Filing Number: 794716
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| Filing Accepted: 12/2/2024 |
| Last/Business Name
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| Street Address
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3059 HOLCOMB RD. |
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PORT CHARLOTTE,
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33981
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| Email Address
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JILLMEAD3059@GMAIL.COM |
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Insured |
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| Last/Business Name* |
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MEAD |
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First Name |
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JILL |
| Policy # * |
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FFH3-000030543 |
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Claim #* |
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01000082025 |
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Attorney is Applicable
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| Last Name* |
WEIDNER
First Name *
KEITH
Initial
W.
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| Street Address* |
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1700 W. MAIN ST., SUITE 100 |
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PENSACOLA
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FL
32502
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| Email Address * |
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KWEIDNER@TWWLAWFIRM.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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FIRST PROTECTIVE 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 10897 |
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| Name of individual responsible for violation (if any):*
JENNIFER EVANS; CARL KRISTENSEN; IRENE STEWART; ERIN THIBODEAUX; ERICA GRADDY; JAMES PEARCE; TYLER ROCH; LARRY BREE MCCORKLE; THOMAS TEMPLETON; SHANANE WHYTE; SAMUEL ADUSEI; JORDAN HERL; JAROD STEVENS; MICHAEL POOL; MARGARET FEATHERMAN; RICHARD COLLI
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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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Unfair Trade Practice
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Unsatisfactory Settlement Offer
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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)(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)(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)(h) |
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Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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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.
COVERAGE A – Dwelling [SPECIAL PROVISIONS – FLORIDA]
We cover:
1. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling
Loss Settlement
Covered property losses are settled as follows:
a. Property of the following types:
(1) Personal property;
(2) Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings;
(3) Structures that are not buildings;
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at actual cash value at the time of loss but not more than the amount required to repair or replace.
2. Buildings under Coverage A or B at replacement cost without deduction for depreciation, subject to the following:
a. [SPECIAL PROVISIONS – FLORIDA] 2. Buildings 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 initially pay the actual cash value, less any applicable deductible. We will then pay any remaining amounts necessary to perform the actual repair or replacement as work is performed and expenses are incurred, 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 for like construction and use on the same premises; or
3. The necessary amount actually spent to repair or replace the damaged building.
F. Mediation or Appraisal. [SPECIAL PROVISIONS – FLORIDA] If you and we fail to agree on a settlement regarding the loss, prior to filing suit, you must notify us of your disagreement in writing so that either party may:
2. Request an appraisal of the loss if we fail to agree on the amount of the loss.
a) A request for appraisal must be in writing and be signed by all Named “Insureds” shown in the Declarations.
At least 10 days before requesting appraisal, the party seeking appraisal must provide the other party with a written estimate of the amount of any dispute that results from the covered cause of loss. The estimate shall include a description of each item of damaged property in dispute as a result of the covered loss, along with the extent of damage and the estimated amount to repair or replace the item.
b) In this event, each party will choose a competent appraiser within 20 days after receiving a written request from the other. To qualify as a competent appraiser, neither the appraiser nor the company that employs the appraiser is entitled to receive a fee that is dependent on the amount of the appraisal award. However, the payment of an hourly or flat fee shall not render an appraiser incompetent under this provision.
c) The two appraisers will choose a competent, disinterested umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a court of record in the state where the “residence premises” is located.
d) The appraisers will separately set the amount of the loss. If the appraisers submit a written report of an agreement to us, the amount agreed upon will be the amount of the loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of the loss.
10. Loss Payment. [SPECIAL PROVISIONS – FLORIDA] We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment and we have not elected our option to repair.
1. Loss will be payable upon the earlier of the following:
a. 20 days after we receive your proof of loss in compliance with SECTION I- CONDITIONS, C. Duties After Loss, paragraph 9, and reach written agreement with you; or
b. 60 days after we receive your proof of loss in compliance with SECTION I- CONDITIONS, C. Duties After Loss, paragraph 9; and
(1) There is an entry of a final judgment; or
(2) There is a filing of an appraisal award or a mediation settlement with us.
c. If payment is not denied, within 90 days after we receive notice of an initial, reopened or supplemental claim.
