Civil Remedy Notice of Insurer Violations
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Filing Number:     793779
Filing Accepted:  11/22/2024
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Complainant
Last/Business Name *  
WIGGINS   First Name   WILLIE MAE
Street Address * 7961 HELSTON DRIVE
City, State Zip * JACKSONVILLE, FL 32208
Email Address * WILLIEWIGGINS59@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   WIGGINS   First Name   WILLIE MAE
Policy # * W014706774 Claim #* 3300510329
Attorney
Attorney is Applicable
Last Name* CAMPIONE First Name * FRANK Initial J
Street Address* 501 W. BAY STREET, SUITE 100
City, State Zip* JACKSONVILLE , FL 32202
Email Address * JASON@CAMPIONELAWPA.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   TOWER HILL INSURANCE EXCHANGE
NAIC Company Code 17179
 
Name of individual responsible for violation (if any):* ANY AND ALL OTHER CLAIMS HANDLERS OR REPRESENTATIVES RESPONSIBLE FOR HANDLING THE CLAIM
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* 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.
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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
* 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 AND SECTION I – PERILS INSURED AGAINST, INCLUDING BUT NOT LIMITED TO: COVERAGE A – DWELLING. ADDITIONAL COVERAGES INCLUDING BUT NOT LIMITED TO ORDINANCE OR LAW, AND ALL OTHER ADDITIONAL COVERAGES PROVIDED UNDER THE APPLICABLE POLICY. ALL OTHER APPLICABLE COVERAGE PROVISIONS, INCLUDING BUT NOT LIMITED TO ALL COVERAGE(S) PROVIDED BY ENDORSEMENT OR RIDER, THE DECLARATIONS PAGE, LOSS PAYMENT OR SETTLEMENT PROVISIONS, AND ALL OTHER PROVISIONS PROVIDING COVERAGE OF THE CLAIM AS PREVIOUSLY SUBMITTED TO THE INSURER. FLORIDA ADMINISTRATIVE CODE SECTIONS VIOLATED 69B-220.201(3) – CODE OF ETHICS. THE WORK OF ADJUSTING INSURANCE CLAIMS ENGAGES THE PUBLIC TRUST. AN ADJUSTER SHALL PUT THE DUTY FOR FAIR AND HONEST TREATMENT OF THE CLAIMANT ABOVE THE ADJUSTER’S OWN INTERESTS IN EVERY INSTANCE. THE FOLLOWING ARE STANDARDS OF CONDUCT THAT DEFINE ETHICAL BEHAVIOR, AND SHALL CONSTITUTE A CODE OF ETHICS THAT SHALL BE BINDING ON ALL ADJUSTERS: 69B-220.201(3) (B)2. – AN ADJUSTER SHALL ADJUST ALL CLAIMS STRICTLY IN ACCORDANCE WITH THE INSURANCE CONTRACT. 69B-220.201(3)(C) – AN ADJUSTER SHALL NOT APPROACH INVESTIGATIONS, ADJUSTMENTS, AND SETTLEMENTS IN A MANNER PREJUDICIAL TO THE INSURED. 69B-220.201(3)(D) – AN ADJUSTER SHALL MAKE TRUTHFUL AND UNBIASED REPORTS OF THE FACTS AFTER MAKING A COMPLETE INVESTIGATION. 69B-220.201(3)(F) – AN ADJUSTER, UPON UNDERTAKING THE HANDLING OF A CLAIM, SHALL ACT WITH DISPATCH AND DUE DILIGENCE IN ACHIEVING A PROPER DISPOSITION OF THE CLAIM.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Tower Hill Insurance Exchange, (“Insurer”) has committed the following in handling the Insured’s claim: 1. Failure to act in due diligence and good faith to resolve claims; 2. Placing financial interest of Insurer before that of the Policyholder and Claimant; 3. Not adjusting the claims promptly and fairly; 4. Not attempting in good faith to handle claims; 5. Looking for ways to deny full recovery to the Insured. On or about May 10th, 2024, Claimant suffered substantial damage to the exterior of the dwelling, due to wind damages, a covered peril under the policy. The policy provides insurance coverage for all the losses, damages, and expenses that Claimant suffered and incurred. The Insurer was provided with an estimate; however, the Insurer still failed to properly evaluate this claim and promptly settle although it has become reasonably clear that it should do so. The Insurer’s improper handling and delay in paying this claim has caused insurmountable damage to the Insured’s home that needs to be remedied immediately. Claimant gave the Insurer prompt and timely notice of Claimant’s claim once damage was discovered. The Insurer has not responded to the claimant’s demand. (1) Estimate for repair as well as other supporting documentation was provided to handling adjuster on October 29, 2024, (2) There are no Invoices for repairs or previous work or maintenance to the roofing to provide, and (3) No EMS documentation in claimant’s possession at this time. The Insurer’s actions amount to but are not limited to the following: 1. Not treating the policyholder with good faith claims conduct 2. Looking for ways to reduce recovery to the Insured 3. Not adjusting claims and evaluating loss properly, promptly, and fairly to provide full and prompt indemnity to the Insured 4. Not training, supervising, or managing adjusters properly so that prompt and full payments are made, but rather placing the company’s interests before the policyholder’s interests 5. Placing the financial interest of the Insurer over that of the Insured. Florida law imposes no requirement to specify a definite cure amount to a civil remedy notice. Talet Enterprises v. Aetna Casualty & Surety Co., 753 So. 2d 1278 (2000). To cure the defects outlines in this civil remedy notice, the Insurer needs to pay the full amount necessary to bring the Insured’s home back to its pre-loss condition. The Insurer must also pay for any statutory costs and fees to which the Insured is entitled. This includes, but is not limited to, attorney's fees and costs, IF INCURRED, pursuant to Florida Statute 627.428, plus a 2.5 multiplier in accordance with the principles of Rowe v. Patient's Compensation Fund.
Comments
User Id Date Added Comment
frank@campionelawpa.com 06-23-2025 Claimant withdraws this notice as the claim has been remedied.
nweber@thig.com 01-10-2025 January 10, 2025 Department of Financial Services Insurance Consumer Assistance Civil Remedy Section Larson Building 200 Gaines Street Tallahassee, FL 32399-0322 RE: Company: Tower Hill Insurance Exchange Company Insured: Willie Wiggins Claim Number: 3300510329 Policy Number: W014706774 Date of Loss: 05/10/2024 DFS File Number: 793779 Acceptance Date: 11/22/2024 Dear Florida Department of Financial Services: Tower Hill Insurance Exchange Company (hereinafter “Tower Hill”) is in receipt of the Civil Remedy Notice of Insurer Violation (hereinafter the “CRN”) filed in this matter on behalf of Willie Wiggins. The CRN is identified as filing number 793779. This shall serve as Tower Hill’s response to the CRN. Tower Hill hereby notifies the Florida Department of Financial Services that all allegations and issues raised in the CRN have been completely and fully resolved by agreement of the parties. In compliance with Florida Statute 624.155(3)(e), Tower Hill states that the circumstances giving rise to the alleged violations have been resolved, and this matter has been fully disposed of by settlement. Under the terms of the settlement, Willie Wiggins has agreed to release Tower Hill from all claims for extra contractual liability or damages. The settlement shall not be construed to be an admission on the part of Tower Hill, or evidencing or indicating in any degree, any admission of the truth or correctness of any claims asserted. Tower Hill denies all of the allegations in the CRN and asserts that it treated its insured fairly and in good faith. Respectfully Submitted, Tower Hill Claims Services, LLC
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