Filing Number: 793875
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| Filing Accepted: 11/22/2024 |
| Last/Business Name
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BROWN-WILLIAMS
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First Name |
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BEVERLY |
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| Street Address
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9521 WINDRIFT CIR |
| City, State Zip
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FORT PIERCE,
FL
34945
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| Email Address
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BEVERLYBEE3@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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BROWN-WILLIAMS |
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First Name |
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BEVERLY |
| Policy # * |
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988683024 |
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Claim #* |
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0771595682 |
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Attorney is Applicable
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| Last Name* |
INNOCENT
First Name *
KIMBERLY
Initial
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| Street Address* |
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1580 SAWGRASS CORPORATE PARKWAY, SUITE 130 |
| City, State Zip* |
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SUNRISE
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FL
33323
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| Email Address * |
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KIMBERLY@INNOCENTLAWFIRM.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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CASTLE KEY INDEMNITY 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 10835 |
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| Name of individual responsible for violation (if any):*
IMANI GILMORE AND THERESA HERNANDEZ
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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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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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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 - Your Property
Dwelling Protection - Coverage A
Property We Cover Under Coverage A:
1. Your dwelling including attached structures. Structures connected to your dwelling by only a
fence, utility line or similar connection are not considered attached structures.
2. Construction materials and supplies at the residence premises for use in connection with your
dwelling.
3. Wall-to-wall carpeting fastened to your dwelling.
Pg 6 of 22
Losses We Cover Under Coverages A and B:
We will cover sudden and accidental direct physical loss to property described in Dwelling Protection- Coverage A and Other Structures Protection - Coverage B except as limited or excluded in this policy.
Lead in paragraph for Losses We Cover Under Coverages A and B, Pg 6 of 22
Losses We Do Not Cover Under Coverages A and B:
We do not cover loss to the property described in Dwelling Protection - Coverage A or Other Structures Protection - Coverage B consisting of or caused by:
***
7.The failure by any insured person to take all reasonable steps to save
and preserve property when the property is endangered by a cause of
loss we cover.
Par. 7., Pg 6 of 22
In addition, we do not cover loss consisting of or caused by any of
the following:
15. a) wear and tear, aging, marring, scratching, deterioration, inherent vice, or latent defect;
***
If any of a) through h) cause the sudden and accidental escape of water or steam from a plumbing, heating or air conditioning system, household appliance or fire protective sprinkler system within your dwelling, we cover the direct physical damage caused by the water or steam. If loss to covered property is caused by water or steam not otherwise excluded, we will cover the cost of tearing out and replacing any part of your dwelling necessary to repair the system or appliance. This does not include damage to the defective system or appliance from which the
water escaped.
Par. 15(a), pg 7 of 22.
21. Weather conditions that contribute in any way with a cause of loss
excluded in this section to produce a loss.
Par. 21, pg 7 of 22.
19. Hurricane means wind, wind gusts, hail, rain, tornadoes,
or cyclones caused by or resulting from a storm system declared by the National Hurricane Center of
the National Weather Service to be a hurricane. The duration of the hurricane includes the time
period, in Florida:
a) beginning at the time a hurricane watch or hurricane warning is issued for any part of Florida
by the National Hurricane Center of the National Weather Service;
b) continuing for the time period during which hurricane conditions exist anywhere in Florida; and
c) ending 72 hours following the termination of the last hurricane watch or hurricane warning
issued for any part of Florida by the National Hurricane Center of
the National Weather Service
AP4763-2, Florida Homeowners Policy Broad Amendatory Endorsement - AP4763-2, par. 19, pg. 2 of 12.
***
II. In Section I- Your Property, the following changes are made:
A. Under Losses We Do Not Cover Under Coverages A And B, the following changes have been made:
1. Items 4, 5, 9, 16, 23 and 24 are replaced by the following:
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23. Hurricane.
This exclusion applies only to:
a) loss in excess of $50,000 to pool enclosures, carports, Florida rooms, sunrooms and patio
enclosures that have any aluminum supporting frames or studs. Loss in excess of $50,000 is excluded
regardless of the number of pool enclosures, carports, Florida rooms, sunrooms and patio
enclosures involved in the loss. This exclusion applies whether or not the pool enclosure, carport,
Florida room, sunroom or patio enclosure is fastened or attached to, or a part of, a building
structure;
b) loss to screens for pool enclosures, carports, Florida rooms, sunrooms or patio enclosures that
have any aluminum supporting frames or studs;
c) loss to fences, whether or not fastened or attached to, or a part of, a building structure; and
d) loss to above ground outdoor pools, awnings and
outdoor antennas, whether or not fastened or
attached to a building structure.
24. We do not cover loss to covered property described in Dwelling Protection - Coverage A or Other Structures Protection - Coverage B when:
a) there are two or more causes of loss to the covered property; and
b) the predominant cause(s) of loss is(are) excluded under Losses We Do Not Cover, items 1.
through 23. Above.
