Filing Number: 793378
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| Filing Accepted: 11/20/2024 |
| Last/Business Name
*
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TURNER
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First Name |
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BARBARA & GREGORY |
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| Street Address
*
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8386 ODIS YARBOROUGH ROAD |
| City, State Zip
*
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GLEN SAINT MARY,
FL
32040
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| Email Address
*
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DAMIAN@JBCONSTRUCTIONLAW.COM |
| Complainant Type:
*
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Insured |
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| Last/Business Name* |
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TURNER |
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First Name |
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BARBARA & GREGORY |
| Policy # * |
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FLP232467 |
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Claim #* |
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1322516-241013 |
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Attorney is Applicable
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| Last Name* |
HUNT
First Name *
DAMIAN
Initial
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| Street Address* |
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PO BOX 351502 |
| City, State Zip* |
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PALM COAST
,
FLORIDA
32135
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| Email Address * |
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DAMIAN@JBCONSTRUCTIONLAW.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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ASI PREFERRED INSURANCE CORP.
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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 13142 |
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| Name of individual responsible for violation (if any):*
RICARDO HERRERRA
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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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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)(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)(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.
Section 1 – Perils Insured Against – Coverage A - DWELLING; Section 1- Conditions – Loss Settlement Section 1 – Conditions - Loss Payment
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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.
The Insured, the Turners, sustained significant storm damage to his property located at 8386 Odis Yarborough Road, Glen Saint Mary, FL 32040. Prior to the loss, ASI PROGRESSIVE issued a policy covering the Insured's home. The Insured filed the subject claim and ASI PROGRESSIVE assigned claim number 1322516-241013. Throughout the investigation, the Insured fully cooperated with all of ASI PROGRESSIVE’s requests, providing access to the property and submitting relevant documentation.
However, despite this cooperation, ASI PROGRESSIVE never provided a final coverage position. As a direct result of ASI PROGRESSIVE’s inaction, the Insured has been forced to retain legal counsel and will likely pursue legal action for breach of contract unless this claim is properly resolved before the expiration of this Civil Remedy Notice (CRN).
On August 20, 2024, Counsel for the Insured filed a Notice of Intent to Initiate Litigation (hereinafter "NOI"). The statute which created the NOI, 627.70152, requires an insurance company to respond to the NOI within ten (10) business days. As such, a response was due on or before September 3, 2024. As of today's date, no response has been received, in direct violation of Section 627.70152. ASI's failure to adopt and implement standards for the proper investigation of the claim and failure to act fairly and honestly toward it's insured has delayed the claim position and has left the Insured without a coverage position.
The Insured has submitted clear and compelling evidence, including photographs, estimates, and weather data, supporting the claim that the roof sustained damage due to a covered peril. Yet, ASI PROGRESSIVE has ignored this evidence and has refused to provide a coverage position. This action is both unjust and contrary to the terms of the policy.
It is apparent that ASI PROGRESSIVE failed to conduct a thorough and honest investigation of the loss. Furthermore, ASI PROGRESSIVE’s conduct is inconsistent with industry standards and regulations.
To cure this CRN, ASI PROGRESSIVE must immediately acknowledge, in writing, that the Insured’s roof sustained damage that warrants replacement, and that the necessary repairs to both the exterior and interior of the property are covered under the policy. This acknowledgment should be provided directly to the Insured’s counsel.
ASI PROGRESSIVE’s refusal to honor this claim, despite having collected premiums for coverage, is an unjust denial of its contractual obligations and a failure to act in good faith. The Insured should not bear the financial burden of damages that are clearly covered by the policy.
We urge ASI PROGRESSIVE to rectify this matter promptly by issuing the appropriate acknowledgment and coverage determination in writing, as outlined above.
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*
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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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