Civil Remedy Notice of Insurer Violations
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Filing Number:     794970
Filing Accepted:  12/3/2024
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Complainant
Last/Business Name *  
JON J. DIAMOND, ET. AL.   First Name   ESTATE OF
Street Address * 9 DOGWOOD TRAIL TERRACE
City, State Zip * OCALA, FL 34472
Email Address * MARKYOONART@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   JON J. DIAMOND   First Name   ESTATE OF
Policy # * 2MR167181501 Claim #* 00201800861
Attorney
Attorney is Applicable
Last Name* MARTIN First Name * KIMBERLEE Initial
Street Address* 350 N. LAKE DESTINY ROAD
City, State Zip* MAITLAND , FLORIDA 32751
Email Address * KMARTIN@ITSABOUTJUSTICE.LAW
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN SECURITY INSURANCE COMPANY
NAIC Company Code 42978
 
Name of individual responsible for violation (if any):* DISCOVERY PENDING
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Claim Denial
Unsatisfactory Settlement Offer
Unfair Trade Practice
* 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.
624.155(1)(b)(3) 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.
626.9541(1)(i)(2) 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.
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)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
* 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 certified copy of the policy is not in the possession of the Insureds, but has been requested from the insurance carrier. Based on information and belief, the following policy provisions are relevant to this civil remedy notice. Section 1 – Coverage A – Dwelling Section 1 – Coverage A – Perils Insured Against Section 1- Conditions – Loss Settlement Section 1 – Conditions - Loss Payment
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

During the policy period, on January 9, 2024, Mark Yoon and Karl Lafferty as Personal Representative for the Estate of Jon J. Diamond (the “Insured(s)”) suffered significant damage to the home located at 9 Dogwood Trail Terrace Ocala, Florida 344772 caused by wind and hail. Prior to this loss, American Security Insurance Company (“ASIC”) issued a homeowner’s insurance policy (Policy # 2MR167181501) for the Insureds’ property. The policy was in full force and effect on the date of loss. After providing notice of the loss, the Insureds fully cooperated with ASIC’s adjustment of the claim, including making the property available for inspection and providing all documents requested. After completing its investigation, ASIC accepted some coverage for the loss. However, ASIC denied full coverage for the roof replacement and otherwise failed to tender the full amount owed for the necessary repairs needed to restore the property to its pre-loss condition. ASIC has underpaid the claim by approximately $25,274.54. On September 23, 2024, the Insured(s) submitted a Notice of Intent to Litigation (NOI) pursuant to section 627.70152. ASIC seemingly maintained its position; however, it did extend a settlement offer. The settlement offer was inadequate compared to the damages claimed. Due to the confidential nature of settlement negotiations, the Insured(s) are unable to provide the amount or elaborate further. In sum though, ASIC did not make a good faith attempt to settle the claim when it could have done so. As a result, the Insureds were left with no choice but to file suit against ASIC for breach of contract. This suit is pending in Marion County, Florida with Case Number 2024-CC-002424. Approximately one month after suit was filed, ASIC now seeks to unnecessarily delay resolution by attempting to invoke appraisal after the service of the NOI and after service of the Insureds’ lawsuit. It has become a pattern and practice of ASIC to unnecessarily delay resolution of its claims when it otherwise could resolve them. ASIC intentionally underpays its claims and then demands appraisal on the remaining amounts after they previously decided to not issue any additional payments. ASIC know or should know that the appraisal process is cost prohibitive to the claimant because each party bears a portion of the expense of its appraisers and umpire pursuant to the terms of the policy. ASIC’s strategy is to undercompensate claims and then demand appraisal so as to leave its Insured(s) with no meaningful redress and acts as a deterrent to prevent parties from challenging ASIC when it underpays its claims. ASIC’s tactics are evidence that it does not act fairly and honestly and that ASIC has failed to implement proper standards for the investigation and handling of its claims. Moreover, ASIC’s decision to invoke appraisal proves that its representatives failed to conduct a proper investigation of the loss, misrepresented the cause of the damages to the residence, and misapplied exclusions in the policy in order to deny coverage for the Insureds’ claim. It has become a general business practice of ASIC to not implement proper claims handling procedures, to hire consultants that routinely ignore or intentionally misidentify relevant evidence, and to not settle claims in good faith when under all circumstances it should have. Worse still, ASIC reverses course and requests appraisal only when its Insureds are forced to file a lawsuit in order to obtain the benefits ASIC should have already paid. It has become a pattern and practice of ASIC to intentionally misrepresent that the loss is not covered by the policy and then, only when faced with the prospect of litigation, does it abandon its prior coverage determination and invoke appraisal. ASIC’s decision to invoke appraisal anytime a lawsuit is filed serves only to protect its bottom-line and deprive its Insureds of attorney’s fees and costs incurred as a result of its fraudulent coverage denial. In order to cure this civil remedy notice, ASIC must immediately tender $25,274.54 payable to Cohen Law Group-Florida PA f/b/o Mark Yoon and Karl Lafferty as Personal Representative for the Estate of Jon J. Diamond prior to the expiration of this notice. The payment should be tendered to the Insured’s attorney, Kimberlee Martin, Esq. at 350 N. Lake Destiny Road, Suite 300, Maitland, FL 32751. The requested amount represents the Insured(s) roof estimate $38,274.54 less the applicable $13,000 deductible. ASIC is in possession of this estimate.
Comments
User Id Date Added Comment
dbatista@shutts.com 01-31-2025 VIA UPLOAD onto DFS website Florida Department of Financial Services Division of Insurance Regulation Consumer Assistance / Civil Remedy Section Larson Building, 200 East Gaines Street Tallahassee, Florida 32399-0322 Re: CIVIL REMEDY NOTICE OF INSURER VIOLATION DOI File No.: 794970 Complainant: Estate of Jon J. Diamond Claim No.: 00201800861 Filed by: Kimberlee Martin, Esq. Reported DOL: January 9, 2024 Dear Sir or Madam: This law firm represents American Security Insurance Company with regard to the Civil Remedy Notice of Insurer Violations filed on behalf of the Complainant, Estate of Jon J. Diamond, on or about December 3, 2024. This action involved a claim made under Policy Number 2MR07291671815 which is no longer at issue. The parties have amicably resolved this claim. Very truly yours, /s/ David Batista David O. Batista
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