Civil Remedy Notice of Insurer Violations
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Filing Number:     794640
Filing Accepted:  11/29/2024
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Complainant
Last/Business Name *  
LARSON   First Name   SOREN
Street Address * 16 ISLAND AVE 4E
City, State Zip * MIAMI BEACH, FL 33139
Email Address * SOREN.LARSON@GMAIL.COM
Complainant Type: * Third Party
Insured
Last/Business Name*   JOHNSON CONTROLS INTERNATIONAL   First Name  
Policy # * MWZY31394823 Claim #* 4A24070YKRB-0001
Attorney
Attorney is Applicable
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   OLD REPUBLIC INSURANCE COMPANY
NAIC Company Code 24147
 
Name of individual responsible for violation (if any):* STEPHEN HIERHOLZER, CLAIMS EXAMINER, SEDGWICK CLAIMS MANAGEMENT SERVICES
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
* 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.
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)(d) Denying claims without conducting reasonable investigations based upon available information.
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 denial of a claim or for the offer of a compromise settlement.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Commercial General Liability Coverage (MWZY313947-23): Policy provides coverage for 'property damage' to third parties arising from covered operations. Additional Insured endorsements A2 and A2A specifically extend coverage to property owners for both ongoing and completed operations. Policy obligates insurer to pay 'those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage.' Coverage applies to damage caused by the insured's contractors or subcontractors performing work within the scope of operations.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On July 1, 2024, JCI's contracted work caused substantial water damage to claimants' property at 16 Island Avenue 4E, Miami Beach. Documented damages total $75,942.54, comprising: 1. B&B Italia Camaleonda sofa replacement: $56,094.75 (manufacturer's quote) 2. Granite flooring replacement with installation: $18,884.79 (Opustone Invoice #71793, Pando Property Services Quote) 3. Professional furniture reupholstery: $963.00 Claims handler Stephen Hierholzer of Sedgwick, acting on behalf of Old Republic Insurance Company: - Initially falsely denied furniture presence without investigation - Reversed position only after confronted with video evidence - Offered $4,709.40 (6.2% of documented damages) without explanation - Responded "Offer stands" to detailed damage documentation - Improperly suggested filing with homeowner's insurance despite clear contractor liability This pattern constitutes: 1. Failure to conduct reasonable investigation 2. Misrepresentation of material facts 3. Failure to implement proper claims standards 4. Bad faith settlement practices All damages are thoroughly documented through professional quotes, photographic evidence, video documentation, and contemporaneous communications. Insurer's conduct demonstrates systematic violation of Florida statutory obligations regarding fair claim settlement practices.
Comments
User Id Date Added Comment
legal.claims@sedgwickcms.com 01-28-2025 Florida Department of Financial Services 200 East Gaines Street Tallahassee FL 32399 RE: CRN Filing No.: 794640 Complainant: Soren Larson and Joshua Goldfarb Claim No.: 4A24070YKRB-0001 Date of Accident: 7/1/2024 Client/Insured: Johnson Controls International Carrier: Old Republic Insurance Company Policy No.: MWZY31394823 Please allow this correspondence to serve as a response to the Civil Remedy Notice of Insurer Violation no. 794640 filed against Old Republic Insurance Company on behalf of Soren Larson and Joshua Goldfarb. The Notice was accepted by the Department of Financial Services on 11/29/2024. Sedgwick, on behalf of Old Republic Insurance Company, respectfully denies the allegations of various statutory violations and assert that we have handled this claim fairly, reasonably and in good faith. A separate response was sent to the complainant on 1/23/2025.
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