Filing Number: 793888
|
| Filing Accepted: 11/23/2024 |
| Last/Business Name
*
|
|
|
ECONOMY INN
|
|
First Name |
|
BGM |
|
| Street Address
*
|
|
94 SAN MARCO AVE |
| City, State Zip
*
|
|
SAINT AUGUSTINE,
FL
32084
|
| Email Address
*
|
|
BGM@WEKLAW.COM |
| Complainant Type:
*
|
|
Insured |
|
| Last/Business Name* |
|
ECONOMY INN |
|
First Name |
|
BRITTANY |
| Policy # * |
|
FICO-000207051 |
|
Claim #* |
|
050000001512 |
|
Attorney is Applicable
|
| Last Name* |
MELENDEZ
First Name *
BRITTANY
Initial
|
| Street Address* |
|
2008 E HARDING ST, ORLANDO FL 32806 |
| City, State Zip* |
|
ORLANDO
,
FL
32806
|
| Email Address * |
|
BRITTANYGMELENDEZ@GMAIL.COM |
|
|
| Insurer Type
*
|
|
 Authorized Insurer
 Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
FRONTLINE INSURANCE UNLIMITED COMPANY
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code 10074 |
|
|
| Name of individual responsible for violation (if any):*
N/A
|
| Type of Insurance
*
Commercial Property & Casualty
|
|
|
| Reason for Notice
*
|
|
|
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.
|
|
| 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)(3)(a) |
|
Failing to adopt and implement standards for the proper investigation of claims.
|
|
| 626.9541(1)(i)(3)(c) |
|
Failing to acknowledge and act promptly upon communications with respect to claims.
|
|
| 626.9541(1)(i)(3)(d) |
|
Denying claims without conducting reasonable investigations based upon available information.
|
|
*
Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
A. Coverage
We will pay for direct physical loss of or damage to
Covered Property at the premises described in the
Declarations caused by or resulting from any Covered
Cause of Loss.
1. Covered Property
Covered Property, as used in this Coverage
Part, means the type of property described in
this section, A.1., and limited in A.2., Property
Not Covered, if a Limit of Insurance is shown in
the Declarations for that type of property.
a. Building, meaning the building or structure
described in the Declarations, including:
(1) Completed additions;
(2) Fixtures, including outdoor fixtures;
(3) Permanently installed:
(a) Machinery and
(b) Equipment;
(4) Personal property owned by you that is
used to maintain or service the building
or structure or its premises. including:
(a) Fire-extinguishing equipment;
(b) Outdoor furniture;
(c) Floor coverings; and
(d) Appliances used for refrigerating,
ventilating, cooking, dishwashing or
laundering;
(5) If not covered by other insurance:
(a) Additions under construction, alterations
and repairs to the building or
structure;
(b) Materials. equipment, supplies and
temporary structures, on or within
100 feet of the described premises.
used for making additions, alterations
or repairs to the building or
structure.
b. Your Business Personal Property located
in or on the building described in the Declarations
or in the open (or in a vehicle) within
100 feet of the described premises, consisting
of the following unless otherwise specified
in the Declarations or on the Your Business
Personal Property - Separation Of
Coverage form:
(1) Furniture and fixtures;
(2) Machinery and equipment;
(3) "Stock";
(4) All other personal property owned by
you and used in your business;
(5) Labor, materials or services furnished or
arranged by you on personal property of
others;
(6) Your use interest as tenant in improvements
and betterments. Improvements
and betterments are fixtures. alterations,
installations or additions:
(a) Made a part of the building or structure
you occupy but do not own; and
(b) You acquired or made at your expense
but cannot legally remove;
(7) Leased personal property for which you
have a contractual responsibility to insure,
unless otherwise provided for under
Personal Property Of Others.
CP 0010 06 07 © ISO Properties, Inc., 2007 Page 1 of 15 ?
c. Personal Property Of Others that is:
(1) In your care, custody or control; and
(2) Located in or on the building described
in the Declarations or in the open (or in
a vehicle) within 100 feet of the described
premises.
However, our payment for loss of or damage
to personal property of others will only
be for the account of the owner of the property.
2. Property Not Covered
Covered Property does not include:
a. Accounts, bills, currency, food stamps or
other evidences of debt, money, notes or
securities. Lottery tickets held for sale are
not securities;
b. Animals, unless owned by others and
boarded by you, or if owned by you, only as
"stock" while inside of buildings;
c. Automobiles held for sale;
d. Bridges, roadways, walks, patios or other
paved surfaces;
e. Contraband, or property in the course of
illegal transportation or trade;
f. The cost of excavations, grading, backfilling
or filling;
g. Foundations of buildings, structures, machinery
or boilers if their foundations are
below:
(1) The lowest basement floor; or
(2) The surface of the ground, if there is no
basement;
h. Land (including land on which the property
is located), water, growing crops or lawns;
I. Personal property while airborne or waterborne;
j. Bulkheads, pilings, piers, wharves or docks;
k. Property that is covered under another
coverage form of this or any other policy in
which it is more specifically described, except
for the excess of the amount due
(whether you can collect on it or not) from
that other insurance;
I. Retaining walls that are not part of a building;
m. Underground pipes, flues or drains;
n. Electronic data, except as provided under
the Additional Coverage, Electronic Data.
Electronic data means information, facts or
computer programs stored as or on, created
or used on, or transmitted to or from
computer software (including systems and
applications software), on hard or floppy
disks, CD-ROMs, tapes, drives, cells, data
processing devices or any other repositories
of computer software which are used
with electronically controlled equipment.
The term computer programs, referred to in
the foregoing description of electronic data,
means a set of related electronic instructions
which direct the operations and functions
of a computer or device connected to
it, which enable the computer or device to
receive, process, store, retrieve or send
data. This paragraph, n., does not apply to
your "stock" of prepackaged software;
o. The cost to replace or restore the information
on valuable papers and records, including
those which exist as electronic data.
Valuable papers and records include but
are not limited to proprietary information,
books of account, deeds, manuscripts, abstracts,
drawings and card index systems.
Refer to the Coverage Extension for Valuable
Papers And Records (Other Than
Electronic Data) for limited coverage for
valuable papers and records other than
those which exist as electronic data;
p. Vehicles or self-propelled machines (including
aircraft or watercraft) that:
(1) Are licensed for use on public roads; or
(2) Are operated principally away from the
described premises.
