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)(E) AN ADJUSTER SHALL HANDLE EVERY ADJUSTMENT AND SETTLEMENT WITH HONESTY AND INTEGRITY, AND ALLOW FAIR ADJUSTMENT OR SETTLEMENT TO ALL PARTIES WITHOUT ANY COMPENSATION OR RENUMERATION TO HIMSELF OR HERSELF EXCEPT TO THAT WHICH HE OR SHE IS LEGALLY ENTITLED. 69B-220.201(3)(F) AN ADJUSTER, UPON UNDERTAKING THE HANDLING OF A CLAIM, SHALL ACT WITH DISPATCH AND DUE DILIGENCE IN ACHIEVING A PROPER DISPOSITION OF THE CLAIM. 69B-220.201(3)(J) AN ADJUSTER SHALL NOT KNOWINGLY FAIL TO ADVISE A CLAIMANT OF THE CLAIMANT’S CLAIM OPTIONS IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF THE INSURANCE CONTRACT. 69B-220.201 (3)(K) 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.
VARIOUS LANGUAGE THROUGHOUT THE POLICY, INCLUDING BUT NOT LIMITED TO THE DECLARATIONS PAGE, THE CHECKLIST OF COVERAGE, POLICY FORM SFI FL HO3 DEC 09 18, POLICY FORM HO 00 03 04 91, POLICY FORM SFIV HO 09 CLP 01 06, POLICY FORM SFIV HO 09 OL1 06 15, POLICY FORM SFIV HO3 09 SP 02 18, THE PROVISIONS GOVERNING COVERAGE FOR CATASTROPHIC GROUND COVER COLLAPSE, THE PROVISOINS COVERING THE ADDITIONAL COVERAGE OF COLLAPSE, THE LOSS PAYMENT PROVISION(S), AND THE PROVISIONS GOVERNING THE DUTIES AND OBLIGATIONS OF THE INSURER. SUCH POLICY LANGUAGE INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING:
YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM.
COLLAPSE COVERAGE
(SFIV HO 09 CLP 01 06)
UNDER SECTION I-PROPERTY COVERAGES
ADDITIONAL COVERAGES
8. COLLAPSE IS DELETED AND REPLACED BY THE FOLLOWING:
8. COLLAPSE
A. WITH RESPECT TO THIS ADDITIONAL COVERAGE:
(1) COLLAPSE MEANS AN ABRUPT FALLING DOWN OR CAVING IN OF A BUILDING OR ANY PART OF A BUILDING WITH THE RESULT THAT THE BUILDING OR PART OF THE BUILDING CANNOT BE OCCUPIED FOR ITS CURRENT INTENDED PURPOSE.
(2) A BUILDING OR ANY PART OF A BUILDING THAT IS IN DANGER OF FALLING DOWN OR CAVING IN IS NOT CONSIDERED TO BE IN A STATE OF COLLAPSE.
(3) A PART OF A BUILDING THAT IS STANDING IS NOT CONSIDERED TO BE IN A STATE OF COLLAPSE EVEN IF IT HAS SEPARATED FROM ANOTHER PART OF THE BUILDING.
(4) A BUILDING OR ANY PART OF A BUILDING THAT IS STANDING IS NOT CONSIDERED TO BE IN A STATE OF COLLAPSE EVEN IF IT SHOWS EVIDENCE OF CRACKING, BULGING, SAGGING, BENDING, LEANING, SETTLING, SHRINKAGE OR EXPANSION.
