Filing Number: 795037
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| Filing Accepted: 12/3/2024 |
| Last/Business Name
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REZK REAL ESTATE HOLDING INC
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First Name |
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| Street Address
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870 MACK BAYOU ROAD |
| City, State Zip
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SANTA ROSA BEACH,
FL
32459
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| Email Address
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ASREZK1@GMAIL.COM |
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Insured |
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| Last/Business Name* |
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REZK REAL ESTATE HOLDING INC |
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First Name |
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| Policy # * |
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AL92-001918-00 |
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Claim #* |
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SWYCSCP00272 |
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Attorney is Applicable
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| Last Name* |
OLADIPO
First Name *
ABIDEMI
Initial
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| Street Address* |
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15257 AMBERLY DRIVE |
| City, State Zip* |
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TAMPA
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FLORIDA
33647
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| Email Address * |
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AOLADIPO@MSO.LAW |
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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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CLEAR BLUE SPECIALTY 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 37745 |
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| Name of individual responsible for violation (if any):*
CLEAR BLUE SPECIALTY INSURANCE COMPANY, CLIFF SPILLER, DAN CONNELL, KELLY DORMAN, MELVIN SMITH, ALONG WITH ALL ADJUSTERS, SUPERVISORS, MANAGERS, AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY THE INSURER IN THE CLAIM.
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| Type of Insurance
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Commercial 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)(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)(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)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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| 626.9541(1)(i)(3)(e) |
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Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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| 626.9541(1)(i)(3)(f) |
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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.
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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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| 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.
BUILDING AND PERSONAL PROPERTY
COVERAGE FORM
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered.
Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations. The words "we", "us" and "our" refer to the company providing this insurance.
Other words and phrases that appear in quotation marks have special meaning. Refer to Section H. Definitions.
A. Coverage
We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss.
Covered Property, as used in this Coverage Part, means the type of property described in this section, A.1., and limited in A.2. Property Not Covered, if a Limit Of Insurance is shown in the Declarations for that type of property.
a. Building, meaning the building or structure described in the Declarations, including:
(1) Completed additions;
(2) Fixtures, including outdoor fixtures;
(3) Permanently installed:
(a) Machinery; and
(b) Equipment;
(4) Personal property owned by you that is used to maintain or service the building or structure or its premises, including:
(a) Fire-extinguishing equipment;
(b) Outdoor furniture;
(c) Floor coverings; and
(d) Appliances used for refrigerating, ventilating, cooking, dishwashing or laundering;
(5) If not covered by other insurance:
(a) Additions under construction, alterations and repairs to the building or structure;
b. Your Business Personal Property consists of the following property located in or on the building or structure described in the Declarations or in the open (or in a vehicle) within 100 feet of the building or structure or within 100 feet of the premises described in the Declarations, whichever distance is greater:
(b) Materials, equipment, supplies and temporary structures, on or within 100 feet of the described premises, used for making additions, alterations or repairs to the building or structure.
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3. Covered Causes Of Loss
See applicable Causes Of Loss form as shown in the Declarations.
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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.
On May 31, 2023, Clear Blue Specialty Insurance Company (“Clear Blue”) issued policy number AL92-001918-00 (the “Policy”) to Rezk Real Estate Holding Inc (“Insured”) for the bulding located at 870 Mack Bayou Road, Santa Rosa Beach, FL 32459 (“Insured Property”) for the period of May 31, 2023 to May 31, 2024. The Policy provides Building limits of $800,000.00 subject to a $40,000.00 Windstorm or Hail Percentage deductible. The Policy provides coverage for direct damage to the Insured Property as a result of wind and/or hail damages.
On June 9, 2023, a tornado struck the Insured Property, causing significant damage. The event resulted in extensive roof damage, leading to interior water damage and other associated damages. Additional impacts included harm to the monument sign and the accumulation of substantial tree and landscaping debris. These damages were visibly evidenced by cracked roof tiles and widespread debris across the Insured Property.
On June 22, 2023, the Insured promptly reported the claim to Clear Blue and granted unfettered access to Clear Blue and its representatives for inspection of the Insured Property. Clear Blue acknowledged the claim and assigned desk adjuster Cliff Spiller for its handling. Additionally, Clear Blue designated field adjuster Dan Conell to conduct an inspection of the Insured Property, which took place on June 29, 2023. Following the inspection, Mr. Conell prepared an itemized estimate of damages to the Insured Property, amounting to $22,724.12 in Replacement Cost Value. Subsequently, on August 11, 2023, Mr. Spiller notified the Insured that Clear Blue’s evaluation of the damages did not exceed the $40,000.00 windstorm or hail deductible. As a result, Clear Blue declined to issue any payment for the claim.
