Filing Number: 794571
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| Filing Accepted: 11/27/2024 |
| Last/Business Name
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| Street Address
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4884 SW ELIM CHURCH RD |
| City, State Zip
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LAKE CITY,
FL
32024
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| Email Address
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PF@WEKLAW.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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SMITH |
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First Name |
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BOBBY |
| Policy # * |
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SJ31046766 |
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Claim #* |
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SL23205103 |
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Attorney is Applicable
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| Last Name* |
FERNANDEZ
First Name *
PATRICIA
Initial
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| Street Address* |
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800 E BROWARD BLVD, SUITE 510 |
| City, State Zip* |
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FORT LAUDERDALE
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FL
33301
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| Email Address * |
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PF@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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SLIDE 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 17227 |
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| Name of individual responsible for violation (if any):*
CANDACE CORLEY AND CLAYTON GREEN
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| Type of Insurance
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Residential Property & Casualty
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| Reason for Notice
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Claim Denial
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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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| 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)(2) |
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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.
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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)(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.
C. Loss Settlement
In this Condition C., the terms "cost to repair or
replace" and "replacement cost" do not include
the increased costs incurred to comply with the
enforcement of any ordinance or law, except to
the extent that coverage for these increased costs
is provided in E.11. Ordinance Or Law under Section
I – Property Coverages. Covered property
losses are settled as follows:
1. Property of the following types:
a. Personal property;
b. Awnings, carpeting, household appliances,
outdoor antennas and outdoor equipment,
whether or not attached to buildings;
c. Structures that are not buildings; and
d. Grave markers, including mausoleums;
at actual cash value at the time of loss but not
more than the amount required to repair or replace.
2. Buildings covered under Coverage A or B at
replacement cost without deduction for depreciation,
subject to the following:
a. If, at the time of loss, the amount of insurance
in this policy on the damaged building
is 80% or more of the full replacement cost
of the building immediately before the loss,
we will pay the cost to repair or replace, after
application of any deductible and without
deduction for depreciation, but not
more than the least of the following
amounts:
(1) The limit of liability under this policy that
applies to the building;
(2) The replacement cost of that part of the
building damaged with material of like
kind and quality and for like use; or
(3) The necessary amount actually spent to
repair or replace the damaged building.
If the building is rebuilt at a new premises,
the cost described in (2) above is limited to
the cost which would have been incurred if
the building had been built at the original
premises.
b. If, at the time of loss, the amount of insurance
in this policy on the damaged building
is less than 80% of the full replacement
cost of the building immediately before the
loss, we will pay the greater of the following
amounts, but not more than the limit of liability
under this policy that applies to the
building:
(1) The actual cash value of that part of the
building damaged; or
(2) That proportion of the cost to repair or
replace, after application of any deductible
and without deduction for depreciation,
that part of the building
damaged, which the total amount of insurance
in this policy on the damaged
building bears to 80% of the replacement
cost of the building.
c. To determine the amount of insurance
required to equal 80% of the full replacement
cost of the building immediately before
the loss, do not include the value of:
(1) Excavations, footings, foundations,
piers, or any other structures or devices
that support all or part of the building,
which are below the undersurface of the
lowest basement floor;
(2) Those supports described in (1) above
which are below the surface of the
ground inside the foundation walls, if
there is no basement; and
(3) Underground flues, pipes, wiring and
drains.
d. We will pay no more than the actual cash
value of the damage until actual repair or
replacement is complete. Once actual repair
or replacement is complete, we will
settle the loss as noted in 2.a. and b.
above.
However, if the cost to repair or replace the
damage is both:
(1) Less than 5% of the amount of insurance
in this policy on the building; and
(2) Less than $2,500;
we will settle the loss as noted in 2.a. and
b. above whether or not actual repair or replacement
is complete.
e. You may disregard the replacement cost
loss settlement provisions and make claim
under this policy for loss to buildings on an
actual cash value basis. You may then
make claim for any additional liability according
to the provisions of this Condition
C. Loss Settlement, provided you notify us
of your intent to do so within 180 days after
the date of loss.
SECTION I – CONDITIONS
C. Loss Settlement
With respect to a loss to buildings covered under
Section I caused by a "Sinkhole loss", paragraph
2.d. of the Loss Settlement Condition is replaced
by the following:
d. We will pay for the loss as follows:
(1) We will pay no more than the actual
cash value of the damaged property,
not including underpinning or grouting
or any other repair technique
performed below the existing
foundation of the building, until you
enter into a contract for the
performance of building stabilization
or foundation repairs. You must enter
into a contract for the performance of
building stabilization or foundation
repairs within 90 days after we
confirm coverage for the “sinkhole
loss” and notify you of such
confirmation. This time period is tolled
if either party invokes the “neutral
evaluation” process, and begins
again 10 days after the conclusion of
the “neutral evaluation” process.