This paragraph does not apply to:
(a) Vehicles or self-propelled machines
or autos you manufacture, process
or warehouse;
(b) Vehicles or self-propelled machines,
other than autos, you hold for sale;
(c) Rowboats or canoes out of water at
the described premises; or
(d) Trailers, but only to the extent provided
for in the Coverage Extension
for Non-owned Detached Trailers;
Page 2 of 15 © ISO Properties, Inc., 2007 CP00100607 ?
q. The following property while outside of
buildings:
(1) Grain, hay, straw or other crops;
(2) Fences, radio or television antennas
(including satellite dishes) and their
lead-in wiring, masts or towers, trees,
shrubs or plants (other than "stock" of
trees, shrubs or plants), all except as
provided in the Coverage Extensions.
3. Covered Causes Of Loss
See applicable Causes Of Loss Form as
shown in the Declarations.
4. Additional Coverages
a. Debris Removal
(1) Subject to Paragraphs (3) and (4), we
will pay your expense to remove debris
of Covered Property caused by or resulting
from a Covered Cause of Loss
that occurs during the policy period. The
expenses will be paid only if they are
reported to us in writing within 180 days
of the date of direct physical loss or
damage.
(2) Debris Removal does not apply to costs
to:
(a) Extract "pollutants" from land or
water; or
(b) Remove, restore or replace polluted
land or water.
(3) Subject to the exceptions in Paragraph
(4), the following provisions apply:
(a) The most we will pay for the total of
direct physical loss or damage plus
debris removal expense is the Limit
of Insurance applicable to the Covered
Property that has sustained
loss or damage.
(b) Subject to (a) above, the amount we
will pay for debris removal expense
is limited to 25% of the sum of the
deductible plus the amount that we
pay for direct physical loss or damage
to the Covered Property that has
sustained loss or damage.
(4) We will pay up to an additional $10,000
for debris removal expense, for each location,
in any one occurrence of physical
loss or damage to Covered Property,
if one or both of the following circumstances
apply:
(a) The total of the actual debris removal
expense plus the amount we pay for
direct physical loss or damage exceeds
the Limit of Insurance on the
Covered Property that has sustained
loss or damage.
(b) The actual debris removal expense
exceeds 25% of the sum of the deductible
plus the amount that we pay
for direct physical loss or damage to
the Covered Property that has sustained
loss or damage.
Therefore, if (4)(a) and/or (4)(b) apply,
our total payment for direct physical loss
or damage and debris removal expense
may reach but will never exceed the
Limit of Insurance on the Covered Property
that has sustained loss or damage,
plus $10,000.
(5) Examples
The following examples assume that
there is no Coinsurance penalty.
EXAMPLE#1
Limit of Insurance:
Amount of Deductible:
Amount of Loss:
Amount of Loss Payable:
Debris Removal Expense:
Debris Removal Expense Payable:
($10,000 is 20% of $50,000.)
$ 90,000
$ 500
$ 50,000
$ 49,500
($50,000- $500)
$ 10,000
$ 10,000
The debris removal expense is less than 25% of the
sum of the loss payable plus the deductible. The sum
of the loss payable and the debris removal expense
($49,500 + $10,000 = $59,500) is less than the Limit
of Insurance. Therefore the full amount of debris
removal expense is payable in accordance with the
terms of Paragraph (3).
EXAMPLE#2
Limit of Insurance:
Amount of Deductible:
Amount of Loss:
Amount of Loss Payable:
Debris Removal Expense:
Debris Removal Expense Payable
Basic Amount:
$ 90,000
$ 500
$ 80,000
$ 79,500
($80,000 - $500)
$ 30,000
Additional Amount:
$ 10,500
$ 10,000
CP 0010 06 07 © ISO Properties, Inc., 2007 Page 3 of 15 ?
The basic amount payable for debris removal expense
under the terms of Paragraph (3) is calculated
as follows: $80,000 ($79,500 + $500) x .25 = $20,000;
capped at $10,500. The cap applies because the sum
of the loss payable ($79,500) and the basic amount
payable for debris removal expense ($10,500) cannot
exceed the Limit of Insurance ($90,000).
The additional amount payable for debris removal
expense is provided in accordance with the terms of
Paragraph (4), because the debris removal expense
($30,000) exceeds 25% of the loss payable plus the
deductible ($30,000 is 37.5% of $80,000), and because
the sum of the loss payable and debris removal
expense ($79,500 + $30,000 = $109,500) would exceed
the Limit of Insurance ($90,000). The additional
amount of covered debris removal expense is
$10,000, the maximum payable under Paragraph (4).
Thus the total payable for debris removal expense in
this example is $20,500; $9,500 of the debris removal
expense is not covered.
b. Preservation Of Property
If it is necessary to move Covered Property
from the described premises to preserve it
from loss or damage by a Covered Cause
of Loss, we will pay for any direct physical
loss or damage to that property:
(1) While it is being moved or while temporarily
stored at another location; and
(2) Only if the loss or damage occurs within
30 days after the property is first moved.
c. Fire Department Service Charge
When the fire department is called to save
or protect Covered Property from a Covered
Cause of Loss, we will pay up to
$1,000, unless a higher limit is shown in the
Declarations, for your liability for fire department
service charges:
(1) Assumed by contract or agreement prior
to loss; or
(2) Required by local ordinance.
No Deductible applies to this Additional
Coverage.
d. Pollutant Clean-up And Removal
We will pay your expense to extract "pollutants"
from land or water at the described
premises if the discharge, dispersal, seepage,
migration, release or escape of the
"pollutants" is caused by or results from a
Covered Cause of Loss that occurs during
the policy period. The expenses will be paid
only if they are reported to us in writing
within 180 days of the date on which the
Covered Cause of Loss occurs.
This Additional Coverage does not apply to
costs to test for, monitor or assess the existence,
concentration or effects of "pollutants".
But we will pay for testing which is
performed in the course of extracting the
"pollutants" from the land or water.
The most we will pay under this Additional
Coverage for each described premises is
$10,000 for the sum of all covered expenses
arising out of Covered Causes of
Loss occurring during each separate 12-
month period of this policy.
e. Increased Cost Of Construction
(1) This Additional Coverage applies only to
buildings to which the Replacement
Cost Optional Coverage applies.
(2) In the event of damage by a Covered
Cause of Loss to a building that is Covered
Property, we will pay the increased
costs incurred to comply with enforcement
of an ordinance or law in the
course of repair, rebuilding or replacement
of damaged parts of that property,
subject to the limitations stated in e.(3)
through e.(9) of this Additional Coverage.
(3) The ordinance or law referred to in e.(2)
of this Additional Coverage is an ordinance
or law that regulates the construction
or repair of buildings or establishes
zoning or land use requirements
at the described premises, and is in
force at the time of loss.
Page 4 of 15 © ISO Properties, Inc., 2007 CP 00 10 06 07 D
. (4) Under this Additional Coverage, we will
not pay any costs due to an ordinance
or law that:
(a) You were required to comply with
before the loss, even when the building
was undamaged; and
(b) You failed to comply with.
