Filing Number: 794303
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| Filing Accepted: 11/26/2024 |
| Last/Business Name
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WHITMER
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First Name |
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EDWARD AND ELIZABETH |
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| Street Address
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115 BAY MAR DRIVE |
| City, State Zip
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FORT MYERS BEACH,
FL
33931
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| Email Address
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JDS@WEKLAW.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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WHITMER |
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First Name |
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EDWARD AND ELIZABETH |
| Policy # * |
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HCPC-HW2-434978-9 |
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Claim #* |
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927274 |
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Attorney is Applicable
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| Last Name* |
SPILLER
First Name *
JASON
Initial
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| Street Address* |
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800 EAST BROWARD BLVD., SUITE 510 |
| City, State Zip* |
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FORT LAUDERDALE
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FLORIDA
33301
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| Email Address * |
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JDS@WEKLAW.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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TYPTAP INSURANCE COMPANY
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| Insurer Name* |
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| Street Address* |
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| City, State Zip* |
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,
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NAIC Company Code 15885 |
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| Name of individual responsible for violation (if any):*
PARESH PATEL
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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 Delay
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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Statutory provision(s) which the insurer allegedly violated.
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| 624.155(1)(b)(1) |
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Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
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| 626.9541(1)(i)(3)(a) |
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Failing to adopt and implement standards for the proper investigation of claims.
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| 626.9541(1)(i)(3)(b) |
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Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
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| 626.9541(1)(i)(3)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
PROPERTY COVERAGES
A. Coverage A – Dwelling
1. We cover:
a. The dwelling on the “residence
premises” shown in the
Declarations, including structures
attached to the dwelling; and
b. Materials and supplies located on or
next to the "residence premises"
used to construct, alter or repair the
dwelling or other structures on the
“residence premises”.
B. Coverage B – Other Structures
1. We cover other structures on the
“residence premises” set apart from the
dwelling by clear space.
This includes structures connected to
the dwelling by only a fence, utility line,
or similar connection.
C. Coverage C – Personal Property
1. Covered Property
We cover personal property owned or
used by an “insured” while it is
anywhere in the world.
After a loss and at your request, we will
cover personal property owned by:
a. Others while the property is on the
part of the “residence premises”
occupied by an "insured"; or
b. A guest or a “residence employee”,
while the property is in any
residence occupied by an
“insured”.
D. Coverage D – Loss of Use
The limit of liability for Coverage D is the
total limit for the coverages in 1. Additional
Living Expense, 2. Fair Rental Value and 3.
Civil Authority Prohibits Use below.
1. Additional Living Expense
a. If a loss covered under PROPERTY
COVERAGES makes that part of the
“residence premises” where you
reside not fit to live in, we cover
any necessary increase in living
expenses incurred by you so that
your household can maintain its
normal standard of living.
b. Payment will be for the shortest
time required to repair or replace
the damage or, if you permanently
relocate, the shortest time required
for your household to settle
elsewhere.
c. In either event, the payment(s) will
be limited to 24 consecutive
months from the date of the
covered loss.
PERIL INSURED AGAINST
1. We insure for direct physical loss to the
property described in Coverages A, B and
C caused only by the peril of windstorm or
hail unless the loss is excluded in
EXCLUSIONS.
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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.
Elizabeth and Edward Whitmer (“Insureds”) purchased an insurance policy ("Policy") from TypTap Insurance Company (“Carrier”) with effective coverage on the date of loss, on or about September 28, 2022, and Policy number HCPC-HW2-434978-9 to insure their property located at 115 Bay Mar Dr., Fort Myers Beach, FL 33931 ("Property").
On or about September 28, 2022, the Property, which is located in Fort Myers, Florida, was completely devastated as a result of Hurricane Ian, a category 5 storm that destroyed Florida’s west coast, requiring the complete demolition of the Property ("Loss"). Specifically, due to the catastrophic winds, a neighboring property’s roof detached from its structure, carried like a sail, and smashed into the Insureds’ Property, causing extensive foundational and/or structural damage that not only rendered it unsafe to inhabit but mandated the Property’s demolition. The Insureds have tragically lost their home as a result of the Loss. While the Insureds’ Property did suffer some flood-related damage, to which the Insureds submitted a claim to their flood insurance carrier and received payment of approximately $250,000.00 (the flood policy’s limits), it was not until the aforementioned impact from the neighboring property that directly caused the structural and foundational issues that ended up costing the Insureds their home.