B. WE INSURE FOR DIRECT PHYSICAL LOSS TO COVERED PROPERTY INVOLVING COLLAPSE OF A BUILDING OR ANY PART OF A BUILDING IF THE COLLAPSE WAS CAUSED BY ONE OR MORE OF THE FOLLOWING:
(1) THE PERILS INSURED AGAINST NAMED UNDER COVERAGE C;
(2) DECAY WITHIN THE BUILDING THAT IS HIDDEN FROM VIEW, UNLESS THE PRESENCE OF SUCH DECAY IS KNOWN TO AN “INSURED” PRIOR TO COLLAPSE;
(3) INSECT OR VERMIN DAMAGE THAT IS HIDDEN FROM VIEW, UNLESS THE PRESENCE OF SUCH DAMAGE IS KNOWN TO AN “INSURED” PRIOR TO COLLAPSE;
(4) WEIGHT OF CONTENTS, EQUIPMENT, ANIMALS OR PEOPLE;
(5) WEIGHT OF RAIN WHICH COLLECTS ON A ROOF; OR
(6) USE OF DEFECTIVE MATERIAL OR METHODS IN CONSTRUCTION, REMODELING OR RENOVATION IF THE COLLAPSE OCCURS DURING THE COURSE OF THE CONSTRUCTION, REMODELING OR RENOVATION.
C. LOSS TO AN AWNING, FENCE, PATIO, DECK, PAVEMENT, SWIMMING POOL, UNDERGROUND PIPE, FLUE, DRAIN, CESSPOOL, SEPTIC TANK, FOUNDATION, RETAINING WALL, BULKHEAD, PIER, WHARF OR DOCK IS NOT INCLUDED UNDER B. (2) THROUGH (6) ABOVE, UNLESS THE LOSS IS A DIRECT RESULT OF THE COLLAPSE OF A BUILDING OR ANY PART OF A BUILDING.
D. THIS COVERAGE DOES NOT INCREASE THE LIMIT OF LIABILITY THAT APPLIES TO THE DAMAGED COVERED PROPERTY.
ORDINANCE OR LAW COVERAGE
(SFIV HO 09 OL1 06 15)
INCLUDED IN THE PREMIUM CHARGED, WE WILL PROVIDE COVERAGE FOR COSTS ASSOCIATED WITH THE ENFORCEMENT OF ANY ORDINANCE OR LAW REGULATING THE CONSTRUCTION, REPAIR, OR DEMOLITION OF A BUILDING OR STRUCTURE INSURED UNDER THIS POLICY SUBJECT TO THE LIMIT AND CONDITIONS DESCRIBED BELOW.
CONDITIONS
• COVERAGE PROVIDED BY THIS ENDORSEMENT ONLY APPLIES WHEN DAMAGE BY A PERIL INSURED AGAINST HAS OCCURRED TO YOUR DWELLING OR OTHER STRUCTURES.
• THE COVERAGE PROVIDED BY THIS ENDORSEMENT APPLIES TO ADDITIONAL COSTS INCURRED DUE SOLELY TO THE ENFORCEMENT OF ANY ORDINANCE OR LAW THAT REQUIRES OR REGULATES THE CONSTRUCTION, REPAIR, OR DEMOLITION, INCLUDING THE COSTS OF REMOVING DEBRIS, DIRECTLY ATTRIBUTABLE TO ORDINANCES OR LAWS REGULATING SUCH. COVERAGE WILL NOT BE AVAILABLE TO COVER INCREASES IN COSTS ATTRIBUTABLE TO ANY OTHER FACTORS.
LIMIT OF LIABILITY
OUR LIMIT OF LIABILITY FOR COVERAGE PROVIDED BY THIS ENDORSEMENT IS 25% OF THE COVERAGE A LIMIT SHOWN ON YOUR DECLARATIONS PAGE. COVERAGE FOR ENFORCEMENT OF ORDINANCES OR LAWS PROVIDED BY THIS ENDORSEMENT IS IN ADDITION TO THE COVERAGE A LIMIT SHOWN ON YOUR DECLARATIONS PAGE.
ALL OTHER PROVISIONS OF YOUR POLICY APPLY.