(5) Under this Additional Coverage, we will
not pay for:
(a) The enforcement of any ordinance or
law which requires demolition, repair,
replacement, reconstruction, remodeling
or remediation of property due
to contamination by "pollutants" or
due to the presence, growth, proliferation,
spread or any activity of
"fungus", wet or dry rot or bacteria;
or
(b) Any costs associated with the enforcement
of an ordinance or law
which requires any insured or others
to test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize,
or in any way respond to, or
assess the effects of "pollutants",
"fungus", wet or dry rot or bacteria . .
(6) The most we will pay under this Additional
Coverage, for each described
building insured under this Coverage
Form, is $10,000 or 5% of the Limit of
Insurance applicable to that building,
whichever is less. If a damaged building
is covered under a blanket Limit of Insurance
which applies to more than one
building or item of property, then the
most we will pay under this Additional
Coverage, for that damaged building, is
the lesser of: $10,000 or 5% times the
value of the damaged building as of the
time of loss times the applicable Coinsurance
percentage.
The amount payable under this Additional
Coverage is additional insurance.
(7) With respect to this Additional Coverage:
(a) We will not pay for the Increased
Cost of Construction:
(i) Until the property is actually repaired
or replaced, at the same
or another premises; and
(ii) Unless the repairs or replacement
are made as soon as reasonably
possible after the loss or
damage, not to exceed two
years. We may extend this period
in writing during the two years.
(b) If the building is repaired or replaced
at the same premises, or if you elect
to rebuild at another premises, the
most we will pay for the Increased
Cost of Construction, subject to the
provisions of e.(6) of this Additional
Coverage, is the increased cost of
construction at the same premises.
(c) If the ordinance or law requires relocation
to another premises, the most
we will pay for the Increased Cost of
Construction, subject to the provisions
of e.(6) of this Additional Coverage,
is the increased cost of construction
at the new premises.
(8) This Additional Coverage is not subject
to the terms of the Ordinance Or Law
Exclusion, to the extent that such Exclusion
would conflict with the provisions of
this Additional Coverage.
(9) The costs addressed in the Loss Payment
and Valuation Conditions, and the
Replacement Cost Optional Coverage,
in this Coverage Form, do not include
the increased cost attributable to enforcement
of an ordinance or law. The
amount payable under this Additional
Coverage, as stated in e.(6) of this Additional
Coverage, is not subject to such
limitation.
f. Electronic Data
(1) Under this Additional Coverage, electronic
data has the meaning described
under Property Not Covered, Electronic
Data.
(2) Subject to the provisions of this Additional
Coverage, we will pay for the cost
to replace or restore electronic data
which has been destroyed or corrupted
by a Covered Cause of Loss. To the extent
that electronic data is not replaced
or restored, the loss will be valued at the
cost of replacement of the media on
which the electronic data was stored,
with blank media of substantially identical
type.
CP00100607 © ISO Properties; Inc., 2007 Page 5 of 15 D
(3) The Covered Causes of Loss applicable
to Your Business Personal Property apply
to this Additional Coverage, Electronic
Data, subject to the following:
(a) If the Causes Of Loss - Special
Form applies, coverage under this
Additional Coverage, Electronic
Data, is limited to the "specified
causes of loss" as defined in that
form, and Collapse as set forth in
that form.
(b) If the Causes Of Loss - Broad Form
applies, coverage under this Additional
Coverage, Electronic Data, includes
Collapse as set forth in that
form.
(c) If the Causes Of Loss Form is endorsed
to add a Covered Cause of
Loss, the additional Covered Cause
of Loss does not apply to the coverage
provided under this Additional
Coverage, Electronic Data.
(d) The Covered Causes of loss include
a virus, harmful code or similar instruction
introduced into or enacted
on a computer system (including
electronic data) or a network to
which it is connected, designed to
damage or destroy any part of the
system or disrupt its normal operation.
But there is no coverage for
loss or damage caused by or resulting
from manipulation of a computer
system (including electronic data) by
any employee, including a temporary
or leased employee, or by an entity
retained by you or for you to inspect,
design, install, modify, maintain, repair
or replace that system.
(4) The most we will pay under this Additional
Coverage, Electronic Data, is
$2,500 for all loss or damage sustained
in any one policy year, regardless of the
number of occurrences of loss or damage
or the number of premises, locations
or computer systems involved. If
loss payment on the first occurrence
does not exhaust this amount, then the
balance is available for subsequent loss
or damage sustained in but not after that
policy year. With respect to an occurrence
which begins in one policy year
and continues or results in additional
loss or damage in a subsequent policy
year(s), all loss or damage is deemed to
be sustained in the policy year in which
the occurrence began.
5. Coverage Extensions
Except as otherwise provided, the following Extensions
apply to property located in or on the
building described in the Declarations or in the
open (or in a vehicle) within 100 feet of the described
premises.
If a Coinsurance percentage of 80% or more,
or a Value Reporting period symbol, is shown
in the Declarations, you may extend the insurance
provided by this Coverage Part as follows:
a. Newly Acquired Or Constructed
Property
(1) Buildings
If this policy covers Building, you may
extend that insurance to apply to:
(a) Your new buildings while being built
on the described premises; and
(b) Buildings you acquire at locations,
other than the described premises,
intended for:
(i) Similar use as the building described
in the Declarations; or
(ii) Use as a warehouse.
The most we will pay for loss or damage
under this Extension is $250,000 at
each building.
(2) Your Business Personal Property
(a) If this policy covers Your Business
Personal Property, you may extend
that insurance to apply to:
(i) Business personal property,
including such property that you
newly acquire, at any location
you acquire other than at fairs,
trade shows or exhibitions;
(ii) Business personal property,
including such property that you
newly acquire, located at your
newly constructed or acquired
buildings at the location described
in the Declarations; or
(iii) Business personal property that
you newly acquire, located at the
described premises.
The most we will pay for loss or
damage under this Extension is
$100,000 at each building.
Page 6 of 15 © ISO Properties, Inc., 2007 CP00100607 ?
(b) This Extension does not apply to:
(i) Personal property of others that
is temporarily in your possession
in the course of installing or performing
work on such property; or
(ii) Personal property of others that
is temporarily in your possession
in the course of your manufacturing
or wholesaling activities.
(3) Period Of Coverage
With respect to insurance on or at each
newly acquired or constructed property,
coverage will end when any of the following
first occurs:
{a) This policy expires;
{b) 30 days expire after you acquire the
property or begin construction of that
part of the building that would qualify
as covered property; or
(c) You report values to us.