This Civil Remedy Notice is also grounded in First Protective Insurance Company’s statutory duty to act in good faith and deal fairly with its insured when handling claims.
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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.
The policyholder, Jill Mead (“Mead”), sustained losses to her property located at 3059 Holcomb Rd., Port Charlotte, FL 33981 caused by and following Hurricane Ian as referenced in this Civil Remedy Notice. Mead timely notified First Protective Insurance Company d/b/a Frontline Insurance (“Frontline”) of the claim. From the outset of the claim, Frontline has disputed the scope and cost of repairs and resisted Mead’s requests and evidence showing the full scope of covered damage and the actual cost to repair. Frontline has repeatedly weaponized the policy provisions to harass and bully Mead with the goal of forcing her to accept less than the full amount she is owed under the policy. This conduct was wrongful, in bad faith, and has caused both unnecessary, unacceptable delay of payment in full on this claim as well as additional harms and losses to Mead over and above the amount owed under the policy of insurance.
Frontline was provided full access to the property to inspect and identify all the covered damage after the storm. However, Frontline’s initial inspection was inadequate and did not result in an accurate estimate of the cost to repair. Frontline’s field adjuster was either not sufficiently experienced or trained to identify all damage caused by wind and properly estimate the full cost of repairs or the field adjuster’s estimate was wrongfully, subsequently adjusted by Frontline to result in an incomplete, inaccurate estimate of the damage. Specifically, Frontline’s initial determination that the entirety of the covered damage resulted in only $32,137.31 replacement cost value on the dwelling was inaccurate and constituted an active effort by Frontline to ignore covered damage and prepare an estimate that would not allow for the full scope of repairs so that Mead could restore her property to its pre-loss condition. Frontline’s initial lowball estimate was an attempt to avoid its obligation to pay this claim in full so Frontline could save money on the claim. This conduct was in bad faith and caused significant, unavoidable delay on this claim.
Frontline chose to rely on its inaccurate, incomplete estimate in issuing an inadequate payment on the claim in the amount of $27,817.31. Frontline knew, or should have known, this minuscule payment would not allow Mead to fully restore her property to its pre-loss condition. This conduct put Mead at risk for further damage both to her home and potentially to her health because the funds Frontline issued were not adequate to fully repair the property. This conduct was in bad faith and showed an intent by Frontline not to adjust this claim in the best interest of Mead as it is required by the policy and applicable Florida law but, rather, to adjust the claim in its own best interest to save money.
As a result of Frontline’s failure to accurately and timely adjust and pay this claim and its errors and incomplete estimate, Mead was forced to incur costs in hiring a reputable, skilled public adjuster to prepare an estimate of the cost to repair the covered damage. Mead’s public adjuster inspected the property and estimated the cost to repair the covered damage at $221,943.08, replacement cost value on the dwelling, which represents a far more accurate estimate of the cost to repair the entirety of the damage caused to Mead’s home by wind during the storm. Had Frontline adjusted the claim initially in good faith and in Mead’s best interest, Frontline’s initial inspection and estimate would have resulted in a fair amount of compensation that would not have forced Mead to have to hire a public adjuster to protect her interests and right to be paid in full on the claim.
Comparing Frontline’s initial estimate of $32,137.31 to Mead’s public adjuster’s estimate of $221,943.08, Frontline’s estimate amounts to an unacceptable 14%—less than a quarter—of the actual claim value. An estimate this inexplicably low could only have been prepared in bad faith with the goal of undermining the claim value so Frontline could pay less on this claim. Frontline’s conduct in this regard—showing a lack of concern for its inadequate adjustment of this claim and its failure and/or refusal to pay Mead what it knows is the true amount required to repair the property—has been in bad faith.