SPECIAL PROVISIONS FOR FLORIDA
(SFIV HO3 09 SP 02 18)
FOR USE WITH ALL HO 00 03 FORMS
DEFINITIONS
THE FOLLOWING DEFINITIONS ARE ADDED:
“CATASTROPHIC GROUND COVER COLLAPSE” MEANS GEOLOGICAL ACTIVITY THAT RESULTS IN ALL OF THE FOLLOWING:
A. THE ABRUPT COLLAPSE OF THE GROUND COVER;
B. A DEPRESSION IN THE GROUND COVER CLEARLY VISIBLE TO THE NAKED EYE;
C. “STRUCTURAL DAMAGE” TO THE “PRINCIPAL BUILDING”, INCLUDING THE FOUNDATION;
D. THE INSURED STRUCTURE BEING CONDEMNED AND ORDERED TO BE VACATED BY THE GOVERNMENTAL AGENCY AUTHORIZED BY LAW TO ISSUE SUCH AN ORDER FOR THAT STRUCTURE.
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COVERAGE D – LOSS OF USE IS DELETED AND REPLACED BY THE FOLLOWING:
WE WILL PAY THE ADDITIONAL EXPENSES YOU INCUR FROM A COVERED LOSS, BUT NO MORE THAN THE LIMIT OF LIABILITY SHOWN FOR
COVERAGE D IN THE DECLARATIONS FOR THE FOLLOWING:
1. ADDITIONAL LIVING EXPENSES INCURRED BY YOU SO THAT YOUR HOUSEHOLD CAN MAINTAIN ITS NORMAL STANDARD OF LIVING
WHEN A LOSS COVERED UNDER THIS SECTION MAKES THAT PART OF THE “RESIDENCE PREMISES” WHERE YOU RESIDE NOT FIT TO
LIVE IN.
PAYMENT WILL BE FOR THE SHORTEST TIME REQUIRED TO REPAIR OR REPLACE THE DAMAGE OR, IF YOU PERMANENTLY RELOCATE, THE
SHORTEST TIME REQUIRED FOR YOUR HOUSEHOLD TO SETTLE ELSEWHERE.
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11. CATASTROPHIC GROUND COVER COLLAPSE.
WE WILL PAY UP TO THE LIMIT OF LIABILITY SHOWN IN YOUR DECLARATIONS FOR LOSS CAUSED BY “CATASTROPHIC GROUND COVER COLLAPSE” TO THE “PRINCIPAL BUILDING” UNDER THE FOLLOWING CONDITIONS:
A. WE INSURE FOR DIRECT PHYSICAL LOSS TO THE “PRINCIPAL BUILDING” CAUSED BY THE PERIL OF “CATASTROPHIC GROUND COVER COLLAPSE”. COVERAGE IS NOT PROVIDED FOR OTHER STRUCTURES ON THE “RESIDENCE PREMISES” FOR LOSS BY “CATASTROPHIC GROUND COVER COLLAPSE”.
B. COVERAGE C APPLIES IF THERE IS A LOSS RESULTING FROM A “CATASTROPHIC GROUND COVER COLLAPSE”, UNLESS THE LOSS IS EXCLUDED ELSEWHERE IN THIS POLICY.
C. DAMAGE CONSISTING MERELY OF THE SETTLING OR CRACKING OF A FOUNDATION, STRUCTURE OR BUILDING DOES NOT CONSTITUTE A LOSS RESULTING FROM A “CATASTROPHIC GROUND COVER COLLAPSE”.
THIS PERIL DOES NOT INCREASE THE LIMIT OF LIABILITY THAT APPLIES TO THE DAMAGED PROPERTY.
THE SECTION I – EXCLUSIONS FOR B. “EARTH MOVEMENT” DOES NOT APPLY TO THIS PERIL.
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UNDER SECTION I – EXCLUSIONS THE FOLLOWING 1. J. IS ADDED.