We will charge you additional premium
for values reported from the date you
acquire the property or begin construction
of that part of the building that would
qualify as covered property.
b. Personal Effects And Property Of Others
You may extend the insurance that applies
to Your Business Personal Property to apply
to:
(1) Personal effects owned by you, your
officers, your partners or members, your
managers or your employees. This Extension
does not apply to loss or damage
by theft.
(2) Personal property of others in your care,
custody or control.
The most we will pay for loss or damage
under this Extension is $2,500 at each described
premises. Our payment for loss of
or damage to personal property of others
will only be for the account of the owner of
the property.
c. Valuable Papers And Records (Other
Than Electronic Data)
(1) You may extend the insurance that
applies to Your Business Personal
Property to apply to the cost to replace
or restore the lost information on valuable
papers and records for which duplicates
do not exist. But this Extension
does not apply to valuable papers and
records which exist as electronic data.
Electronic data has the meaning described
under Property Not Covered,
Electronic Data.
(2) If the Causes Of Loss - Special Form
applies, coverage under this Extension
is limited to the "specified causes of
loss" as defined in that form, and Collapse
as set forth in that form.
(3) If the Causes Of Loss - Broad Form
applies, coverage under this Extension
includes Collapse as set forth in that
form.
(4) Under this Extension, the most we will
pay to replace or restore the lost information
is $2,500 at each described
premises, unless a higher limit is shown
in the Declarations. Such amount is additional
insurance. We will also pay for
the cost of blank material for reproducing
the records (whether or not duplicates
exist), and (when there is a duplicate)
for the cost of labor to transcribe
or copy the records. The costs of blank
material and labor are subject to the applicable
Limit of Insurance on Your
Business Personal Property and therefore
coverage of such costs is not additional
insurance.
d. Property Off-premises
(1) You may extend the insurance provided
by this Coverage Form to apply to your
Covered Property while it is away from
the described premises, if it is:
{a) Temporarily at a location you do not
own, lease or operate;
(b) In storage at a location you lease.
provided the lease was executed after
the beginning of the current policy
term; or
(c) At any fair, trade show or exhibition.
CP 0010 06 07 © ISO Properties, Inc., 2007 Page 7 of 15 ?
(2) This Extension does not apply to property:
(a) In or on a vehicle; or
(b) In the care, custody or control of
your salespersons, unless the property
is in such care, custody or control
at a fair, trade show or exhibition.
(3) The most we will pay for loss or damage
under this Extension is $10,000.
e. Outdoor Property
You may extend the insurance provided by
this Coverage Form to apply to your outdoor
fences, radio and television antennas
(including satellite dishes), trees, shrubs
and plants (other than "stock" of trees,
shrubs or plants), including debris removal
expense, caused by or resulting from any of
the following causes of loss if they are Covered
Causes of Loss:
(1) Fire;
(2) Lightning;
(3) Explosion;
(4) Riot or Civil Commotion; or
(5) Aircraft.
The most we will pay for loss or damage
under this Extension is $1,000, but not
more than $250 for any one tree, shrub or
plant. These limits apply to any one occur- •
rence, regardless of the types or number of
items lost or damaged in that occurrence.
f. Non-owned Detached Trailers
(1) You may extend the insurance that
applies to Your Business Personal
Property to apply to loss or damage to
trailers that you do not own, provided
that:
(a) The trailer is used in your business;
(b) The trailer is in your care, custody or
control at the premises described in
the Declarations; and
(c) You have a contractual responsibility
to pay for loss or damage to the
trailer.
(2) We will not pay for any loss or damage
that occurs:
(a) While the trailer is attached to any
motor vehicle or motorized conveyance,
whether or not the motor vehicle
or motorized conveyance is in
motion;
(b) During hitching or unhitching operations,
or when a trailer becomes accidentally
unhitched from a motor
vehicle or motorized conveyance.
(3) The most we will pay for loss or damage
under this Extension is $5,000, unless a
higher limit is shown in the Declarations.
(4) This insurance is excess over the
amount due (whether you can collect on
it or not) from any other insurance covering
such property.
Each of these Extensions is additional insurance
unless otherwise indicated. The Additional Condition,
Coinsurance, does not apply to these Extensions.
B. Exclusions And Limitations
See applicable Causes Of Loss Form as shown in
the Declarations.
C. Limits Of Insurance
The most we will pay for loss or damage in any
one occurrence is the applicable Limit of Insurance
shown in the Declarations.
The most we will pay for loss or damage to outdoor
signs, whether or not the sign is attached to a
building, is $2,500 per sign in any one occurrence.
The amounts of insurance stated in the following
Additional Coverages apply in accordance with the
terms of such coverages and are separate from
the Limit(s) of Insurance shown in the Declarations
for any other coverage:
1. Fire Department Service Charge;
2. Pollutant Clean-up And Removal;
3. Increased Cost Of Construction; and
4. Electronic Data.
Payments under the Preservation Of Property Additional
Coverage will not increase the applicable
Limit of Insurance.
Page 8 of 15 © ISO Properties, Inc., 2007 CP00100607 D
D. Deductible
In any one occurrence of loss or damage (hereinafter
referred to as loss), we will first reduce the
amount of loss if required by the Coinsurance
Condition or the Agreed Value Optional Coverage.
If the adjusted amount of loss is less than or equal
to the Deductible, we will not pay for that loss. If
the adjusted amount of loss exceeds the Deductible,
we will then subtract the Deductible from the
adjusted amount of loss, and will pay the resulting
amount or the Limit of Insurance, whichever is
less.
When the occurrence involves loss to more than
one item of Covered Property and separate Limits
of Insurance apply, the losses will not be combined
in determining application of the Deductible.
But the Deductible will be applied only once per
occurrence.
EXAMPLE #1
(This example assumes there is no Coinsurance
penalty.)
Deductible: $ 250
Limit of Insurance - Building #1: $ 60,000
Limit of Insurance - Building #2: $ 80,000
Loss to Building #1 : $ 60,100
Loss to Building #2: $ 90,000
The amount of loss to Building #1 ($60,100) is less
than the sum ($60,250) of the Limit of Insurance applicable
to Building #1 pl_us the Deductible.
The Deductible will be subtracted from the amount of
loss in calculating the loss payable for Building #1 :
$ 60,100
250
$ 59,850 Loss Payable - Building #1
The Deductible applies once per occurrence and
therefore is not subtracted in determining the amount
of loss payable for Building #2. Loss payable for
Building #2 is the Limit of Insurance of $80,000.
Total amount of loss payable:
$59,850 + $80,000 = $139,850
EXAMPLE#2
(This example, too, assumes there is no Coinsurance
penalty.)
