Civil Remedy Notice of Insurer Violations
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Filing Number:     793462
Filing Accepted:  11/20/2024
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Complainant
Last/Business Name *  
FLORES   First Name   STEVEN AND LUANN
Street Address * 2291 WADEVIEW LOOP
City, State Zip * SAINT CLOUD, FL 34769
Email Address * STEVENFLORES90@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   FLORES   First Name   STEVEN AND LUANN
Policy # * FLP399985 Claim #* 1437149-241013
Attorney
Attorney is Applicable
Last Name* PHARIS First Name * BRANDON Initial M
Street Address* 350 N. LAKE DESTINY RD
City, State Zip* MAITLAND , FL 32751
Email Address * BPHARIS@ITSABOUTJUSTICE.LAW
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   ASI PREFERRED INSURANCE CORP.
NAIC Company Code 13142
 
Name of individual responsible for violation (if any):* GAIL SIBBLE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Pattern and Practice of Unfair and Unjust Claims Handling
Other : Failure to Train and Supervise Employees and Agents
* 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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Based on information and belief, the following policy provisions apply to this civil remedy notice: Section 1 – Property Coverage: Coverage A – Dwelling 10. Loss Payment. We will adjust all losses with you. . .
 
* 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, Steven and Luann Flores (the “Insureds”) suffered damage to their residence located at 2291 Wadeview Loop, Saint Cloud, FL 34769, which was caused by Hurricane Milton. Prior to the loss, ASI Preferred Insurance Corp. (“ASI”) issued a homeowner’s insurance policy (Policy # FLP399985) for the Insured’s property. The policy was in full force and effect on the date of loss. ASI assigned claim number After providing notice of the loss, the Insured fully cooperated with ASI’s adjustment of the claim, including making their property available for inspection and providing all documents requested. ASI wrongfully under adjusted the Insureds’ request for a full roof replacement based on the extensive damages resulting from Hurricane Milton. ASI opened coverage for a repair of more than 37% of the Insured’s roof. Upon information and belief ASI was provided information during the adjustment of the claim and is fully aware that this roof requires a full replacement and not a repair, however, instead of doing what it is charged with as an insurance carrier in the State of Florida, ASI has chosen to underpay its Insureds and force the Insureds to retain an attorney in order to fight for what is rightfully the Insureds. This is not the first case where ASI has conducted itself in this manner, in fact it has become a pattern and practice for ASI to routinely act in a manner that could be perceived as being conducted to defraud its insureds and swindle them out of benefits that are rightfully owed to its insureds. Upon information and belief ASI has misrepresented the facts of the Insured’s Hurricane Milton claim by providing information that only a roof repair was required. Upon information and belief ASI is in possession of the requisite facts to support that a roof replacement is required due to the extensive damages from Hurricane Milton. Instead of adjusting the claim based on these facts ASI has intentionally chosen to under adjust the claim of its Insureds and require its Insureds to dispute the coverage determination before being willing to do the right thing and make full payment for the claim. Again, this does not appear to be an isolated incident. Upon information and belief ASI has established a pattern and practice of underpaying its Insureds claims when it is fully aware that the insureds damages are more extensive than what ASI is allowing coverage for. Just recently 60 Minutes did a story alleging how a Florida insurance company has defrauded its insureds by changing estimates without notifying the adjusters who originally drafted the estimate for a much higher amount. Additionally, a now defunct Florida insurance company who was sued alleging that it instructed its adjusters to not write for specific damages resulting from Hurricane Irma. It appears that ASI is determined to follow the path of these insurance companies in its outright and potentially fraudulent conduct towards its insureds. To add insult to injury, the Insured involved in this claim is a first responder who risks his life on a day-to-day basis to protect our community. To know this is how ASI treats its first responders in their time of need should be a call to all first responders, whether in Florida or abroad, to put significant thought into whether to insure with a company that treats first responders in this manner. To remedy this CRN, UPC must immediately tender the full amount of insurance benefits still owed of $41,899.41 for a full roof replacement, less any applicable deductible and subject to applicable coverage limitations and prior payments set forth in the policy. The payment should be tendered to the Insured’s attorney, Brandon M. Pharis, Esq. at 350 N. Lake Destiny Road, Suite 300, Maitland, FL 32751.
Comments
User Id Date Added Comment
darryl_j_roles@progressive.com 01-15-2025 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 Mr. Pharis, on January 15, 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.

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DFS-10-363
Rev. 10/14/2008