In addition to losing their home, the Insureds lost thousands of dollars in personal items and, obviously, had to find a new place to live while their home is being rebuilt (which, to date – over two years later – is still ongoing).
The Insureds engaged a construction company, Everglades Construction Group, who provided a proposal of $673,846.00 to rebuild their home. This documentation was provided to the Carrier, along with photographs and estimates from their public adjuster, Firehouse Adjusters, who assisted them in handling the claim against the Carrier for the wind-related portion of the damages.
Upon receiving notice of the claim, the Carrier acknowledged it and assigned claim number 927274 ("Claim") to the Loss. Thereafter, the Carrier inspected and documented the observable damages, and prepared an estimate in the amount of $171,621.82 Replacement Cost Value, and $158,654.59 in Actual Cash Value for the wind-related damage to the dwelling itself. However, despite the clear underpayment for the dwelling portion, the Carrier completely omitted payment for any contents or additional living expenses, which they were clearly aware of and were provided with clear, uncontested evidence in support of same.
To date, despite cooperating with everything asked of them by the Carrier, complying with all necessary conditions of their Policy, and providing all necessary supporting documentation substantiating the Carriers clear underpayment and breach of the Policy, the Insureds are still without adequate compensation to rebuild their home that was lost in its entirety as a result of the Loss. The Carrier has unequivocally failed to properly adjust this Claim, as further elaborated above. Rather than paying the actual damages and/or trying to settle with the Insureds, the Carrier has failed to act in good faith, delaying any prompt resolution of the claim. The Carrier has not attempted, in good faith, to settle this claim when, under the circumstances, it could and should have done so had it acted fairly and honestly toward the policyholders and with due regard to the policyholders' interests. As a result of this incident, the Insureds have lost their Property, lost of use of the Property, and possessions therein.
As a direct consequence of the Carrier’s failure to adjust this Loss in good faith and make adequate payment, the Insureds continue to be without sufficient compensation for the damages sustained at the Insureds' Property.
By stating the above detailed facts, it is clear that the Carrier has violated the following Florida statutes:
• 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 Insureds and with due regard for their interest;
• 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)(d) Denying claims without conducting reasonable investigations based upon available information.
To date, the Carrier has acted in bad faith and failed to provide coverage under the Policy to the Insureds. As a direct result of Carrier’s underpayment of the Claim and breach of the Florida Statutes, the Insureds was forced to seek the help of licensed professionals to assist them, including a public adjuster 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 Carrier knowingly and intentionally, and in bad faith delays the settlement process in order to further disadvantage the Insureds. The financial detriment caused to the Insureds are a direct result of the Carrier’s reckless treatment of the claims process. The Insureds submitted all documents requested in a timely fashion, made their property available for inspection, submitted estimates and requests. However, the Carrier failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim.
To deny the Insureds the benefits clearly due and owing under the Policy, for which he has time and time again been making premium payments for and after he has satisfied all of their obligations is morally and ethically reprehensible, and reeks of Unfair Claims Practice and Bad Faith. Upon information and belief, the aforementioned actions complained of, among others, were made by the Carrier so often as to constitute a general business practice, evidencing a motive to enhance the Carrier’s profits, and designed to cause a detrimental effect to its policyholders. The above clearly depicts that the Carrier adjusted this claim in bad faith, continue to act in bad faith towards its Insureds, and that the Carrier is in direct violation of Unfair Claims Practices.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should the Carrier 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, the Carrier must: (1) Immediately tender the Policy limits, minus prior payments and the Policy’s deductible, in US dollars to the Insureds which is fairly owed to the Insureds under the insurance policy and would reasonably compensate the Insureds in order to put the Property back to its pre-loss condition; (2) Agree to reimburse the Insureds for interest on the amount of benefits that was found to be due and owing to the Insureds, relating back to the date of loss; and (3) Agree to reimburse the Insureds’ reasonable attorneys’ fees and costs for having to become involved to resolve the claim.
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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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