Regrettably, Clear Blue and its representatives, including Cliff Spiller and Dan Conell, lacked the necessary qualifications to properly assess the damages to the Insured Property and/or willfully disregarded the extent of the damages, seemingly to benefit Clear Blue’s financial interests. This was evident in the inadequate estimate produced by Mr. Conell, which failed to fairly account for the full scope of the damages sustained by the Insured Property. Such actions constitute a misrepresentation of pertinent facts or insurance policy provisions related to the coverages at issue, in violation of Section 626.9541(1)(i)(3)(b), Florida Statutes.
Moreover, this reflects a recurrent business practice by Clear Blue across the state of Florida, wherein it engages adjusters and other representatives for the purpose of undervaluing the actual damages to insured properties, thereby maximizing Clear Blue’s profits at the expense of its insureds. This conduct demonstrates Clear Blue’s failure to adopt and implement standards for the proper investigation of claims, as required under Section 626.9541(1)(i)(3)(a), Florida Statutes.
As a result of Clear Blue’s inadequate investigation of the claim, the Insured was compelled to secure legal representation to assist in presenting its claim to Clear Blue. On August 15, 2023, a letter of representation was sent to Clear Blue on behalf of the Insured. Clear Blue acknowledged the Insured’s legal representation in a letter dated September 5, 2023, signed by Mr. Spiller, in which Clear Blue requested additional information to proceed with the adjustment of the claim—despite this not being the Insured’s responsibility.
To support its claim, the Insured, through its legal representatives, retained Structural Engineering and Inspections, Inc. (“SEI”) to conduct an engineering inspection and provide an expert report regarding the cause and origin of the damages to the Insured Property. The SEI report, dated December 12, 2023, and signed by Byron K. Anderson, P.E., concluded that the tornado on June 9, 2023, was classified as an EF-1 event by the NOAA Damage Assessment Toolkit, with recorded maximum winds of up to 105 mph. SEI further determined that the physical damage to the building's roof was directly caused by this tornado. Additionally, SEI noted that the widespread damage to the roof tiles, coupled with the unavailability of replacement tiles, rendered the roof irreparable and necessitated its full replacement. SEI also produced an itemized estimate of damages in the amount of $230,774.75.
The Insured also engaged a general contractor to prepare an estimate of the actual costs required to restore the Insured Property to its pre-loss condition. The Insured retained LSC Construction Consultants (“LSC”), which provided an itemized estimate totaling $165,688.40. This amount reflects the true cost of restoring the Insured Property, considering the current market rates for labor, materials, and permits in the area. All of this information was promptly provided to Clear Blue to aid in its adjustment of the claim but it was ultimately ignored as the Insured was not properly paid for the covered damages.
Throughout the handling of this claim, the Insured has fully complied with all Duties After Loss provisions outlined in the Policy. This includes promptly reporting the claim, granting unfettered access to the Insured Property for inspection, providing all available information and documentation related to the claim, notarizing a Sworn Statement in Proof of Loss on June 3, 2024, to attest to the damages incurred, and retaining experts—including attorneys, engineers, and general contractors—to present a comprehensive and accurate assessment of the damages sustained on June 9, 2023. In stark contrast, Clear Blue has failed to act in good faith to settle the claim when, under the circumstances, it could and should have done so had it acted fairly, honestly, and with due regard for the Insured’s interests, as required under Section 624.155(1)(b)(1), Florida Statutes. Clear Blue has ignored the Insured’s repeated requests for assistance and disregarded the Insured’s considerable efforts to adjust the claim—efforts that are not the Insured’s responsibility under the Policy and case law. Furthermore, Clear Blue has failed to promptly provide a reasonable written explanation for the denial of the claim or any offer of a compromise settlement, as mandated by Section 626.9541(1)(i)(3)(f), Florida Statutes.
On January 31, 2024, Clear Blue reassigned the claim to desk adjuster Melvin Smith. Mr. Smith, via email, stated that Clear Blue had reviewed the reports provided by the Insured's engineer and building experts but determined that the amount of covered damages did not exceed the Policy's deductible. However, Mr. Smith failed to provide any rationale for this coverage determination, did not specify which aspects of the Insured’s reports required clarification, and denied the claim without conducting a reasonable investigation based on the available information, in violation of Section 626.9541(1)(i)(3)(d), Florida Statutes. Furthermore, Mr. Smith continued communicating with the Insured’s representative, making vague and generalized requests for additional information, despite the fact that the Insured had already provided all relevant documentation regarding the loss. These ambiguous requests lacked specificity as to what information was needed or why it was necessary, representing a clear and deliberate attempt to fabricate a failure-to-comply defense under the Duties After Loss provision.