J. LOSS CAUSED BY “SINKHOLE”
(1) “SINKHOLE” MEANS A LANDFORM CREATED BY SUBSIDENCE OF SOIL, SEDIMENT, OR ROCK AS UNDERLYING STRATA ARE DISSOLVED BY GROUNDWATER. A “SINKHOLE” FORMS BY COLLAPSE INTO SUBTERRANEAN VOIDS CREATED BY DISSOLUTION OF LIMESTONE OR DOLOSTONE OR BY SUBSIDENCE AS THESE STRATA ARE DISSOLVED.
THIS EXCLUSION 1.J. DOES NOT APPLY IN THE EVENT OF “STRUCTURAL DAMAGE” FROM “CATASTROPHIC GROUND COVER COLLAPSE”.
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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.
1) CLAIM DENIAL; 2) FAILURE TO PROMPTLY INVESTIGATE CLAIM; 3) FAILURE TO PROPERLY INVESTIGATE CLAIM; 4) FAILURE TO ADJUST LOSS; 5) FAILURE TO ACT IN DUE DILIGENCE AND GOOD FAITH TO RESOLVE CLAIM; 6) PLACING FINANCIAL INTEREST OF INSURER BEFORE THAT OF POLICY HOLDERS AND CLAIMANTS; 7) FAILURE TO PROPERLY TRAIN, EVALUATE AND MANAGE ADJUSTERS; 8) LOOKING FOR WAYS TO DENY COVERAGE, PAY LESS, DELAY PAYMENT AND OTHERWISE “LOW BALL” OR “STONE WALL” CLAIM; 9) THE REASONS FOR THIS MAY BE ATTRIBUTED TO IMPROPER TRAINING, SUPERVISION, AND/OR MOTIVATION OF ADJUSTERS AND CLAIMS SUPERVISORS. THE INSURER MAY HAVE FAILED TO ADOPT THE PROPER STANDARDS OF INVESTIGATION AND ADJUSTMENT OF LOSSES OR IS OTHERWISE NOT IMPLEMENTING THOSE STANDARDS BECAUSE FULL PAYMENT AND PROMPT PAYMENT FOR THE LOSS IS NOT OCCURRING.
THE INSURANCE COMPANY ISSUED A POLICY OF INSURANCE TO THE INSURED, WHICH PROVIDED COVERAGE FOR LOSS CAUSED BY A CATASTROPHIC GROUND COVER COLLAPSE AND COLLAPSE OCCURRING DURING THE POLICY PERIOD. ON OR ABOUT MARCH 6, 2017, THE INSURED SUFFERED A DIRECT PHYSICAL LOSS TO HIS INSURED PROPERTY THAT WAS INSURED BY THE INSURANCE COMPANY DUE TO CATASTROPHIC GROUND COVER COLLAPSE AND/OR COLLAPSE. THE INSURED PROMPTLY REPORTED THE LOSS TO THE INSURANCE COMPANY. THE INSURED HAS MADE AN APPLICATION FOR INSURANCE BENEFITS UNDER THE POLICY, BUT THE INSURER HAS FAILED AND REFUSED TO PAY THE FULL BENEFITS TO WHICH THE INSUREDS ARE ENTITLED FOR THE LOSS. THE INSURANCE COMPANY HAS BREACHED THE POLICY OF INSURANCE BY FAILING TO PAY ALL OF THE BENEFITS DUE UNDER THE POLICY.
THE INSURANCE COMPANY RETAINED PINNACLE ENGINEERING AND CONSULTING (PINNACLE), WHO IDENTIFIED STRUCTURAL DAMAGE TO THE INSURED PROPERTY UNDER CRITERION 1 AND 2. PINNACLE ALSO RECORDED FLOOR ELEVATION OF 5.3 INCHES WITHIN THE INTERIOR FLOOR SLAB. FURTHER, PINNACLE OBSERVED A DEPRESSION IN THE FLOOR SLAB OF THE INSURED PROPERTY. FINALLY, PINNACLE CONCLUDED THAT THE FLOOR DEFLECTION WAS THE RESULT OF REDUCTION OF SOIL VOLUME DUE TO THE DECOMPOSITION OF ORGANIC MATERIAL (HIDDEN DECAY WITHIN THE FOUNDATION SYSTEM. THAT SAID, PINNACLE CONCLUDED THAT A CATASTROPHIC GROUND COVER COLLAPSE EVENT HAD NOT OCCURRED ON THE INSURED PROPERTY AS THEY WERE NOT RELATED TO “GEOLOGICAL ACTIVITY” AND DUE TO A GOVERNMENTAL AGENCY NOT HAVING CONDEMNED THE PROPERTY. PINNACLE DID NOT ADDRESS WHETHER THE PROPERTY HAD SUSTAINED A COLLAPSE, AS PROVIDED IN POLICY FORM SFIV HO 09 CLP 01 06.