Once you enter into such contract, we
will settle the loss as described in this
Condition and pay the amount
necessary to begin and perform such
repairs as the work is performed and
as expenses are incurred. The
stabilization and all other repairs to
the buildings covered under Section I
must be completed within 12 months
after entering into the contract for
repairs unless:
(a) There is mutual agreement
between us and you;
(b) The claim is involved with the
“neutral evaluation” process;
(c) The claim is in litigation; or
(d) The claim is under mediation.
However, if the cost to repair or
replace the damage is both:
(a) Less than 5% of the amount of
insurance in this policy on the
building; and
(b) Less than $2,500;
we will settle the loss as noted in this
Condition whether or not you have
entered into a contract to perform the
building stabilization or foundation
repairs.
(2) If the repairs have begun and the
professional engineer selected or
approved by us determines that the
recommended repairs cannot be
completed within the policy limits, we
must:
(a) Complete the recommended
repairs; or
(b) Pay the policy limits without a
reduction for the repair expenses
incurred.
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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.
Bobby Smith (the "Insured") purchased an insurance policy ("Policy") from Slide Insurance Company ("Slide"), with effective coverage on the date of the loss, on or about August 30, 2023, and policy number SJ31046766 to insure his home located at 4884 SW Elim Church Rd. Lake City FL 32024 (the "Property"). On or about August 30, 2023, the aforementioned Property suffered severe damage as the result of Hurricane Idalia, which caused ensuing damages to the Property, including but not limited to the roof, exterior, as well as water damage on the ceiling, walls, hallway damage ceiling, flooring, kitchen ceiling and walls, laundry room walls & ceiling, damage in the loft as well. The Insured promptly reported his claim to Slide. Slide acknowledged receipt of the claim by generating claim number SL23205103. Slide sent a vendor to place a tarp on the roof, as the Hurricane created a opening in the roof allowing water and the elements to enter the property. Slide’s vendor failed to adequately tarp the roof which resulted in additional unnecessary damage to the property.
Slide sent a field adjuster to inspect and he generated an estimate. Slide made a low-ball coverage decision that broadly ignored the damage sustained to the Property valuing the damage at $3,102.29, after withholding the deductible and deprecation. It was clear that Slide was trying to reduce their contractual obligation by undervaluing the damage to the insureds’ Property from the start, despite the fact that the Insureds actively provided all proof of claim needed to have their claim evaluated fairly. The Insureds sought out a contractor, Fred Perry’s Quality Construction (“Fred Perry”), to assist them with evaluating their damages. Fred Perry estimated the damage in the amount of $241,225.98.
Fred Perry placed a proper tarp on the steep roof and immediately sent their estimate to Slide. Upon receipt of the Insured’s Notice of Intent to Litigate, Slide requested mediation which resulted in an impasse. The Insured was forced to retain legal counsel and initiated his lawsuit against Slide in January 2024. Then, in February 2024, after the suit was filed, Slide issued a second payment to the Insured for $45,417.77, nearly fifteen times the amount of its original payment. This second payment was still deficient, as it did not consider the full extent of damages to the property, nor did it include any amounts for the attorney’s fees and costs that the insured was entitled to. Slide’s dramatically insufficient coverage decision has resulted in further damages to the Insureds by preventing them from returning their Property to its pre-loss condition, rather than participating in the settlement process in good faith.
After being provided plenty of evidence (including photos, estimates, access to the property, and proof of mitigation efforts) showing that wind caused damage to the roof, exterior and interior of the property that will require repairs, Slide continues to refuse to provide additional money in order to begin these repairs. Slide has the resources to repair this home, based in part off of the premiums that the Insured has been paying, but instead forced the Insured to pursue legal recourses for the money due under the contract of insurance.
The Insured has fully complied with all applicable Policy provisions requiring cooperation with the?investigation;?however, Slide 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 Insured, Slide has continued its pre-suit failures to act in good faith into litigation by delaying the prompt resolution of the claim. Slide 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 policyholder and with due regard to the policyholder's interests.? Rather, Slide has acted with only its own profit and shareholders in mind.