Ultimately, the Insured filed a Notice of Intent to Initiate Litigation (NOI) on June 26, 2024. In response, on July 24, 2024, Clear Blue requested appraisal of the matter. However, appraisal was not appropriate for several reasons, the most significant being Clear Blue's failure to comply with the statutory timeline under Section 627.70152, Florida Statutes. Pursuant to the statute, the insurer must respond to an NOI within 10 business days. Given that the NOI was filed on June 26, 2024, the deadline for Clear Blue to respond was July 11, 2024. By failing to request appraisal within this timeframe, Clear Blue missed its opportunity to invoke appraisal. Furthermore, the statute requires that the appraisal process be completed within 90 days of the 10-business-day response period. Had Clear Blue timely requested appraisal by July 11, 2024, the deadline to complete the appraisal process would have been October 9, 2024. Clear Blue's untimely response renders its appraisal request invalid.
Notwithstanding the above, the Insured, in compliance with the terms of the Policy, named Tom Gannon as its appraiser on July 25, 2023. However, Clear Blue failed to acknowledge this communication and neglected to advance the appraisal process or properly continue its claims investigation. This constitutes a violation of Section 626.9541(1)(i)(3)(c), Florida Statutes, which requires insurers to promptly acknowledge and act upon communications regarding claims. To date, and as a direct result of Clear Blue’s mishandling of the claim and its failure to establish and implement proper standards for the investigation of claims, the Insured remains unable to fully recover from the loss.
In Florida, the work of adjusting insurance claims engages the public trust. Clear Blue has breached the public’s trust by its adjustment of the Insured’s claim of loss. Clear Blue has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. Clear Blue has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insured’s claim for damages. Clear Blue has failed to promptly settle the Insured’s claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the Insured’s pleas otherwise, Clear Blue has continued to refuse to acknowledge its obligation to conduct a proper investigation.
Moreover, Clear Blue has not attempted in good faith to settle the Insured’s claim 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 their interests. Clear Blue has done everything possible to delay and/or deny the claim. Furthermore, Clear Blue is required to properly investigate and adjust claims and cannot place that burden upon the insureds. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005)(“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insureds…”). Clear Blue was timely put on notice of the Insured’s loss and claim for damages. The Insured have complied with all of Clear Blue’s requests to date and the carrier has still failed to treat this claim with good-faith. This intentional delay with the claim has led to direct prejudice of the Insured, who continues to be held hostage unless/until Clear Blue engages in good faith claims handling. To date, Clear Blue has still refused to fully pay the amount owed under the Policy. To make matters worse, the Insured has incurred incredible costs and efforts to adjust their own loss, with detailed and substantiated damages presented to Clear Blue in the form of a repair estimate evidencing $230,774.75 in Replacement Cost Valuation. Clear Blue’s stubborn and/or negligent refusal to fully indemnify the Insured for the covered damages has resulted in a confluence of consequential damages including, but not limited to, excess damages stemming from Clear Blue’s maladroit adjustment of the claim, the unaffordability of the Insured Property given the loss of utility and the indefinite delay to address the ongoing dispute, additional costs and expenses to adjust its own loss that include retaining a public adjuster and an attorney, among many other otherwise unnecessary consequences but for the negligence and nefarious business practices of Clear Blue.
It is clear that Clear Blue is not treating the Insured with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the Insured; and ignoring the Insured’s pleas for assistance; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing Clear Blue’s interests before the Insured’s interests; refusing to pay the full amount owed to the Insured despite the fact that Clear Blue has been on notice of the damages and looking for ways to delay and/or deny full recovery to the Insured, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. Clear Blue’s actions are in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(e), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), and 626.9541(1)(i)(3)(h), Florida Statutes.
All of the aforementioned are part of what appears to be an ongoing pattern and practice of behavior by Clear Blue that demonstrates a wanton and reckless disregard for insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, Clear Blue must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of these type of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) Clear Blue must create and implement adequate guidelines for the proper investigation and evaluation of these type of claims and for the training and supervision of employees with regard to these type of claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other insureds from being treated unfairly and wrongfully; (3) Clear Blue must pay the Insured $230,774.75 for all of the damages sustained as a result of the loss, less the applicable deductible, limitations, plus all contractual damages owed, attorney’s fees, costs and interest, under Sections 57.041 and 627.70131(5)(a) Florida Statutes; and (4) Clear Blue must act fairly and honestly towards its Insured and with due regard for their interests in attempting to settle its Insured’s claim.
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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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