BY LETTER DATED OCTOBER 2, 2020, NEARLY 3 MONTHS AFTER THE REPORT OF THE LOSS, SFIC DENIED THE INSURED’S CLAIM. IN ITS LETTER SFIC STATED THAT, BASED ON THEIR ENGINEER’S REPORT, THAT THE DAMAGES WERE CAUSED BY NATURAL LONG-TERM SETTLEMENT AND THAT THEY ELIMINATED CATASTROPHIC GROUND COVER COLLAPSE. THIS WAS BASED ON THE ENGINEERS FLOOR ELEVATION STUDY AND GEOLOGICAL STUDY. NOTABLY, QUOTING PINNACLE, SFIC ACKNOWLEDGED THAT THE INTERIOR FLOOR DEFLECTION WAS ATTRIBUTED TO REDUCTION OF SOIL VOLUME DUE TO THE DECOMPOSITION OF ORGANIC SOIL MATERIAL. ODDLY THEN, SFIC’S DENIAL LETTER DID NOT ADDRESS THE ADDITIONAL COVERAGE OF COLLAPSE. AS SUCH, SFIC MISREPRESENTED PERTINENT FACTS OR INSURANCE POLICY PROVISIONS RELATING TO OVERAGES AT ISSUE.
IT IS SIGNIFICANT TO NOTE THAT PINNACLE ENGINEERING AND CONSULTING’S REPORT AND TESTING DATA DETAILED DECOMPOSITION OF ORGANIC MATERIALS, WHICH HAD RESULTED A REDUCTION OF SOIL VOLUME AND INTERIOR FLOOR SLAB DEFLECTION/SLOPING WHICH RESULTED IN CRACKS AND SEPARATIONS IN THE INTERIOR WALLS. IN THE FERNANDEZ REPORT PINNACLE CONCLUDED THAT SUCH CHANGE WAS “NOT RELATED TO GEOLOGICAL ACTIVITY.” PARADOXICALLY, IN A REPORT ISSUED BY PINNACLE ENGINEERING BY ITS OWNER AND PRINCIPAL ENGINEER, BARRY SMITH, P.E., PINNACLE, EVALUATING A PROPERTY FOR CATASTROPHIC GROUND COVER COLLAPSE, CONCLUDED THE FOLLOWING REGARDING DECOMPOSITION OF ORGANIC MATERIALS BENEATH ANOTHER PINELLAS COUNTY PROPERTY, “GEOLOGICAL ACTIVITY INVOLVING TIME-RELATED CHANGING OF SOILS CRITICAL TO THE SUPPORT OF THE STRUCTURE RESULTED OF DOWNWARD SOIL MOVEMENT WITH LOCAL COLLAPSE ZONES… IN ORDER TO CORRECT THE DETRIMENTAL EFFECTS OF THE PROBLEMATIC GEOLOGICAL ACTIVITY AND RESTORE CRITICAL SUPPORT TO THE FOUNDATION AND INTERIOR FLOOR SLAB OF THE HOME, WE RECOMMEND THAT A SYSTEM OF FOUNDATION/SLAB UNDERPINNING, FLOWABLE FILL PLACEMENT, AND POLYURETHANE MATERIAL INJECTION IS IMPLEMENTED.” ACCORDINGLY, IN SIMILARLY SITUATED PROPERTIES, PINNACLE HAS CONCLUDED SUCH CONDITIONS WARRANT REPAIR TO PREVENT IMMINENT, FURTHER COLLAPSE OF THE STRUCTURE. IT IS APPARENT THAT MR. FERNANDEZ IS BEING TREATED DIFFERENTLY THAN OTHER INSUREDS, THAT MATERIAL MISREPRESENTATIONS REGARDING BOTH THE POLICY AND THE FACTS SURROUNDING HIS CLAIM ARE BEING MADE BY SFIC AND/OR ITS RETAINED ENGINEERS, THAT THE INSURER DENYING CLAIMS WITHOUT CONDUCTING REASONABLE INVESTIGATIONS BASED UPON AVAILABLE INFORMATION; AND THAT SFIC IS FAILING TO ADOPT AND IMPLEMENT STANDARDS FOR THE PROPER INVESTIGATION OF CLAIMS.
