Civil Remedy Notice of Insurer Violations
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Filing Number:     794127
Filing Accepted:  11/26/2024
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Complainant
Last/Business Name *  
O'NEILL   First Name   DONNA
Street Address * 5633 72ND STREET N
City, State Zip * ST. PETERSBURG, FL 33709
Email Address * DONNAONEILL@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   O'NEILL   First Name   DONNA
Policy # * 273625 Claim #* 940808
Attorney
Attorney is Applicable
Last Name* WOOD First Name * ANGELA Initial
Street Address* 350 N. LAKE DESTINY ROAD
City, State Zip* MAITLAND , FLORIDA 32751
Email Address * AWOOD@ITSABOUTJUSTICE.LAW
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
NAIC Company Code 12944
 
Name of individual responsible for violation (if any):* ERICK HERRARA
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Claim Delay
* 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)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
* 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 certified copy of the policy is not in the Insureds’ possession, but based on information and belief, the following policy provisions are relevant to this civil remedy notice. Section 1 - Property Coverages – Coverage A – Dwelling Section 1 – Perils Insured Against – Coverage A-Dwelling and Coverage B-Other Structures Section 1- Conditions –Loss Settlement Section 1 – Conditions –Loss Payment by violating the following statutory provisions:
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about January 9, 2024 the Insured, Donna O’Neill, suffered damage to her home located at 5633 72nd St. N, St. Petersburg, FL 33709 as a result of a wind and water event. Prior to the loss, Homeowners Choice Property & Casualty Insurance Company (“Homeowners Choice”), had issued a policy of insurance (Policy No.: 273625) for the Insured’s property. Said policy, which was issued prior to the loss, was in full force and effect and afforded coverage for damage caused by the wind and water. Homeowners Choice was timely notified of the loss by the Insured and assigned claim number 940808. During the course of Homeowners Choice’s investigation, the Insured made her property available for inspection, provided facts and information surrounding the loss, and complied with Homeowner Choice’s adjustment of the claim. Although Homeowners Choice acknowledged the Insured’s property was damaged by the wind and water, Homeowners Choice inexplicably underpaid a majority of the damages claimed, specifically with respect to the roof and interior damage. Homeowners Choice came to its coverage determination by ignoring relevant facts and information provided by the Insured and her contractors that established the damages to the roof were substantial and required a full replacement. Most concerning, Homeowners Choice and its representatives intentionally downplayed and misrepresented the scope of the damages. Homeowners Choice failed to conduct a thorough evaluation as to the age and repairability of the roof that caused it to substantially undervalue the loss as a whole. Homeowners Choice also omitted key facts from its coverage decision and misapplied exclusions to minimize its financial exposure in the claim. On March 15, 2024, Homeowners’ Choice issued its’ coverage decision and advised the Insured that if the roof was replaced and documentation shown the depreciated value of $2,449.86 would be paid. Prior to filing the Notice of Intent to Litigate, the Insured provided Homeowners Choice with an invoice and proof that the roof had in fact been replaced. Despite this, Homeowners Choice has failed to provide the depreciated value its’ own adjusters calculated. It is clear that Homeowners Choice has not acted honestly or fairly towards its Insured. Homeowners Choice and its representatives have failed to conduct a proper investigation of the loss, misrepresented the cause and scope of damages at the residence, and misapplied exclusions in the policy in order to wrongfully underpay the Insured’s claim. It has become a general business practice of Homeowners Choice to not implement proper claims handling procedures, to hire consultants that routinely ignore or intentionally misidentify relevant evidence, and to not settle claims in good faith when under all circumstances it should have. As is the case here, it is a pattern and practice for Homeowners Choice to arbitrarily undervalue claims without conducting reasonable investigations based upon information and evidence available to it. It is also a pattern and practice of Homeowners Choice to fail to disburse payments it agrees it owes. In order to cure this civil remedy notice, Homeowners Choice must immediately acknowledge in writing that the Insured’s property was damaged by a wind and water event and that replacement of the roof is covered by the policy. Homeowners Choice must also tender the undisputed benefits owed to replace the roof pursuant to the terms of the policy. The written acknowledgement and payment should be issued to the Insureds’ counsel, Angela A. Wood, Esq., at 350 N. Lake Destiny Road, Suite 300, Maitland, FL 32751.
Comments
User Id Date Added Comment
Legal@hcpci.com 01-23-2025 This is Homeowners Choice Property & Casualty Insurance Company’s (“HCPCI”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by attorney Angela Wood on behalf of Donna O’Neill (“Insured”). HCPCI reviewed this CRN and conducted a thorough review of the subject claim (“claim”) and confirmed it handled the claim properly. Regarding an aspect of the claim, HCPCI issued payments for it on the information available to HCPCI and the circumstances at the time of such payments. HCPCI handled the claim in accordance with the policy and all statutory and regulatory requirements. HCPCI denies each allegation of bad faith and improper conduct in the CRN. At all times, HCPCI acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. Otherwise, the CRN is deficient. Generally, pursuant to Florida Statutes, Section 624.155, CRNs must identify and set forth statutory provisions insurers allegedly violated in handling insureds’ insurance claims along with specific, relevant insurance contract language and facts and circumstances. The foregoing provides insurers with notice of alleged statutory violations AND the opportunity to cure such alleged violations. Instead of complying with Florida Statutes, Section 624.155, the Insured’s attorney in the CRN contained an inaccurate recitation of the facts, failed to reference specific, relevant insurance policy language; cited irrelevant statutes; and relied on inaccurate and conclusory statements. The Insured’s laundry list of inapplicable statutes is insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Furthermore, the Insured’s attorney filed a lawsuit based on the claim prior to the filing of this CRN. Regardless of the fact there were no violations in this case, any action by HCPCI to cure violations alleged in the CRN could have been used against HCPCI in the lawsuit. The foregoing shows abuse by the Insured and the Insured’s attorney of the CRN and legal processes. Also and generally, the CRN constitutes an abuse of the CRN process, contravenes the purpose of CRNs, which is to promote resolution of issues in insurance claims. The CRN must be rejected, and it cannot serve as the basis of any action against HCPCI. Upon request by the Florida Department of Financial Services, HCPCI will provide to the DFS detailed correspondence HCPCI provided regarding the claim.
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