The Deductible and Limits of Insurance are the same
as those in Example #1 .
Loss to Building #1 : $ 70,000
(Exceeds Limit of Insurance plus Deductible)
Loss to Building #2: $ 90,000
(Exceeds Limit of Insurance plus Deductible)
Loss Payable - Building #1 : $ 60,000
(Limit of Insurance)
Loss Payable - Building #2: $ 80,000
(Limit of Insurance)
Total amount of loss payable: $ 140,000
E. Loss Conditions
The following conditions apply in addition to the
Common Policy Conditions and the Commercial
Property Conditions.
1. Abandonment
There can be no abandonment of any property
to us.
2. Appraisal
If we and you disagree on the value of the
property or the amount of loss, either may
make written demand for an appraisal of the
loss. In this event, each party will select a competent
and impartial appraiser. The two appraisers
will select an umpire. If they cannot
agree, either may request that selection be
made by a judge of a court having jurisdiction.
The appraisers will state separately the value
of the property and amount of loss. If they fail
to agree, they will submit their differences to
the umpire. A decision agreed to by any two
will be binding. Each party will:
a. Pay its chosen appraiser; and
b. Bear the other expenses of the appraisal
and umpire equally.
If there is an appraisal, we will still retain our
right to deny the claim.
CP 0010 06 07 © ISO Properties, Inc., 2007 Page 9 of 15 ?
3. Duties In The Event Of Loss Or Damage 4. Loss Payment
a. You must see that the following are done in a. In the event of loss or damage covered by
the event of loss or damage to Covered this Coverage Form, at our option, we will
Property: either:
(1) Notify the police if a law may have been (1) Pay the value of lost or damaged propbroken.
erty;
(2) Give us prompt notice of the loss or (2) Pay the cost of repairing or replacing the
damage. Include a description of the lost or damaged property, subject to b.
property involved. below;
(3) As soon as possible, give us a descrip- (3) Take all or any part of the property at an
tion of how, when and where the loss or agreed or appraised value; or
damage occurred. (4) Repair, rebuild or replace the property
(4) Take all reasonable steps to protect the with other property of like kind and qual-
Covered Property from further damage, ity, subject to b. below.
and keep a record of your expenses We will determine the value of lost or damnecessary
to protect the Covered Prop- aged property, or the cost of its repair or
erty, for consideration in the settlement replacement, in accordance with the appliof
the claim. This will not increase the cable terms of the Valuation Condition in
Limit of Insurance. However, we will not this Coverage Form or any applicable propay
for any subsequent loss or damage vision which amends or supersedes the
resulting from a cause of loss that is not Valuation Condition.
a Covered Cause of Loss. Also, if feasible,
set the damaged property aside and b. The cost to repair, rebuild or replace does
in the best possible order for examina- not include the increased cost attributable
tion. to enforcement of any ordinance or law
(5) At our request, give us complete invenregulating
the construction, use or repair of
tories of the damaged and undamaged
any property.
property. Include quantities, costs, val- C. We will give notice of our intentions within
ues and amount of loss claimed. 30 days after we receive the sworn proof of
(6) As often as may be reasonably required,
loss.
permit us to inspect the property proving d. We will not pay you more than your finanthe
loss or damage and examine your cial interest in the Covered Property.
books and records. e. We may adjust losses with the owners of
Also permit us to take samples of dam- lost or damaged property if other than you.
aged and undamaged property for in- If we pay the owners, such payments will
spection, testing and analysis, and per- satisfy your claims against us for the ownmit
us to make copies from your books ers' property. We will not pay the owners
and records. more than their financial interest in the Cov-
(7) Send us a signed, sworn proof of loss
ered Property.
containing the information we request to f. We may elect to defend you against suits
investigate the claim. You must do this arising from claims of owners of property.
within 60 days after our request. We will We will do this at our expense.
supply you with the necessary forms. g. We will pay for covered loss or damage
(8) Cooperate with us in the investigation or within 30 days after we receive the sworn
settlement of the claim. proof of loss, if you have complied with all
b. We may examine any insured under oath,
of the terms of this Coverage Part and:
while not in the presence of any other in- (1) We have reached agreement with you
sured and at such times as may be rea- on the amount of loss; or
sonably required, about any matter relating
to this insurance or the claim, including an
(2) An appraisal award has been made.
insured's books and records. In the event of
an examination, an insured's answers must
be signed.
Page 10 of 15 © ISO Properties, Inc., 2007 CP00100607 ?
h. A party wall is a wall that separates and is
common to adjoining buildings that are
owned by different parties. In settling covered
losses involving a party wall, we will
pay a proportion of the loss to the party wall
based on your interest in the wall in proportion
to the interest of the owner of the adjoining
building. However, if you elect to repair
or replace your building and the owner
of the adjoining building elects not to repair
or replace that building, we will pay you the
full value of the loss to the party wall, subject
to all applicable policy provisions including
Limits of Insurance, the Valuation
and Coinsurance Conditions and all other
provisions of this Loss Payment Condition.
Our payment under the provisions of this
paragraph does not alter any right of subrogation
we may have against any entity, including
the owner or insurer of the adjoining
building, and does not alter the terms of the
Transfer Of Rights Of Recovery Against
Others To Us Condition in this policy.
5. Recovered Property
If either you or we recover any property after
loss settlement, that party must give the other
prompt notice. At your option, the property will
be returned to you. You must then return to us
the amount we paid to you for the property. We
will pay recovery expenses and the expenses
to repair the recovered property, subject to the
Limit of Insurance.
6. Vacancy
a. Description Of Terms
(1) As used in this Vacancy Condition, the
term building and the term vacant have
the meanings set forth in (1)(a) and
(1)(b) below:
(a) When this policy is issued to a tenant,
and with respect to that tenant's
interest in Covered Property, building
means the unit or suite rented or
leased to the tenant. Such building is
vacant when it does not contain
enough business personal property
to conduct customary operations.
(b) When this policy is issued to the
owner or general lessee of a building,
building means the entire building.
Such building is vacant unless at
least 31 % of its total square footage
is:
(i) Rented to a lessee or sub-lessee
and used by the lessee or sublessee
to conduct its customary
operations; and/or
(ii) Used by the building owner to
conduct customary operations.
(2) Buildings under construction or renovation
are not considered vacant.
b. Vacancy Provisions
If the building where loss or damage occurs
has been vacant for more than 60 consecutive
days before that loss or damage occurs:
(1) We will not pay for any loss or damage
caused by any of the following even if
they are Covered Causes of Loss:
(a) Vandalism;
(b) Sprinkler leakage, unless you have
protected the system against freezing;
(c) Building glass breakage;
(d) Water damage;
(e) Theft; or
(f) Attempted theft.
