Filing Number: 793300
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| Filing Accepted: 11/19/2024 |
| Last/Business Name
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| Street Address
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195 CEDAR ISLAND ROAD |
| City, State Zip
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PERRY,
FL
32348
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| Email Address
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STACIGRIFFIS@HOTMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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GRIFFIS |
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First Name |
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JODY |
| Policy # * |
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03119943 |
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Claim #* |
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CH0524427473 |
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Attorney is Applicable
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| Last Name* |
KANDELL
First Name *
SCOTT
Initial
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| Street Address* |
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2665 S BAYSHORE DRIVE, SUITE 500 |
| City, State Zip* |
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MIAMI
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FLORIDA
33133
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| Email Address * |
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CRNREPLY@KKPFIRM.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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MONARCH NATIONAL 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 15715 |
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| Name of individual responsible for violation (if any):*
AGENTS OF MONARCH NATIONAL INSURANCE COMPANY
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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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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)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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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.
Failure to provide specific policy language is not a fatal omission in complying with Fla. Stat. 624.155. Presently the policy is unavailable to the Insureds. Insureds are unsure and unaware of policy language that applies to the carrier's violation of Florida’s statutes. Insureds reserve the right to add applicable policy language at such time the policy is made available.
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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 September 26, 2024, the insured property located at 195 Cedar Island Road, Perry, Florida 32348 (“Property”), owned by Jody and Staci Griffis (“Insureds”), suffered catastrophic damage resulting in a total loss due to Hurricane Helene.
Hurricane Helene struck Perry, Florida as a powerful Category 4 storm, leaving behind extensive destruction. The hurricane generated winds over 140 mph, devastating nearly 90% of homes and infrastructure. This event marks one of the most severe impacts on Florida’s Big Bend region in recent history. Specifically, this natural disaster devastated Perry, Florida, which was in the eye of the storm along with the immediate surrounding neighborhoods.
At the time of loss, the Property was insured under a residential homeowner’s insurance policy, Policy No. 03119943 (“Policy”), issued by Monarch National Insurance Company (“Monarch”). The Policy covers losses due to wind damage, a peril which indisputably affected the Property during Hurricane Helene.
Following the Insureds’ prompt reporting of the loss, Claim No. CH0524427473 (“Loss”), Monarch arranged an inspection by Forensic Consultants of North America. This inspection noted that the Property — then reduced to the remnants of a wood-framed, one-story structure on wood piles — was severely impacted by Hurricane Helene. However, Monarch issued a denial on November 18, 2024, citing Forensic Consultants of North America’s conclusion that storm surge was the cause of the destruction rather than the 145 mph wind speeds which hammered the area for over six hours, thus excluding coverage under the Policy.
Despite the engineering report, there is no dispute that the Property sustained intense wind forces from the hurricane, causing damage independent of flood-related forces. Monarch has completely failed to acknowledge the impact of the wind, instead broadly categorizing the total loss as flood damage to their financial advantage. Monarch fails to address the severe winds which impacted the property well before the storm surge even arrived in an effort to avoid providing coverage. This approach appears to be part of a pattern and practice of wrongful denial in similar claims to avoid paying for wind damage. The systematic denial of these claims by categorizing them solely as flood rather than acknowledging the severe winds which caused destruction to the property first is an act of bad faith on behalf of Monarch.
Under Florida’s Valued Policy Law (“VPL”), Fla. Stat. 627.702, when a covered peril renders property a total loss, as in this case, the insurer must pay the full policy limits. It is undisputed that the Insureds’ Property is a total loss, and therefore they are entitled to the policy limits.
To cure these violations, Monarch must issue payment under Florida’s VPL for the Policy limits under Coverages A and B, compensating the Insureds fully for the total loss of the insured Property due to wind damage, as well as pay all statutory interest on overdue amounts.
Monarch has made numerous material misrepresentations as to the facts of this Loss with the intent of effecting settlement of this claim on less favorable terms than those provided in the Policy. Monarch has insisted via communications that it intends on promptly handling and resolving this claim but has substantially delayed said resolution. As a general business practice, Monarch has demonstrated, both throughout this claim, and others, that it has failed to adopt and implement standards for the proper investigation of claims, frequently delaying its insureds’ claims and leaving them to retain their own adjusters and attorneys to ensure proper handling.
Monarch has not attempted in good faith to settle this claim when under all the circumstances it could and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for their interests. It has failed to promptly settle this claim when the obligation to settle has become reasonably clear.
As a result of Monarch’s lack of cooperation, the Insureds have been forced to exercise their only remaining option: retaining counsel and filing a lawsuit, costing them money and reducing their ultimate recovery, preventing them from being fully indemnified and denying them the opportunity to rebuild their Property.
Monarch has acted in bad faith by denying the Insureds’ claim without fully investigating or accounting for the wind damage sustained by the Property. In failing to provide the owed benefits, Monarch has neglected its duty to act fairly and in good faith toward the Insureds. Monarch must promptly pay the full policy limits for the total loss of the Insureds’ Property in accordance with Florida’s VPL to cure these violations.
In order to remedy these violations, Monarch must immediately issue an undisputed payment in connection with this claim as well as statutory interest under Fla. Stat. 627.70131 and undertake bilateral adjustment of the claim with the Insureds or their representatives per the terms and conditions of the Policy, at minimum outlining any disputes and setting forth the reasons in support of any position or compromise.
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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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