Mead also submitted sworn proof of loss to Frontline in January 2023 supported by her public adjuster’s itemized estimate and photo report. However, Frontline did not give this evidence meaningful consideration by immediately offering more money on the claim. Rather, Frontline’s response was to ask Mead to open her property a second time so that Frontline could be provided a second opportunity to inspect the property, identify all covered damage, and accurately estimate the cost to repair. Following the re-inspection, Frontline prepared a second estimate of the damages at $161,332.43 replacement cost value on the dwelling, which it subsequently increased to $164,939.85. Frontline did not offer any explanation as to why it had initially estimated the damages at only $32,137.31 and only increased its estimate by more than five times after Mead hired a public adjuster, provided a competing estimate and sworn proof of loss, and demanded Frontline pay the claim in full.
The fact that Mead had to jump through such incredible hoops just to get Frontline to increase its estimate shows Frontline’s sole goal in adjusting this claim was to bully and harass Mead into eventually giving up on her rights and accepting less than the full amount to which she is entitled on this claim. Had Frontline adjusted the claim in Mead’s best interest from the outset, there would not have been such substantial delay of payment and additional strain and hardship placed on Mead as a result of Frontline’s wrongful conduct. Frontline’s stairstep increases in its estimates and delay on the claim also shows Frontline chose to ignore credible evidence from its insured and rely solely on persons it retained whom it knew would assist Frontline in undervaluing the claim and paying less than the full and fair value of the claim.
In addition, Frontline’s decision to offer another inadequate payment of only $114,054.79 following the re-inspection and Mead’s submission of substantial evidence showing the damages were much greater than Frontline initially represented to Mead was in bad faith and was an attempt by Frontline to offer Mead some payment in hopes she would accept a smaller amount and discontinue her fight for payment in full. Mead will not. Although Frontline issued an additional payment of $39,115.97, the bulk of this payment was attributed to loss of use and personal property, not the dwelling. Also, these payments were not made until almost six months after the loss although Frontline had complete access to the property immediately after the loss and adequate information to have issued such payments mere weeks or a month after the storm. Frontline has not offered any credible reason for its delay in this regard in violation of its contractual and statutory obligations to Mead to efficiently and accurately adjust this claim in Mead’s best interest.
Frustrated with Frontline’s dilatory and wrongful handling of this claim, Mead retained a contractor to perform the necessary roof replacement and other repairs in January, 2024. Mead paid her contractor $85,759.79 to perform these necessary repairs. She submitted proof of her payment to Frontline immediately to recover this amount as a necessary expense incurred. Rather than immediately issue payment to Mead for the amount she paid to her contractor, Frontline chose to continue its pattern of stall and delay. Eighteen months after the loss the parties remained in dispute over the scope and cost of repairs, and on April 17, 2024, Frontline demanded an appraisal in this matter and appointed its appraiser, Bree McCorkle. Mead promptly appointed James Headrick as her appraiser. The appraisal inspection took place on May 29, 2024. This was Frontline’s third inspection of the property. The appraisers appointed Richard Collins as their umpire. Following the appraisal inspection, Frontline began issuing repetitive, comprehensive requests for information from Mead with the goal of intimidating and harassing her.
Specifically, Frontline demanded Mead produce all invoices and receipts for work completed on the property since date of loss, all expert reports, repair estimates, receipts, invoices, bid, photos, videos secured or provided in relation to the claimed damages, copies of any correspondence relating to the loss such as contracts, work authorizations, and assignment of benefits, executed authorization forms for any records Frontline deems necessary to its investigation. This included, but was not limited to, executed authorization forms to submit to Federal Emergency Management Agency (FEMA), all settlement documents from damages occurring due to flood from either FEMA or Mead’s flood carrier, an acknowledgment that a flood claim was or was not filed, a copy of Mead’s Flood Sworn Proof of Loss, a copy of Mead’s flood claim estimate and coverage determination letter provided by Mead’s flood insurance carrier and/or FEMA, a copy of any field and/expert reports and photos obtained for this claim, a list of the cited content items claimed and given by Mead to her flood insurance carrier and/or FEMA, and copies of all payments received from Mead’s flood carrier and/or FEMA.
