Filing Number: 794363
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| Filing Accepted: 11/26/2024 |
| Last/Business Name
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NAZARETH
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First Name |
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RICHARD |
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| Street Address
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124 S BUMBY AVE |
| City, State Zip
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ORLANDO,
FL
32803
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| Email Address
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RICHARD@NAZARETHLAW.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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USAA CASUALTY INSURANCE COMPANY |
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First Name |
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| Policy # * |
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CIC1 - 006411405 90A |
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Claim #* |
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006411405-801 |
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Attorney is Applicable
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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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USAA CASUALTY 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 25968 |
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| Name of individual responsible for violation (if any):*
3J7Q23859XQDM@CLAIMS.USAA.COM
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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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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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| 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)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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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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| 626.9541(1)(i)(3)(f) |
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Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
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| 626.9541(1)(i)(3)(g) |
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Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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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.
N/A
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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.
Insured Property: 124 S. Bundy Ave., Orlando, FL 32803
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DESCRIPTION OF VIOLATION
This Civil Remedy Notice (CRN) is submitted pursuant to Section 624.155, Florida Statutes, and serves to provide USAA Insurance with notice of its violations of Florida law and to give the insurer the statutory opportunity to cure these violations.
Summary of Facts:
The insured submitted a valid claim under a homeowner’s insurance policy for property damage resulting from a hurricane. The damages included but were not limited to:
• Wind Damage: Severe structural damage to the roof, exterior walls, and other parts of the property.
• Water Damage: Damage caused by water intrusion exacerbated by USAA’s failure to promptly address the insured’s claim.
Despite clear evidence of covered losses, USAA:
1. Failed to timely investigate, evaluate, and resolve the claim.
2. Grossly undervalued the damages, offering a settlement far below the repair and restoration costs, which were supported by detailed estimates, reports, and invoices.
3. Engaged in actions constituting unfair claim settlement practices in violation of Florida law.
The insurance coverage was clearly sufficient to cover the full scope of damages, yet USAA’s actions and omissions demonstrate a deliberate disregard for the insured’s rights under the policy.
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VIOLATIONS OF FLORIDA STATUTES
The insurer has violated the following provisions of Florida law, including but not limited to:
1. Section 624.155(1)(b)(1): Failing to attempt 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.
2. Section 624.155(1)(b)(3): Failing to promptly settle claims, where the obligation to settle is reasonably clear under one portion of the insurance policy coverage, to influence settlements under other portions of the insurance policy coverage.
3. Section 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims.
4. Section 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
5. Section 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims.
6. Section 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information.
7. Section 626.9541(1)(i)(3)(f): Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for the denial of a claim or for the offer of a compromise settlement.
8. Section 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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OPPORTUNITY TO CURE
USAA is hereby provided an opportunity to cure these violations in accordance with Section 624.155, Florida Statutes. To cure the defects outlined in this CRN, USAA must:
1. Tender the full amount of the claim as supported by documentation, repair estimates, and reports.
2. Pay all statutory interest due for the delay in claim payments.
3. Reimburse the insured for all reasonable attorneys’ fees and costs incurred as a result of USAA’s bad-faith conduct.
Failure to cure within the statutory period will result in the insured pursuing all available remedies under Florida law, including filing a bad faith lawsuit in the Ninth Judicial Circuit Court, Orange County, Florida.
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CONCLUSION
This Notice of Civil Remedy is intended to comply with all notice requirements set forth under Florida law. If USAA has any questions regarding this Notice or requires additional information, it should promptly contact the undersigned.
Respectfully,
Richard Martin Nazareth
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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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