Filing Number: 793587
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| Filing Accepted: 11/20/2024 |
| Last/Business Name
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| Street Address
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2655 S. LE JEUNE ROAD SUITE PH1-F |
| City, State Zip
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CORAL GABLES,
FL
33134
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| Email Address
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KEVIN@SASIETALAW.COM |
| Complainant Type:
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Other |
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| Last/Business Name* |
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HERNANDEZ |
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First Name |
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YOANDER |
| Policy # * |
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12-1004442-04 |
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Claim #* |
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UNKNOWN |
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Attorney is Applicable
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| Last Name* |
DIAZ
First Name *
KEVIN
Initial
D
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| Street Address* |
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2655 S. LE JEUNE ROAD SUITE PH1-F |
| City, State Zip* |
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CORAL GABLES
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FLORIDA
33134
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| Email Address * |
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KEVIN@SASIETALAW.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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TYPTAP 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 15885 |
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| Name of individual responsible for violation (if any):*
UNKNOWN
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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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Unfair Trade Practice
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Other
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Failure to Issue a Claim Number or Investigate the Claim
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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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| 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)(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)(e) |
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Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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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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| 626.9541(1)(o)(1) |
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Knowingly collecting any sum as a premium or charge for insurance, which is not then provided, or is not in due course to be provided, subject to acceptance of the risk by the insurer, by an insurance policy issued by an insurer as permitted by this code.
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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 I – PROPERTY COVERAGES
A. Coverage A – Dwelling.
1. We cover:
a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to
the dwelling; and
b. Materials and supplies located on or next to the "residence premises" used to construct, alter or
repair the dwelling or other structures on the "residence premises".
2. We do not cover land, including land on which the dwelling is located.
SECTION I – PERILS INSURED AGAINST
A. Coverage A – Dwelling and Coverage B – Other Structures.
We insure against direct physical loss to property described in Coverages A and B.
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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.
Typtap Insurance Company failed to promptly acknowledge the Insured, Yoander Hernandez's, claim for water damages sustained as a result of a sudden and accidental discharge/overflow of water in his home (i.e., water damage loss) that occurred on October 13, 2022 to the Insured's property located at 9205 Keating Dr. Palm Beach Gardens, FL 33410. Typtap failed to properly adopt and implement standards to open new claims, properly assign a claim number to a matter reported to them, and conduct an adequate investigation regarding their Insured's property.
Typtap never responded to the Insured's representative, Aid Adjuster & Appraiser Consultants, LLC, in numerous attempts that the latter made via phone and email inquiring about the claim status for the Insured's water damage loss noted above.. A copy of the numerous attempts at contacting Typtap Insurance Company are attached hereto as supporting documentation for this Civil Remedy Notice. The Insurer has a duty to investigate claims when reported. Typtap failed to communicate with the Insured and its representative in assigning a claim number to the October 13, 2022 water damage loss. At no point did Typtap bother communicating with the Insureds following numerous letters sent to Typtap including an October 20, 2022 correspondence sent via email to claims@typtap.com containing a Letter of Representation advising of the 90 day deadline to determine coverage for the claim stating:
Attn: Claims Department,
Please see attached correspondence for Yoander Hernandez policy number 12-100442-04.
(Docs: LOR / CP / 90DayLtr)"
No response was received from Typtap.
A Second e-mail was sent on November 3, 2022 by Aid Adjuster & Appraiser Consultants, LLC on behalf of the Insured requesting a status for the same claim. Specifically, the email states:
"Attn: Claims Department,
Please assist us with status for Yoander Hernandez policy number 12-1004442-04.
Today, our office attempted to obtain information from your claims department, unfortunately we were unable to receive any information. Our called was transferred to Homeowner's Choice Insurance claims department every time we dialed your claims department contact number 844-289-7968.
Kindly provide updates on this claim caused by water damage."
Like the first email, no response was ever received.
A Third e-mail was sent on December 20, 2022 by Aid Adjuster & Appraiser Consultants, LLC on behalf of the Insured requesting a status for the same claim. Specifically, the email states:
"Attn: Claims Department,
Attached you will find our estimate along with restoration company report as well as leak detection.
Please assist us with status for Yoander Hernandez policy number 12-1004442-04.
Our office attempted to obtain information from your claims department in numerous occasions (6 times total), unfortunately we were unable to receive any information. Our called was transferred to Homeowner's Choice Insurance claims department every time we dialed your claims department contact number 844-289-7968.
Kindly provide updates on this claim caused by water damage.
Thank you in advance for your prompt response."
Like the first 2 emails, the Third e-mail was never responded to by Typtap.
A fourth e-mail, including several attachments, was sent to Typtap Insurance company to its claims e-mail providing additional documents to Typtap. No response by Typtap was ever received to this e-mail.
Mr. Hernandez has paid Typtap premiums in exchange for residential insurance coverage to his property and should be able to have an insurance company respond adequately to his attempts (through his representative) at opening a claim for water damages to his property.
It is clear that Typtap made egregious errors that have cost the Insured time and expense. Typtap Insurance Company should be held responsible for failing to investigate the insured's water damage claim and failing to ever assign a claim number for a severe matter that they were placed on ample notice of.
To correct Typtap Insurance Company's egregious errors and violations of Florida law as set forth above and explained in the facts and circumstances above, Typtap must pay the Insured's damages from the loss of $94,274.19 as explained in the damage estimate prepared by Aid Adjuster & Appraiser Consultants, LLC and the mitigation invoices incurred by the Insured as a result of their water loss in the amount of $5,117.19.
Any and all responses to this Civil Remedy Notice should be addressed to:
Kevin D. Diaz, Esq.
c/o Yoander Hernandez
Sasieta Law, PLLC
2655 S. Le Jeune Road, Suite PH1-F
Coral Gables, FL 33134
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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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