Filing Number: 795250
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| Filing Accepted: 12/4/2024 |
| Last/Business Name
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| Street Address
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1037 RAINTREE DRIVE |
| City, State Zip
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PALM BEACH GARDENS,
FL
33410
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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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LOCKE |
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First Name |
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RICHARD |
| Policy # * |
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HCPC-HO3-334280-4 |
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Claim #* |
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929369 |
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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
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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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HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
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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 12944 |
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| Name of individual responsible for violation (if any):*
ANNIE STEWART; CHAVANNES ADE
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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 Denial
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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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
We will provide the insurance described in this policy in return for the premium and compliance with all applicable
provisions of this policy
DEFINITIONS
"Insured location" means:
a. The "residence premises";
7. "Occurrence" means an accident, including
continuous or repeated exposure to substantially
the same general harmful conditions, which
results, during the policy period, in:
a. "Bodily injury"; or
b. "Property damage".
11. "Property damage" means physical injury to,
destruction of, or loss of use of tangible property.
SECTION I - PROPERTY COVERAGE
COVERAGE A – Dwelling
We cover:
1. The dwelling on the "residence premises" shown
in the Declarations, including attached structures
and attached wall-to-wall carpeting if damage to
the dwelling is caused by a covered loss;
ADDITIONAL COVERAGES
COVERAGE A – Dwelling
We cover:
1. The dwelling on the "residence premises" shown
in the Declarations, including attached structures
and attached wall-to-wall carpeting if damage to
the dwelling is caused by a covered loss;
SECTION I - PERILS INSURED AGAINST
COVERAGE A – DWELLING and COVERAGE B –
OTHER STRUCTURES
We insure against risk of direct loss to property
described in Coverages A and B only if that loss is a
physical loss to property.
SECTION I - CONDITIONS
10. Loss Payment.
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.
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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 September 28, 2022, Homeowners Choice Property & Casualty Insurance Company (hereinafter “Homeowners”) sold an insurance policy, identified by policy number HCPC-HO3-3342850-11, to Richard Locke for his home located at 1037 RainTree Dr., Palm Beach Gardens, FL 33410 (hereinafter “Home”). Homeowner’s sold Mr. Locke an H03 policy with broad coverages, including but not limited to coverage for hurricane damage. On or about September 28, 2022, while the subject policy was in full force and effect a Hurricane Ian caused substantial damage to the Home, which resulted in claim no. 929369 (hereinafter “Loss”).
After receiving prompt notice of the loss, Homeowner’s sent off a field to inspect the home and photograph the property. As a result of the review, Homeowner’s issued its claim decision for the loss claiming that the property showed signs “wear and tear and deterioration due to age and exposure to the element” despite the roof being installed only two years prior to this loss. Furthermore, Homeowner’s chose to issue the policy to Mr. Locke and accepted premiums for this property.
At the same time, Mr. Locke, through ICA Public Adjusters, investigated and adjusted the loss, determining a value of the Loss under Coverages A at $115,269.18 for roof and interior repairs. Since litigation, Mr. Locke has provided vendor estimates to reflect the market value cost of the necessary repairs to bring his home back to its pre-loss condition.
Homeowner’s adjustment of the loss was not a fair or honest adjustment of the loss. Homeowner’s adjustment of the loss was intended to provide the illusion of a fair adjustment, to avoid payment to Mr. Locke. Homeowner’s knows or should know that its adjustment of the Loss is not a fair or honest assessment of the Loss, yet Homeowner’s has refused to attempt to settle the Loss with Mr. Locke and his representatives. Homeowner’s has made the practice of denying and under valuing a claim in order to leverage more favorable claim settlements and to avoid having to fairly and honestly adjust and pay for losses.
Further, Homeowner’s failed to assign an unbiased adjusting team to handle the loss. Homeowner’s does not have appropriate standards in place to be able to investigate claims such as the Loss at Mr. Locke’s Home. Homeowner’s’ failure to have appropriate standards, led to the assignment of an inadequate inspection team, which ultimately led to Homeowner’s’ unfair and dishonest adjustment of the Loss.
In total, and as exhibited above, Homeowner’s has implemented a strategy and approach to the Loss that is unfair, and Homeowner’s is unfairly attempting to settle the Loss. In order to remedy the above referenced violations, Homeowner’s must promptly fairly and honestly assess or reassess the Loss so that it may engage in good faith settlement negotiations with Mr. Locke and his representatives.
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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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