CONCERNED WITH THE SUFFICIENCY OF THE INSURER’S INVESTIGATION, THE INSURED STRUCTURAL ENGINEERING AND INSPECTIONS INC., (SEI) TO CONDUCT AN INSPECTION OF THE PROPERTY AND PERFORM CORE TESTING OF THE SLAB. IN CONDUCTING ITS FLOOR ELEVATION SURVEY, SEI FOUND A TOTAL FLOOR ELEVATION DIFFERENCE OF 5.4 INCHES WITHIN THE INTERIOR OF THE HOME ADDITIONALLY, THIS ELEVATION DIFFERENCE OCCURS OVER A DISTANCE AS SMALL AS 20 FEET. THIS INCREASE OF .1 INCHES IN THE STRUCTURE WAS RECORDED LESS THAN 5 MONTHS AFTER PINNACLE’S EVALUATION, INDICATING ACTIVE ABRUPT MOVEMENT OF THE SLAB. BASED ON THIS AND ADDITIONAL OBSERVATIONS, SEI ISSUED A LETTER TO THE BUILDING SERVICES DEPARTMENT, DATED MARCH 4, 2021, INFORMING THEM THAT DANGEROUS AND/OR UNSAFE CONDITIONS AS DEFINING WITHIN THE FLORIDA BUILDING CODE EXIST AT THE FERNANDEZ PROPERTY.
THEREAFTER, THE BUILDING OFFICIAL FOR THE CITY OF LARGO INSPECTED THE PROPERTY. BASED UPON ITS INSPECTION, THE BUILDING OFFICIAL FOR THE CITY OF LARGO DECLARED THE PRINCIPAL BUILDING UNFIT FOR HUMAN HABITATION OR OCCUPANCY AND THAT IT WAS UNLAWFUL TO OCCUPY THE BUILDING. WITH THIS BRANDING BY THE BUILDING OFFICIAL, THE PRINCIPAL BUILDING CANNOT BE OCCUPIED FOR ITS CURRENT INTENDED PURPOSE.
ON MARCH 29, 2021, SEI ISSUED A REPORT OF ITS FINDINGS WHEREIN IT CONCLUDED THAT CATASTROPHIC GROUND COVER COLLAPSE HAD OCCURRED AT THE INSURED PROPERTY. BASED UPON ITS FINDINGS, SEI RECOMMENDED EITHER DEMOLITION OF THE RESIDENCE AND REBUILD UPON A DEEP FOUNDATION OR LIMITED DEMOLITION AND A PROGRAM OF STABILIZATION AND FOUNDATION REPAIR/REPLACEMENT OF STRUCTURAL COMPONENTS. SEI’S SECOND OPTION WAS ESTIMATED TO COST $484,315.00, EXCLUSIVE OF COSMETIC REPAIRS TO THE STRUCTURE FOLLOWING STABILIZATION. THE PRINCIPAL BUILDING HAS SUSTAINED A TOTAL LOSS DUE TO THE COVERED PERIL OF CATASTROPHIC GROUND COVER COLLAPSE. SIMULTANEOUSLY, THE INSURED PROPERTY HAS SUSTAINED A TOTAL LOSS DUE TO THE COVERED PERIL OF COLLAPSE.
