Filing Number: 794880
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| Filing Accepted: 12/2/2024 |
| Last/Business Name
*
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GRAYSON
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First Name |
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ELBERT |
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| Street Address
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353 NE 208 TER |
| City, State Zip
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MIAMI,
FL
33179
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| Email Address
*
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LL@WEKLAW.COM |
| Complainant Type:
*
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Insured |
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| Last/Business Name* |
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GRAYSON |
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First Name |
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ELBERT |
| Policy # * |
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FLA408416 |
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Claim #* |
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127794-231001 |
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Attorney is Applicable
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| Last Name* |
LIEB
First Name *
LORA
Initial
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| Street Address* |
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800 E BROWARD BLVD #510 |
| City, State Zip* |
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FORT LAUDERDALE
,
FLORIDA
33301
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| Email Address * |
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LL@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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AMERICAN STRATEGIC INSURANCE CORP.
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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 10872 |
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| Name of individual responsible for violation (if any):*
TRAVIS MURPHY
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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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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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| 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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
A complete copy of the policy is not in the insured's possession
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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.
Prior to July 27, 2023, American Strategic Insurance Corp. (hereinafter “ASI”) sold an insurance policy under Progressive, identified by policy number FLA40816, to Elbert Grayson for his home located at 353 NE 208 Terrace, Miami, FL 33179 (hereinafter “Home”). ASI sold Mr. Grayson an H03 policy with broad coverages, including but not limited to coverage for storm damage. On or about July 27, 2023, while the subject policy was in full force and effect a severe thunderstorm caused substantial damage to the Home, which resulted in claim no. 127794-231001(hereinafter “Loss”).
After receiving prompt notice of the loss, ASI hired TSI Adjusters to inspect the home and photograph the property. As a result of the review, ASI issued its claim decision for the loss claiming that the property required approximately $6,465.94 worth of repairs to six different rooms of the home. At the same time, Mr. Grayson, through public adjuster company Five Star, investigated and adjusted the loss, determining a value of the Loss under Coverages A at $65,136.65.
ASI adjustment of the loss was not a fair or honest adjustment of the loss. ASI’s adjustment of the loss was intended to provide the illusion of a fair adjustment, to avoid full payment to Mr. Grayson. ASI knows or should know that its adjustment of the Loss is not a fair or honest assessment of the Loss, yet ASI has refused to attempt to negotiate the Loss with Mr. Grayson and his representatives. ASI has made the practice of undervaluing a claim in order to leverage more favorable claim settlements and to avoid having to fairly and honestly adjust and pay for losses.
Further, ASI failed to assign an unbiased adjusting team to handle the loss. ASI does not have appropriate standards in place to be able to investigate claims such as the Loss at Mr. Grayson’s Home. ASI’s failure to have appropriate standards, led to the assignment of an inadequate inspection team, which ultimately led to ASI’s unfair and dishonest adjustment of the Loss.
In total, and as exhibited above, ASI has implemented a strategy and approach to the Loss that is unfair, and ASI is unfairly attempting to settle the Loss. In order to remedy the above referenced violations, ASI must promptly fairly and honestly assess or reassess the Loss so that it may engage in good faith settlement negotiations with Mr. Grayson and
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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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