Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 793020

Filing Accepted: 11/18/2024

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Complainant

Last/Business Name *

ROMANELLO

First Name

DOROTHY AND LAWRENCE

Street Address *

3634 VALLEYBROOK WAY

City, State Zip *

THE VILLAGES, FL 32163

Email Address *

MCOHEN@ITSABOUTJUSTICE.LAW, DORRIEDO@AOL.COM

Complainant Type: *

Insured

Last/Business Name*		ROMANELLO		First Name		DOROTHY AND LAWRENCE
Policy # *		FLP229390		Claim #*		1433009-241013

Attorney

Attorney is Applicable

Last Name*	COHEN First Name * MADISON Initial
Street Address*		350 N LAKE DESTINY RD.
City, State Zip*		MAITLAND , FLORIDA 32751
Email Address *		MCOHEN@ITSABOUTJUSTICE.LAW

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		ASI PREFERRED INSURANCE CORP.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 13142

Name of individual responsible for violation (if any):* TRAVIS MURPHY, AND ALL ADJUSTERS, AGENTS, REPRESENTATIVES, OF ASI PREFERRED INSURANCE CORP. WHO WORKED ON THIS CLAIM
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Delay
	Unsatisfactory Settlement Offer
	Unfair Trade Practice
	Claim Denial

* 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.
	624.155(1)(b)(3)		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.
	626.9541(1)(i)(2)		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.
	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)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.
	626.9541(1)(i)(3)(d)		Denying claims without conducting reasonable investigations based upon available information.
	626.9541(1)(i)(3)(f)		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.
	626.9541(1)(i)(3)(g)		Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
	626.9541(1)(i)(4)		Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

A certified copy of the policy is not in the Insureds’ possession, but based on information and belief, the following policy provisions are relevant to this civil remedy notice. Section 1 – Property Coverages – Coverage A – Dwelling Section 1 – Perils Insured Against – Coverage A-Dwelling and Coverage B-Other Structures Section 1 – Conditions –Loss Settlement Section 1 – Conditions –Loss Payment

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about October 10, 2024, the Insureds, Dorothy and Lawrence Romanello, suffered significant damage to their home located at 3634 Valleybrook Way, The Villages, Florida, 32163 as a result of Hurricane Milton. Hurricane Milton was a powerful Category 3 hurricane with maximum wind speed of 120 mph when it made landfall in Florida. The Villages, where the Insureds reside, was in the direct path of Hurricane Milton as the storm moved inland and experienced high sustained winds and wind gusts, as well as substantial rainfall. Insured’s community has thousands of residents who were impacted by Hurricane Milton and who suffered severe damages. Prior to the loss, ASI Preferred Insurance Corporation (hereinafter, “ASI”), issued an insurance policy (Policy No.: FLP229390) for the Insureds’ property. Said policy, which was issued prior to the loss, was in full force and effect on the date of loss and afforded coverage for damage caused by a hurricane. ASI was timely notified of the loss by the Insured and assigned claim number 1433009-241013. During the course of ASI’s investigation, the Insureds made their property available for inspection, provided facts and information surrounding the loss, and complied with Insurers adjustment of the claim. Upon information and belief, ASI routinely engage in a pattern and practice of refusing to insurance benefits it knows it owes as a means to “starve” its insureds and force them to take less than what they are owed. Although ASI acknowledged the Insureds’ property was damaged by the catastrophic storm, ASI inexplicably underpaid a majority of the damages claimed, specifically with respect to the roofing system and exterior of the residence. ASI came to its coverage determination by ignoring relevant facts and information provided by the Insureds and their contractors that established the substantial damages to the roofing system were unquestionably the result of Hurricane Milton and required a full replacement. Most concerning, ASI and its representatives intentionally downplayed and misrepresented the scope of the damages. Insurers also omitted key facts from its coverage decision and misapplied exclusions to minimize its financial exposure in the claim. ASI’s dilatory tactics have continued even after the Insureds notice of intent to initiate litigation. A certified copy of the policy is not in the Insureds’ possession, despite the formal request sent on October 23, 2024. Furthermore, Insureds have pleaded with ASI to properly pay for the damages prior to going to the courthouse, however, ASI has refused to properly adjust the claim. As a result of Insurer’s flawed investigation and refusal to tender the full benefits owed under the policy, Insureds are forced to file suit against ASI for breach of contract. Notably, the independent adjuster that Insurer sent out to conduct the re-inspection of the property stated that they were instructed by the Insurer to not adjust claim damage to the roofing system for replacement when full replacement would be warranted. Furthermore, ASI’s “Senior Property Adjuster” Travis Murphy FL License #W872444 materially misrepresented the facts in the response to the notice, acknowledging the notice of intent to initiate litigation that was received on November 1, 2024 did in fact provide a pre-suit settlement demand which itemizes damages, attorney fees and costs. After receiving the correspondence, Insured’s counsel politely tried to reason with Mr. Murphy to reach a fair and proper resolution to the claim in light of the amount of loss dispute. The Insurer’s reinspection took place on November 5th, 2024. As we sit here today, Mr. Murphy has not provided any meaningful response to resolve the dispute nor has the Insurer provided the estimate from the reinspection. ASI has not acted honestly or fairly towards its Insureds during the adjustment of its claim. ASI and its representatives have failed to conduct a proper investigation of the loss, misrepresented the cause and scope of damages at the residence, and misapplied exclusions in the policy in order to wrongfully underpay the Insureds’ claim. It has become a general business practice of Insurers to not implement proper claims handling procedures, to hire consultants that routinely ignore or intentionally misidentify relevant evidence, and to not settle claims in good faith when under all the circumstances it should have. ASI capriciously denies coverage or otherwise refuses to tender full payment owed under their policies without conducting reasonable investigations based on information available to it. ASI insured this property against a hurricane loss knowing full and well that such catastrophic event was statistically likely and collected insurance premiums from Insurers but has failed to honor its obligation to Insureds when it needed ASI. As such, ASI has once again put its corporate profits ahead of the interests of its insureds. As evidenced here, it is a pattern and practice for ASI to arbitrarily undervalue claims without conducting reasonable investigations based upon information and evidence available to it. It is also a general business practice of ASI to not respond to claim communications, to not explain what information is necessary to process the claim, and to not explain why benefits are continuing to be withheld under the policy. ASI’s actions are part of a broader scheme to delay claims and avoid issuing payment that ASI knows is owed to its insureds. In order to cure this civil remedy notice, ASI must immediately acknowledge in writing that the damages claimed by the Insureds were caused by Hurricane Milton and that replacement of the roofing system, and any other damages caused by Hurricane Milton, are covered under the insurance policy. ASI must also tender the undisputed benefits owed to replace the roof pursuant to the terms of the policy. The written acknowledgement and payment should be issued to the Insureds’ counsel, Madison Cohen, Esq., Cohen Law Group, at 350 N. Lake Destiny Road, Suite 300, Maitland, FL 32751.

Comments

User Id		Date Added		Comment
darryl_j_roles@progressive.com		01-06-2025		While ASI Preferred Insurance Corp 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 Ms. Cohen, on January 6, 2025.

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. 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