(2) With respect to Covered Causes of Loss
other than those listed in b.(1)(a)
through b.(1)(f) above, we will reduce
the amount we would otherwise pay for
the loss or damage by 15%.
7. Valuation
We will determine the value of Covered Property
in the event of loss or damage as follows:
a. At actual cash value as of the time of loss
or damage, except as provided in b., c., d.
and e. below.
b. If the Limit of Insurance for Building satisfies
the Additional Condition, Coinsurance,
and the cost to repair or replace the damaged
building property is $2,500 or less, we
will pay the cost of building repairs or replacement.
CP 00 10 06 07 © ISO Properties, Inc., 2007 Page 11 of 15 ?
The cost of building repairs or replacement
does not include the increased cost attributable
to enforcement of any ordinance or
law regulating the construction, use or repair
of any property.
However, the following property will be valued
at the actual cash value even when attached
to the building:
(1) Awnings or floor coverings;
(2) Appliances for refrigerating, ventilating,
cooking, dishwashing or laundering; or
(3) Outdoor equipment or furniture.
c. "Stock" you have sold but not delivered at
the selling price less discounts and expenses
you otherwise would have had.
d. Glass at the cost of replacement with
safety-glazing material if required by law.
e. Tenants' Improvements and Betterments at:
(1) Actual cash value of the lost or damaged
property if you make repairs
promptly.
(2) A proportion of your original cost if you
do not make repairs promptly. We will
determine the proportionate value as follows:
(a) Multiply the original cost by the number
of days from the loss or damage
to the expiration of the lease; and
(b) Divide the amount determined in (a)
above by the number of days from
the installation of improvements to
the expiration of the lease.
If your lease contains a renewal option,
the expiration of the renewal option period
will replace the expiration of the
lease in this procedure.
(3) Nothing if others pay for repairs or replacement.
F. Additional Conditions
The following conditions apply in addition to the
Common Policy Conditions and the Commercial
Property Conditions.
1. Coinsurance
If a Coinsurance percentage is shown in the
Declarations, the following condition applies.
a. We will not pay the full amount of any loss if
the value of Covered Property at the time of
loss times the Coinsurance percentage
shown for it in the Declarations is greater
than the Limit of Insurance for the property.
Instead, we will determine the most we will
pay using the following steps:
(1) Multiply the value of Covered Property
at the time of loss by the Coinsurance
percentage;
(2) Divide the Limit of Insurance of the
property by the figure determined in
Step (1);
(3) Multiply the total amount of loss, before
the application of any deductible, by the
figure determined in Step (2); and
(4) Subtract the deductible from the figure
determined in Step (3).
We will pay the amount determined in Step
(4) or the limit of insurance, whichever is
less. For the remainder, you will either have
to rely on other insurance or absorb the
loss yourself.
EXAMPLE #1 (UNDERINSURANCE)
When: The value of the property is:
The Coinsurance percentage
for it is:
The Limit of Insurance for it is:
The Deductible is:
The amount of loss is:
Step (1): $250,000 x 80% = $200,000
$250,000
80%
$100,000
$ 250
$ 40,000
(the minimum amount of insurance to
meet your Coinsurance requirements)
Step (2): $100,000 + $200,000 = .50
Step (3): $40,000 X .50 = $20,000
Step (4): $20,000 - $250 = $19,750
We will pay no more than $19,750. The remaining
$20,250 is not covered.
Page 12 of 15 © ISO Properties, Inc., 2007 CP 00 10 06 07 D
EXAMPLE #2 (ADEQUATE INSURANCE)
When: The value of the property is:
The Coinsurance percentage
for it is:
The Limit of Insurance for it is:
The Deductible is:
The amount of loss is:
$250,000
80%
$200,000
$ 250
$ 40,000
The minimum amount of insurance to meet your Coinsurance
requirement is $200,000 ($250,000 x 80%).
Therefore, the Limit of Insurance in this example is
adequate and no penalty applies. We will pay no
more than $39,750 ($40,000 amount of loss minus
the deductible of $250).
b. If one Limit of Insurance applies to two or
more separate items, this condition will apply
to the total of all property to which the
limit applies.
EXAMPLE #3
When: The value of the property is:
Building at Location #1:
Building at Location #2:
Personal Property
at Location #2:
The Coinsurance percentage
for it is:
The Limit of Insurance for
Buildings and Personal Property
at Locations #1 and #2 is:
The Deductible is:
The amount of loss is:
Building at Location #2:
Personal Property
at Location #2:
Step (1): $250,000 x 90%:::: $225,000
$ 75,000
$100,000
$ 75,000
$250,000
90%
$180,000
$ 1,000
$ 30,000
$ 20,000
$ 50,000
(the minimum amount of insurance to
meet your Coinsurance requirements
and to avoid the penalty shown below)
Step (2): $180,000 + $225,000:::: .80
Step (3): $50,000 x .80 = $40,000
Step (4): $40,000 - $1,000 :::: $39,000
We will pay no more than $39,000. The remaining
$11,000 is not covered.
2. Mortgage holders
a. The term mortgageholder includes trustee.
b. We will pay for covered loss of or damage
to buildings or structures to each mortgageholder
shown in the Declarations in
their order of precedence, as interests may
appear.
c. The mortgageholder has the right to receive
loss payment even if the mortgageholder
has started foreclosure or similar action on
the building or structure.
d. If we deny your claim because of your acts
or because you have failed to comply with
the terms of this Coverage Part, the mortgageholder
will still have the right to receive
loss payment if the mortgageholder:
(1) Pays any premium due under this Coverage
Part at our request if you have
failed to do so:
(2) Submits a signed, sworn proof of loss
within 60 days after receiving notice
from us of your failure to do so; and
(3) Has notified us of any change in ownership,
occupancy or substantial change
in risk known to the mortgageholder.
All of the terms of this Coverage Part will
then apply directly to the mortgageholder.
e. If we pay the mortgageholder for any loss
or damage and deny payment to you because
of your acts or because you have
failed to comply with the terms of this Coverage
Part:
(1) The mortgageholder's rights under the
mortgage will be transferred to us to the
extent of the amount we pay; and
(2) The mortgageholder's right to recover
the full amount of the mortgageholder's
claim will not be impaired.
At our option, we may pay to the mortgageholder
the whole principal on the mortgage
plus any accrued interest. In this event,
your mortgage and note will be transferred
to us and you will pay your remaining mortgage
debt to us.
f. If we cancel this policy, we will give written
notice to the mortgageholder at least:
(1) 10 days before the effective date of
cancellation if we cancel for your nonpayment
of premium; or
(2) 30 days before the effective date of
cancellation if we cancel for any other
reason.