However, any sudden and accidental loss to property described in Dwelling Protection - Coverage A or Other Structures Protection - Coverage B that follows items 1. through 23. is covered, unless excluded by this policy.
AP4763-2, Florida Homeowners Policy Broad Amendatory Endorsement - AP4763-2, par. 23 and 24, pg 4 of 12.
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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.
In Florida, the work of adjusting insurance claims engages the public trust. Castle Key Indemnity Company (“INSURER”) has breached the public’s trust by its adjustment of Beverly Brown-Williams’s (“INSURED”) claim of loss. INSURER’S principal address is 8333 Bryan Dairy Road, Suite 300, Largo, FL 33777. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED'S insurance claim for damages. INSURER has failed to promptly settle the INSUREDS’ insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED'S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy.
This claim involves the INSURED'S property located at 9521 Windrift Cir, Fort Pierce, FL 34945, which sustained significant damage from a wind/hail damage loss on or around May 19, 2024. Specifically, hail damaged the Property. INSURER acknowledged the claim and assigned a field adjuster to inspect the loss.
In correspondence dated October 17, 2024, INSURER incorrectly determined:
“Our inspection found that the roof shingles do not have any sudden and accidental damages but instead show signs of wear and tear and aging. We can also see that the gutters have unrelated damage and prior repair attempts to these sections. Lastly, the AC fins appear to also have unrelated damage that is not from a sudden and accidental loss covered on this policy.”
This determination was made notwithstanding the fact that the INSURED had already submitted a detailed estimate on October 17, 2024, prepared by public adjuster Richard Mosley of Ask An Adjuster, totaling $45,463.46. On the same day, INSURER denied the claim entirely.
Subsequently, on November 15, 2024, INSURER, through its representative Imani Gilmore, requested:
“At your earliest convenience please send Castle Key a copy of any/all estimates for your client’s damaged [sic] which you believe should be paid for in relation to this date of loss for our review.”
In response, on November 18, 2024, the INSURED's counsel resubmitted the same estimate previously provided on October 17, 2024. Despite this, Ms. Gilmore informed the INSURED:
“It appears that you may be claiming additional damage not originally inspected or reviewed by our adjusters. In order to schedule a re-inspection, please speak with your client for available dates, along with morning/afternoon arrival preferences, as an adjuster will be reaching out shortly to coordinate a date and time.”
This statement by Ms. Gilmore reflects INSURER’s continued failure to address the damages outlined in INSURED’s detailed estimate, even after the estimate had been resubmitted. INSURER’s suggestion of "additional damage not originally inspected" is misleading, as the damages claimed were clearly presented in the initial estimate and remain unchanged.
The Policy explicitly provides coverage for "sudden and accidental direct physical loss" to property described under Dwelling Protection - Coverage A and Other Structures Protection - Coverage B unless such losses are limited or excluded elsewhere in the policy (Pg. 6 of 22). The relevant provision states:
Losses We Cover Under Coverages A and B:
“We will cover sudden and accidental direct physical loss to property described in Dwelling Protection - Coverage A and Other Structures Protection - Coverage B except as limited or excluded in this policy.”
The exclusions cited by INSURER, such as wear and tear, aging, and deterioration (Par. 15(a), Pg. 7 of 22), do not bar coverage when the damages result in or lead to sudden and accidental loss. The Policy further underscores that consequential damages following an excluded cause are often covered. INSURER’s reliance on weather conditions as an exclusion (Par. 21, Pg. 7 of 22) similarly ignores the Policy's provision to cover damages arising directly from a hurricane as defined under the Florida Homeowners Policy Broad Amendatory Endorsement (AP4763-2, Par. 19, Pg. 2 of 12).
As of today, 46 days have passed since the claim was reported, and INSURER has failed to issue a single payment. The INSURED has suffered significant delays and has been forced to expend out-of-pocket funds to pursue their rightful claim. INSURER's poor claim investigation and continued denial of the damages outlined in the October 17, 2024, estimate constitute a clear breach of its contractual and statutory obligations.
Florida Statute §624.02 defines "insurance" as a contract to indemnify or provide security against a contingent loss. Prompt payment is a cornerstone of this obligation, enabling the INSURED to mitigate damages and restore their property. INSURER's failure to act in good faith and timely settle the claim has only compounded the INSURED's losses.
To cure the defects outlined in this Civil Remedy Notice, INSURER must:
1. Tender $42,963.46, representing the damages set forth in the estimate, less deductible, plus interest;
2. Acknowledge its obligation under the Policy to address the damages promptly and fairly.
This notice is submitted to perfect the INSURED’s right to pursue the civil remedy provided under Fla. Stat. §624.155. INSURER’s continued failure to comply within the statutory cure period will result in further legal action.
The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty.
The INSURED was and still is, forced to expend out-of-pocket monies to submit her insurance claim, e.g., retaining a public adjuster, an attorney, and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them.
INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must tender to the INSURED $42,963.46 as set forth above plus interest. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155.
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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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