Filing Number: 793728
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| Filing Accepted: 11/21/2024 |
| Last/Business Name
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JEAN
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First Name |
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NICHOLAS AND MARIE |
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| Street Address
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24271 RIVERFRONT DR. |
| City, State Zip
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PORT CHARLOTTE,
FL
33980
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| Email Address
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ERIKA@THEPARDOLAWFIRM.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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JEAN |
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First Name |
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NICOLAS AND MARIE |
| Policy # * |
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SJ30264762 |
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Claim #* |
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SL22209791 |
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Attorney is Applicable
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| Last Name* |
PARDO
First Name *
ERIKA
Initial
L.
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| Street Address* |
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9700 S. DIXIE HWY., SUITE 660 |
| City, State Zip* |
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MIAMI
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FL
33156
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| Email Address * |
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ERIKA@THEPARDOLAWFIRM.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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SLIDE 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 17227 |
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| Name of individual responsible for violation (if any):*
PATRICIA LONG
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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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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)(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)(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)(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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Governed by the cited authorities, the subject policy provides coverage for sudden and accidental roofing system failures that allow ensuing water at the subject property as a result of Hurricane Ian’s heavy wind and rain. The loss payment provision and governing law provides that the insurer has a fiduciary duty to in good faith to promptly investigate, adjust, and issue payment of the undisputed amount of the loss and damages.
Furthermore, the policy provides coverage for, inter alia, assessments in relation to remediation, as well as the amount necessary to perform remediation. The operative relevant Policy of Insurance at issue is an “all risk” Policy which provides as follows and ensuing damages for mold as follows:
SECTION I-PERILS INSURED AGAINST
A. Coverage A-Dwelling and Coverage B- Other Structures
1. We insure against risk of direct physical loss to property described in Coverages A and B.
***
E. Additional Coverages
12. “Fungi” Wet or Dry Rot, Or Bacteria
a. We will pay up to $10,000 for:
(1) The total of all loss payable under Section I – Property Coverages caused by “fungi,” wet or dry rot, or bacteria;
(2) The cost to remove “fungi,” wet or dry rot, or bacteria from property covered under Section I – Property Coverages;
(3) The cost to tear out and replace any part of the building or other covered property as needed to gain access to the “fungi,” wet or dry rot, or bacteria; and
(4) The cost of testing of air or property to confirm the absence, presence, level of “Fungi,” Wet or Dry Rot or Bacteria whether performed prior to, during or after: (a) Removal;
(b) Repair;
(c) Restoration; or
(d) Replacement. The cost of such testing will be provided only to the extent that there is a reason to believe that there is the presence of “fungi,” wet or dry rot, yeast or bacteria.
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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 Complainants and Insureds, NICHOLAS JEAN and MARIE JEAN (hereinafter referred to as “ComplainantS”), maintained a homeowner’s policy of insurance (herein after referred to as “Policy”) with SLIDE INSURANCE COMPANY (hereinafter referred to as “Slide”), which provides coverage for sudden and accidental damages and losses arising from a sudden and accidental roofing system failure which allows ensuing water damages at the subject property which in part may be due to Hurricane Ian’s heavy wind and rain which said damages first manifested on or about September 28, 2022 (“Loss”).
The Loss caused substantial, direct and consequential damages, and Slide’s general business practice of willful, wanton, immoral, deceptive and bad faith claim handling policies, procedures, guidelines, protocol, adjusting, investigating, drawing valuations and issuing payment for the claims, has caused the Complainants to suffer further harm and extra-contractual damages which have accrued, and will continue to accrue.
The stated misconduct outlined below is collectively referred to as “Bad Faith,” and the specific, straightforward factual and/or legal considerations in relation thereto are further outlined below for its consideration in accordance with Fla. Stat. Sec. 624.155 and the cited legal authorities associated therewith.
On or about September 28, 2022, the Complainants suffered direct physical loss to the subject property by way of ensuing water damage that first manifested on said date.
During the adjustment of the claim, the Complainants (through his retained counsel) hired Full Pro Restoration (hereinafter referred to as “Full Pro”), to perform the necessary, industry wide practice of performing moisture meter assessments coupled with the corresponding thermal imaging, to detect latent conditions, which, if undetected, will serve to create toxic conditions at the subject property.