CP 00 10 06 07 © ISO Properties, Inc., 2007 Page 13 of 15 ?
g. If we elect not to renew this policy, we will
give written notice to the mortgageholder at
least 10 days before the expiration date of
this policy.
G. Optional Coverages
If shown as applicable in the Declarations, the following
Optional Coverages apply separately to
each item.
1. Agreed Value
a. The Additional Condition, Coinsurance,
does not apply to Covered Property to
which this Optional Coverage applies. We
will pay no more for loss of or damage to
that property than the proportion that the
Limit of Insurance under this Coverage Part
for the property bears to the Agreed Value
shown for it in the Declarations.
b. If the expiration date for this Optional Coverage
shown in the Declarations is not extended,
the Additional Condition, Coinsurance,
is reinstated and this Optional Coverage
expires.
c. The terms of this Optional Coverage apply
only to loss or damage that occurs:
(1) On or after the effective date of this
Optional Coverage; and
(2) Before the Agreed Value expiration date
shown in the Declarations or the policy
expiration date, whichever occurs first.
2. Inflation Guard
a. The Limit of Insurance for property to which
this Optional Coverage applied will automatically
increase by the annual percentage
shown in the Declarations.
b. The amount of increase will be:
(1) The Limit of Insurance that applied on
the most recent of the policy inception
date, the policy anniversary date, or any
other policy change amending the Limit
of Insurance, times
(2) The percentage of annual increase
shown in the Declarations, expressed as
a decimal (example: 8% is .08), times
(3) The number of days since the beginning
of the current policy year or the effective
date of the most recent policy change
amending the Limit of Insurance, divided
by 365.
EXAMPLE
If: The applicable Limit of Insurance is: $ 100,000
The annual percentage increase is: 8%
The number of days since the
beginning of the policy year
(or last policy change) is: 146
The amount of increase is:
$100,000 X .08 X 146 + 365 = $ 3,200
3. Replacement Cost
a. Replacement Cost (without deduction for
depreciation) replaces Actual Cash Value in
the Valuation Loss Condition of this Coverage
Form.
b. This Optional Coverage does not apply to:
(1) Personal property of others;
(2) Contents of a residence;
(3) Works of art, antiques or rare articles,
including etchings, pictures, statuary,
marbles, bronzes, porcelains and bric-abrac;
or
(4) "Stock", unless the Including "Stock"
option is shown in the Declarations.
Under the terms of this Replacement Cost
Optional Coverage, tenants' improvements
and betterments are not considered to be
the personal property of others.
c. You may make a claim for loss or damage
covered by this insurance on an actual cash
value basis instead of on a replacement
cost basis. In the event you elect to have
loss or damage settled on an actual cash
value basis, you may still make a claim for
the additional coverage this Optional Coverage
provides if you notify us of your intent
to do so within 180 days after the loss or
damage.
d. We will not pay on a replacement cost basis
for any loss or damage:
(1) Until the lost or damaged property is
actually repaired or replaced; and
(2) Unless the repairs or replacement are
made as soon as reasonably possible
after the loss or damage.
Page 14 of 15 © ISO Properties, Inc., 2007 CP 0010 06 07 D
With respect to tenants' improvements and
betterments, the following also apply:
(3) If the conditions in d.(1) and d.(2) above
are not met, the value of tenants' improvements
and betterments will be determined
as a proportion of your original
cost, as set forth in the Valuation Loss
Condition of this Coverage Form; and
(4) We will not pay for loss or damage to
tenants' improvements and betterments
if others pay for repairs or replacement.
e. We will not pay more for loss or damage on
a replacement cost basis than the least of
(1 ), (2) or (3), subject to f. below:
(1) The Limit of Insurance applicable to the
lost or damaged property;
(2) The cost to replace the lost or damaged
property with other property:
(a) Of comparable material and quality;
and
(b) Used for the same purpose; or
(3) The amount actually spent that is necessary
to repair or replace the lost or
damaged property.
If a building is rebuilt at a new premises, the
cost described in e.(2) above is limited to
the cost which would have been incurred if
the building had been rebuilt at the original
premises.
f. The cost of repair or replacement does not
include the increased cost attributable to
enforcement of any ordinance or law regulating
the construction, use or repair of any
property.
4. Extension Of Replacement Cost To
Personal Property Of Others
a. If the Replacement Cost Optional Coverage
is shown as applicable in the Declarations,
then this Extension may also be shown as
applicable. If the Declarations show this Extension
as applicable, then Paragraph
3.b.(1) of the Replacement Cost Optional
Coverage is deleted and all other provisions
of the Replacement Cost Optional Coverage
apply to replacement cost on personal
property of others.
b. With respect to replacement cost on the
personal property of others, the following
limitation applies:
If an item(s) of personal property of others
is subject to a written contract which governs
your liability for loss or damage to that
item(s), then valuation of that item(s) will be
based on the amount for which you are liable
under such contract, but not to exceed
the lesser of the replacement cost of the
property or the applicable Limit of Insurance.
H. Definitions
1. "Fungus" means any type or form of fungus,
including mold or mildew, and any mycotoxins,
spores, scents or by-products produced or released
by fungi.
2. "Pollutants" means any solid, liquid, gaseous or
thermal irritant or contaminant, including
smoke, vapor, soot, fumes, acids, alkalis,
chemicals and waste. Waste includes materials
to be recycled, reconditioned or reclaimed.
3. "Stock" means merchandise held in storage or
for sale, raw materials and in-process or finished
goods, including supplies used in their
packing or shipping.
CP 00 10 06 07 © ISO Properties, Inc., 2007 Page 15 of 15 0
COMMERCIAL PROPERTY
CP 10 30 06 07
CAUSES OF LOSS - SPECIAL FORM
Words and phrases that appear in quotation marks have special meaning. Refer to Section G., Definitions.
A. Covered Causes Of Loss
When Special is shown in the Declarations, Covered
Causes of Loss means Risks Of Direct
Physical Loss unless the loss is:
1. Excluded in Section B., Exclusions; or
2. Limited in Section C., Limitations;
that follow.
A. Coverage
1. Business Income
Business Income means the:
a. Net Income (Net Profit or Loss before income
taxes) that would have been earned
or incurred; and
b. Continuing normal operating expenses
incurred, including payroll.
For manufacturing risks, Net Income includes
the net sales value of production.
Coverage is provided as described and limited
below for one or more of the following options
for which a Limit of Insurance is shown in the
Declarations:
(1) Business Income Including "Rental
Value".
(2) Business Income Other Than "Rental
Value".
(3) "Rental Value".