As a direct consequence of Slide’s failure to adjust this Loss in good faith and make any supplemental payment, the Insureds continue to be without adequate compensation for the damages sustained at the Insured’s Property more than a year ago and are continuing to sustain considerable hardship. Upon information and belief, Slide, as part of its general business practice, initially low-balls its policyholders. Slide does this in a calculated and systematic scheme that begins with manipulating the software system used in estimating its property damage claims. It appears that Slide issues its adjusters estimating software which contains construction pricing below the fair market value. It also appears that Slide trains its claim adjusters to overlook and/or turn a blind eye to a number of routine costs that Slide knows most policyholders generally would not know to request but are actually covered under the insured’s policy. Moreover, as part of this scheme, after making one initial low-ball payment – Slide stalls and intentionally delays the claim, changing adjusters, all under the false pretense that it’s “investigating” the claim. Slide has violated Florida Statute § 624.155(1)(b)(1) by continuously not attempting in good faith to settle this claim when it should have done so if it had acted fairly and honestly towards its insureds. Slide has also violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle this obviously covered claim to influence settlement in its favor. Despite being presented all of the indisputable evidence of the amount of damage sustained by this Property, it is a disgrace that the Insureds have been treated in this manner by their insurance company after sustaining an obviously covered loss, submitting to every demand of Slide, and making a good faith effort to resolve in an attempt to amicably come to a fair resolution. Slide violated Florida Statutes § 626.9541(1)(i)(2) and § 626.9541(1)(i)(3)(b) by making material misrepresentations to the Insureds for the purpose and with the intent to settle the claim on less favorable terms than those provided and contemplated by the policy. Slide was informed multiple times of the discrepancies and inconsistencies of the low-ball payment issued to the Insureds. While Slide was made aware of this information for the purpose of obtaining the money contractually owed to the Insureds under its insurance policy to attempt to return their home to its pre-loss condition in a timely fashion, Slide accepted that information and has used it to play the delay game with the Insureds, knowing all too well the additional damage and hardship that was being placed on the Insureds by its actions. Slide violated § 626.9541(1)(i)(3)(a) when it failed to adopt and implement standards for the proper investigations of claims. Under no circumstances is there an excuse for the lack of a proper investigation in this case. Slide and their representatives are willfully blind and grossly underqualified to handle a loss such as the one sustained by the Insureds. In addition, after being placed on notice as to the blatant underpayment of the Insureds’ claim, Slide has yet to rectify their actions and do right by the Insureds by paying the money they are contractually owed. Slide violated § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon the communications with respect to the claim. There still has yet to be significant action taken by Slide to this date, despite Slide being presented with the flawed rationale behind their underpayment of the Insureds’ claim. Slide violated § 626.9541(1)(i)(3)(g) by failing to promptly notify the Insureds of any additional information necessary for processing the claim. The Insureds have more than complied with each and every request and there has still been no action by Slide. In the event Slide is in need of additional information, they have failed to promptly notify the Insureds in a timely manner. This pattern of behavior is perpetuated by Slide and their representatives undeterred by the Ethical Requirements that are imposed by law on all Adjusters. Fla. Admin. Code Ann. R. (3) explicitly states the adjustment of insurance claims engage the trust of the public, and therefore, an adjuster has a duty of fair and honest treatment of the insureds throughout the insurance claim process. Several duties and responsibilities to the Insureds were violated in the handling of this claim, which are specifically listed responsibilities of an Adjuster in the Florida Administrative Code. These breached duties and responsibilities include adjusters from Slide approaching the investigation and settlement in a manner prejudicial to the Insureds, failing to allow a fair settlement with the Insureds, and acting with due diligence in achieving a proper disposition of the claim. In contrast to the legislative intent motivating the enumeration of an Adjuster’s responsibilities outlined in the Administrative Code, the Insureds were not afforded the professional duties entrusted on Slide by the public. To date, Slide has failed to adequately compensate the Insureds for the damage that occurred on August 30, 2023. As a direct result of Slide’s delay, the Insureds were forced to seek the help of legal counsel to assist them. Due to the amount of time that has passed since the date of loss, this acknowledgement is evidence that Slide knowingly and intentionally are delaying the claims process in order to further disadvantage the Insureds. The financial detriment caused to the Insureds and their family is a direct result of Slide’s reckless delay of the claim process. The Insureds are dutiful customers who made it a priority to pay their insurance premiums to ensure that in such an event as this devastating incident, their home would be covered. The Insureds timely filed their claim and fulfilled all of their post-loss obligations. All requested information and documentation has been turned over to Slide and their representatives promptly by the Insureds. However, Slide failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim, failed to inform the Insureds how they may remedy any deficiencies in their claim, and failed to provide them with qualified representatives to ensure the claim was initially adjusted, evaluated, and estimated properly. To deny the Insureds the benefit of their bargain after they satisfied all of their obligations is morally and ethically reprehensible, and reeks of Unfair Trade Practice. Upon information and belief, the aforementioned actions complained of, among others, were made by Slide so often as to constitute a general business practice, evidencing a motive to enhance Slide’s profits, and designed to cause a detrimental effect to its policy holders. Slide was aware that the Insureds’ damages were covered and took advantage of its Insureds in an attempt to force them into an irreparably disadvantaged position, which they hope will force the Insureds to settle for less coverage than they are contractually entitled to under the policy. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Slide 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, Slide must: (1) Immediately tender all insurance proceeds due and owing to the Insureds that are fairly owed to the Insureds under the insurance policy that would reasonably place the Insureds back to a pre-loss condition; (2) Agree to reimburse the Insureds’ reasonable attorneys’ fees and costs for having to become involved to resolve the claim; (3) 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. The Insured hereby request that Slide now make a reasonable counter-offer before the expiration of the cure period.
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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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