Filing Number: 793069
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| Filing Accepted: 11/19/2024 |
| Last/Business Name
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UNDERWAGER
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First Name |
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DOUGLAS AND ALICIA |
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| Street Address
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3972 SUNSET LAKE DRIVE |
| City, State Zip
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LAKELAND,
FL
33810
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| Email Address
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WITHHELD |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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UNDERWAGER |
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First Name |
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DOUGLAS AND ALICIA |
| Policy # * |
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4192684392 |
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Claim #* |
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01000113953 |
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Attorney is Applicable
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| Last Name* |
GUTIERREZ
First Name *
DANIEL
Initial
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| Street Address* |
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924 DELANEY AVENUE |
| City, State Zip* |
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ORLANDO
,
FLORIDA
32806
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| Email Address * |
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SERVICE@DGPALAW.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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FIRST PROTECTIVE 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 10897 |
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| Name of individual responsible for violation (if any):*
ANA M. ALVARADO
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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 Delay
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Claim Denial
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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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| 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)(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)(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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| 626.9541(1)(i)(3)(g) |
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Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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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.
The carrier has failed to properly adjust and pay the claim pursuant to the Section I – Conditions, Loss Settlement provision and the Section I – Conditions, Loss Payment provision.
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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.
On or about June 26, 2024, the home of Alicia and Douglas Underwager (hereinafter referred to the “Insureds”) was damaged by a storm. Specifically, lightning caused damage to the exterior of the home and interior damages ensued. The Insureds reported these damages to their homeowners’ insurance company, Frontline Insurance (hereinafter referred to as “Insurer”). The Insurer responded to the claim and inspected the damages. Additionally, the Insurer retained an engineer to inspect the property.
The engineer confirmed that brown tree branches and damaged lightning fixtures are considered collateral damage from lightning striking the property. However, despite this acknowledgement the engineer did not find storm or lightning damages to the roof. The insurer acknowledged minimal coverage of $1,390.85 after application of the deductible.
The Insureds believed the damages to much more extensive than what the carrier acknowledged. Therefore, they retained an attorney. Additionally, a contractor on behalf of the Insureds inspected the property and prepared an estimate of damages for repairs to lightning and storm related damages. The contractor’s estimate included replacement of the roof and interior repairs and totaled $163,440.69 RCV and $160,633.39 ACV.
It is clear that the carrier is not treating the Insureds with good faith claims conduct by failing to pay a claim clearly owed, not adjusting the claim and evaluating the loss properly, failing to promptly and fairly provide full and prompt indemnity to the Insureds, failing to provide a reasonable explanation in writing of the basis in the insurance policy in relation to the facts for the denial of the claim, and failing to implement proper standards for the adjustment and investigation of claims by its adjusters. This Insurer is placing the company’s interests before the Insureds’ interests when a reasonable carrier in a similar position would have provided full coverage. In particular, it is a business practice of the Insurer to severely lowball tile roof damage claims with their initial claim adjustment with the intent of effecting settlement of such claims on less favorable terms than those provided by the policy.
All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the Insured’s rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $160,633.39 ACV (after application of the deductible and reduction for prior payment) 2.) Pay the statutory interest on the amount of unpaid damages from the date the loss was reported to the date payment is finally made.
A copy of this form has been submitted to the FDFS and has been printed out and mailed to the following parties providing them notice of the filing of the Civil Remedy Notice:
First Protective Insurance Company DBA Frontline Insurance
500 International Parkway
Lake Mary, Florida 32746
Certified Return Receipt #9589 0710 5270 1579 4213 47
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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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