During the adjustment of the claim, all relevant documents from Full Pro, were dutifully provided. To date, no adjuster and/or qualified expert has been retained by Slide to dispute findings of elevated latent levels of water moisture at the subject property via the moisture meter assessments coupled with the corresponding thermal imaging.
Moreover, the Complainants (through his retained counsel) hired OGA Solution LLC to perform mold testing at the subject property. All relevant documents from OGA Solution LLC were dutifully provided during the pre-suit adjustment of the claim. To date, no adjuster and/or qualified expert has been retained by Slide to dispute the positive findings of mold at the subject property.
Pursuant to the positive findings of mold, the Complainant (through his retained counsel) hired Full Pro, to perform the necessary, industry-wide practice of mold remediation, given the positive findings of mold at the subject property. All relevant documentation in relation to the mold remediation performed by Full Pro, was dutifully provided too Slide. To date, no adjuster and/or qualified expert has been retained by Slide to dispute the necessity and/or reasonable course of repairs by way of the mold remediation services provided.
Slide inspected the subject property by way of a field adjuster by the name of Jarvis McKiver (hereinafter referred to as “Mr. McKiver”). It is important to note that Mr. McKiver is not a licensed roofer and all indications as of the date of this filing are that he is not duly qualified to take into consideration latent water damage and the necessary repairs in relation to same. In addition, all indications are that he is not a duly qualified expert that can attest as to the efficient proximate being due to any purported excluded causes of loss.
In addition, as of the date of this filing, Mr. McKiver has failed to dispute the latent water damage that was detected via the moisture meter assessments and/or corresponding thermal imaging, as well as the necessary water remediation services provided, coupled with the mold testing (which was found positive), and corresponding mold remediation to protect the inhabitants of the subject property from toxic conditions.
Based on the insufficient adjustment of the claim as outlined herein, Slide on or about October 16, 2023, issued a wholly unsatisfactory valuations of $4,952.57 (replacement cost value) and $4,729.46 (actual cash value) for the loss.
In opposition to same, and during the adjustment of the claim, on or about July 9, 2023 (prior to suit being filed), the Complainants (through his retained counsel) provided an estimate with a valuation of $207,139.86 replacement cost value, that duly takes into consideration the full extent of the latent conditions, that serve to create a plethora of extra contractual damages that continue to accrue, given Slide’s general business practice of failing to adjust the full extent of the damages as outlined herein. In other words, the Complainants notified Slide of its unsatisfactory, lowball valuation of the underlying claim.
On or about July 9, 2023, the Complainants (through his retained counsel) filed its original Civil Remedies Notice (hereinafter referred to as “CRN”) putting Slide on notice of the alleged bad faith conduct. On or about August 3, 2023, Slide filed its Response. Of importance, therein, Slide alleged that the original CRN failed to provide sufficient specificity as to how the carrier violated the purported 624.155 provisions.
As to the purported lack of sufficient specificity, the facts outlined above clearly rebut any perceived prejudice in said regard. The sufficient specificity and/or particularity as to the facts and/or circumstances outlined by this bad faith conduct cannot be clearer.
To cure the above stated immoral, deceptive, unlawful and collectively defined general business practice of bad faith claims handling practices that are knowingly, willfully, wantonly and/or with a reckless disregard for the insured’s interests being implemented, Universal must perform as follows within 60 days of receiving this CRN:
I. Take corrective action in association with the Bad Faith claims handling practices by way of rectifying same, and thereafter duly adjusting, investigating and issuing payment for all benefits owed to the Complainants as per the industry wide accepted standards outlined herein.
To hold otherwise, would allow Slide’s bad faith claims handling described above to leave the insureds, the insureds’ counsel, the insurer’s counsel, and even the judiciary guessing as to when and how Slide will duly perform.
These continuously vacillating positions and cherry-picking of the described bad faith conduct outlined herein, not only serves to maximize Slide’s prospective financial gains by being able to avoid paying benefits, it also serves to minimize Slide’s loss adjusting expenses as it sees fit to the invariable detriment of the insureds, the Complainants, and ultimately the tax paying citizens of this State that bear the expense of the judicial system, which needs to be unraveled due to the tangled web created by Universal.
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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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