If option (1) above is selected, the term Business
Income will include "Rental Value". If option
(3) above is selected, the term Business
Income will mean "Rental Value" only.
If Limits of Insurance are shown under more
than one of the above options, the provisions
of this Coverage Part apply separately to each.
We will pay for the actual loss of Business Income
you sustain due to the necessary "suspension"
of your "operations" during the "period
of restoration". The "suspension" must be
caused by direct physical loss of or damage to
property at premises which are described in
the Declarations and for which a Business Income
Limit of Insurance is shown in the Declarations.
The loss or damage must be caused
by or result from a Covered Cause of Loss.
With respect to loss of or damage to personal
property in the open or personal property in a
vehicle, the described premises include the
area within 100 feet of the site at which the described
premises are located.
With respect to the requirements set forth in
the preceding paragraph, if you occupy only
part of the site at which the described premises
are located, your premises means:
(a) The portion of the building which you
rent, lease or occupy; and
{b) Any area within the building or on the
site at which the described premises
are located, if that area services, or
is used to gain access to, the described
premises.
2. Extra Expense
a. Extra Expense Coverage is provided at the
premises described in the Declarations only
if the Declarations show that Business Income
Coverage applies at that premises.
b. Extra Expense means necessary expenses
you incur during the "period of restoration"
that you would not have incurred if there
had been no direct physical loss or damage
to property caused by or resulting from a
Covered Cause of Loss.
We will pay Extra Expense {other than the
expense to repair or replace property) to:
(1) Avoid or minimize the "suspension" of
business and to continue operations at
the described premises or at replacement
premises or temporary locations,
including relocation expenses and costs
to equip and operate the replacement
location or temporary location.
(2) Minimize the "suspension" of business if
you cannot continue "operations".
We will also pay Extra Expense to repair or
replace property, but only to the extent it
reduces the amount of loss that otherwise
would have been payable under this Coverage
Form.
CP
|
| |
*
Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Economy Inn ("Insured") purchased an insurance policy ("Policy") from Frontline Insurance Unlimited ("Frontline”) with effective coverage on the date of loss, on or about September 28, 2022, and Policy number FICO-000207051to insure their property located 94 San Marco Ave., Saint Augustine, FL 32084 (the "Property").??
On or about September 28, 2022, the Property suffered severe damage as a result of Category 4 Hurricane Ian. As a result of this catastrophic hurricane, the Property sustained immediate direct wind damage to the roofing system, exterior and ensuing water damage. (“Loss”). Frontline was notified of the Loss on or about October 12, 2022 and was granted access to the property in order to complete their inspection. Frontline acknowledged the claim and assigned claim number? 050000001512 ("Claim") to the Loss
Frontline assigned independent adjuster Jason Green to inspect the subject property. Mr. Greene confirmed that the observed wind damage to the property that was due to Hurricane Ian. He identified 10 damaged shingles throughout multiple slopes of the roof. Based upon this inspection, Frontline valued the damages as $2,573.01 which fell below the hurricane deductible. Despite finding numerous location of wind damaged shingles across all areas of the roof structure, Frontline only allocated repair of .34 square feet of shingles.
The shingle roof was under scoped and had inaccurate measurements. Frontline failed to appropriately evaluate and assess the damage severely undervaluing the Loss and scope. Further, Frontline failed to fully and adequately indemnify the Insured for benefits owed.
Frontline has not made any supplemental payment or attempted to fully investigate the totality of the damages at the property with an appropriate investigative team. Frontline still fails to appropriately assess the scope and cost of the damages.
The Insured cooperated entirely throughout the investigation, promptly reported his loss and compiled with the post-loss conditions. Yet, Frontline failed and acted in a manner not consistent with proper post loss claim handling. The rationale and coverage amounts are not only conflicting but appear only to be rendered in order for FRONTLINE to avoid paying what is rightfully owed to the Insured pursuant to the insurance policy for which they paid premiums. The investigation supports significant damage, yet the adjustment of the claim fails to get the property back to its pre-loss condition.
After being provided plenty of evidence (including photos, contractor estimates, sworn proof of loss, and access to the property upon discovery of the leak) showing the extensive Hurricane Ian damage FRONTLINE continues to refuse to provide additional money.
The Insured has fully complied with all applicable Policy provisions requiring cooperation with the?investigation;?however, FRONTLINE has unequivocally failed to properly adjust this Claim, as further elaborated above. Rather than paying the actual damages and/or trying to appropriately settle with the Insured, FRONTLINE has continued its pre-suit failures to act in good faith into litigation by delaying the prompt resolution of the claim. FRONTLINE has not attempted, in good faith, to fully indemnify the Insured, under the circumstances, it could and should have done so had it acted fairly and honestly toward the policyholder and with due regard to the policyholder's interests.? Rather, FRONTLINE has acted with only its own profit and shareholders in mind.
As a direct consequence of Frontline’s failure to adjust this Loss in good faith and make supplemental payments, the Insured continues to be without adequate compensation for the damages sustained at the Insured's Property more than two years.??
To date, FRONTLINE has in bad faith failed to provide sufficient coverage under the Policy to the Insured. The Insured’ property continues to be in disarray. As a direct result of FRONTLINE’s underpayment of the Claim and breach of the Florida Statutes, the Insured was?forced to seek the?help of licensed professionals to assist her, including, roofing contractor and legal counsel.?Due to the amount of time that has passed since the date of loss and the information discussed above, there is irrefutable evidence that FRONTLINE knowingly and intentionally, and in bad faith delayed the settlement process in order to further disadvantage the Insured. The financial detriment caused to the Insured is a direct result of FRONTLINE reckless treatment of the claims process. The Insured submitted all documents requested in a timely fashion, made their property available for inspection immediately after the discovery of the loss, submitted an estimate, and satisfied all requests. However, FRONTLINE failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim.?
To deny the Insured the benefit clearly due and owing under the Policy, for which they have time and time again been making premium payments for and after they has satisfied all of their obligations is morally and ethically reprehensible and reeks of Unfair Claims Practice and Bad Faith.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should FRONTLINE fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, Frontline must: (1) Immediately tender all proceeds due and owing to the Insured that are fairly owed to the Insured under the insurance policy that would reasonably compensate the Insured in order to put the loss property back to its pre-loss condition; the Insured’s representative has provided their estimate for the repairs in the total amount of $124,273.70 for damage (2) Agree to reimburse the Insured's reasonable attorneys’ fees and costs for having to become involved to resolve the claim; and (3) Agree to reimburse the Insured for interest on the amount of benefits that was found to be?due and owing to the Insured, relating back to the date of loss.
|
|
|
*
|
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.
|
DFS-10-363
Rev. 10/14/2008
|