THE COVERED BUILDING IS IN NEED OF STABILIZATION AND ABOVE-GROUND, COSMETIC REPAIRS. THE INSURANCE COMPANY KNEW THAT THAT THE INSURED PROPERTY HAD SUSTAINED SIGNIFICANT STRUCTURAL DAMAGE DUE TO CATASTROPHIC GROUND COVER COLLAPSE AND, YET, TOOK NO ACTION TO ISSUE PAYMENT PURSUANT TO THE POLICY OR, OTHERWISE, REPAIR THE HOME TO PREVENT FURTHER DAMAGES. THE INSURANCE COMPANY’S ACTIONS IN THIS REGARD ARE IN WILFULL DISREGARD FOR THE SAFETY OF ITS INSURED AND OF THE PROVISIONS OF THE INSURANCE POLICY FOR WHICH IT CHARGED PREMIUM.
THE INSURANCE COMPANY HAS FAILED TO SATISFACTORILY SETTLE THE INSURED’S CLAIM AND HAS DEPRIVED THE INSURED OF AN APPROPRIATE RESOLUTION OF THIS CLAIM. THE INSURANCE COMPANY HAS FAILED AND REFUSED TO PROPERLY INVESTIGATE THE LOSS AND HAS FAILED AND/OR REFUSED TO TENDER THE FULL AMOUNT OF INSURANCE PROCEEDS DUE AND OWING TO THE INSURED. THE INSURANCE COMPANY HAS BREACHED THE POLICY OF INSURANCE BY FAILING AND REFUSING TO PROPERLY INVESTIGATE THE LOSS; FAILING AND/OR REFUSING TO TENDER ANY INSURANCE PROCEEDS DUE AND OWING TO THE INSURED.
IN ORDER TO CURE THE CONDUCT GIVING RISE TO THE VIOLATIONS DESCRIBED HEREIN, THE INSURANCE COMPANY MUST ACKNOWLEDGE THAT A COVERED LOSS HAS OCCURRED AND ISSUE PAYMENT FOR ALL COVERED DAMAGES. THE INSURED RELIES UPON THE ESTIMATE OF SEI FOR THOSE REPAIR MEASURES NECESSARY TO REPAIR THE BUILDING’S STRUCTURE AND PREVENT FURTHER DAMAGE. IN THE ALTERNATIVE, AS THE BELOW GROUND REPAIRS AND ADDITION OF ABOVE-GROUND, COSMETIC REPAIRS TO THE STABILIZATION OF THE COVERED BUILDING ARE LIKELY TO EXCEED POLICY LIMITS, THE INSURANCE COMPANY MAY PAY CURE THE ABOVE VIOLATIONS BY ISSUING PAYMENT TO THE INSURED FOR THE FULL COVERAGE A DWELLING LIMITS OF $225,000, COVERAGE D LOSS OF USE $22,500, ORDINANCE AND LAW LIMITS OF $56,250, FOR A TOTAL OF $303,750. IN ADDITION, AS THE INSURANCE COMPANY HAS FORCED THE INSURED TO INITIATE A LAWSUIT TO RECOVER THOSE POLICY PROCEEDS RIGHTFULLY OWED TO HER. THE INSURANCE COMPANY MUST ISSUE PAYMENT TO THE INSURED FOR REASONABLE ATTORNEYS’ FEES, COSTS, AND INTEREST ON ANY CURE PAYMENTS- PURSUANT TO 627.70131, 627.428. ALL APPLICABLE STATUES ARE FROM 2019, WHEN THE SUBJECT POLICY OF INSURANCE WAS FORMED.
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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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