Frontline has also issued additional requests for a sworn proof of loss when one was already provided in January 2023, fully supported by Mead’s public adjuster’s itemized estimate and photo report. Frontline additionally disputed Mead’s payment of $85,759.79 to her contractor based on a roofing permit it pulled from public records. Without proper foundation or evidence, Frontline disputed the validity of Mead’s payment to her contractor and refused to pay this cost as a legitimate expense incurred pursuant to the terms of the policy. Overall, Frontline’s dilatory and unacceptable adjustment of the claim in this manner shows Frontline has failed to implement and follow adequate guidelines for the proper investigation to evaluate claims and the appropriate training and supervision of its employees and adjusters resulting in the statutory violations identified in this Civil Remedy Notice above.
These repeated demands for information post-appraisal by Frontline, which arrived approximately every thirty (30) days after the appraisal inspection was conducted, were issued with the goal of harassing Mead, burying her in exhaustive, burdensome requests for information that Frontline does not need to assess the covered damage in this matter and pay Mead the fair amount she is owed. Frontline has inspected the property on three occasions and has had ample access and time to identify the covered damage and determine the cost to repair. Frontline’s only goal in requesting voluminous documents relating to flood damage and other repairs is to provide Frontline with grounds to further limit, exclude, or deny portions of Mead’s claim. Frontline’s delay and stall tactics in this regard were wrongful and designed to tire and exhaust Mead into accepting less than the full amount she is owed on this claim.
Rather than work to issue an Appraisal Award and expeditiously resolve this claim, Frontline has chosen to delay this claim by burdening Mead with requests for unnecessary documents and information and wrongfully disputed her incurred expenses. The voluminous documents Frontline has repeatedly requested, many of which Mead does not have, have no bearing on Frontline’s ability to assess the damage and prepare an accurate estimate of the cost to repair. Rather, Frontline has wrongfully used these irrelevant document requests as a burden to resolution of this claim. This conduct has been in bad faith and has violated Frontline’s statutory and contractual obligations to Mead to adjust this claim efficiently, accurately, and in Mead’s best interest. As a result of Frontline’s wrongful conduct, the matter now sits at a standstill seven months after Frontline initiated appraisal in this matter, and now more than two years after the loss, with no reasonable explanation or grounds for this kind of unacceptable delay.
Frontline’s failure and/or refusal to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards Mead is wrongful conduct. As a result of Frontline’s wrongful conduct, Mead was and still is forced to expend out of pocket monies to submit her insurance claim, e.g., retaining a public adjuster and appraiser to assist in identifying the covered damage and estimating the cost to repair and legal counsel to file this Civil Remedy Notice in hopes of finally forcing Frontline to honor its obligations under the insurance policy to pay the entirety of the insurance proceeds due and owing to Mead.
Frontline is obligated to Mead to tender all insurance proceeds owing and due so that the necessary repairs can commence. Frontline’s refusal to tender the appropriate amount due has been in bad faith and is a breach of the insurance agreement which requires Frontline to pay timely and promptly so that Mead can mitigate her damages and be put back into the position she was in prior to the loss as quickly as possible.
To date, Frontline has failed to timely pay or deny the claim in full in direct violation of Fla. Stat. § 627.70131. Frontline’s actions, in this regard, have been in bad faith.
It is clear from Frontline’s failure to issue the benefits owed and its intentional attempt to avoid its full obligations to Mead, that Frontline has engaged in a pattern of fraudulent and dilatory tactics to the prejudice and harm of Mead. To cure the defects outlined in this Civil Remedy Notice, Frontline must:
(1) Act fairly and honestly towards Mead and with due regard for her interest in attempting to settle this claim;
(2) Cease any further delay in the issuance of the Appraisal Award and, once issued, expeditiously pay the Appraisal Award in good faith;
(3) Immediately tender all insurance monies due and owing to Mead with statutory interest; and
(4) Pay Mead the fair value of her insurance claim.
First Protective Insurance Company’s address is 500 International Parkway, Lake Mary, FL 32746.
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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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