Civil Remedy Notice of Insurer Violations
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Filing Number:     796148
Filing Accepted:  12/10/2024
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Complainant
Last/Business Name *  
BRIAN D. BOERNER AND SARAH BOERNER   First Name  
Street Address * 6719 ROCK BRIDGE LANE
City, State Zip * ELLENTON, FL 34222
Email Address * BRIANBOERNER1@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   BRIAN D. BOERNER AND SARAH BOERNER   First Name  
Policy # * ARK13061 Claim #* 1436806-241013
Attorney
Attorney is Applicable
Last Name* MASCI First Name * MICHAEL Initial
Street Address* 925 FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * MMASCI@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   ASI PREFERRED INSURANCE CORP.
NAIC Company Code 13142
 
Name of individual responsible for violation (if any):* ADAM DENNE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
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)(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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(f) 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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Loss settlement provision
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The carrier was put on notice of the insureds’ Hurricane Milton claim. The carrier initially attempted to low-ball the claim and wrongfully found the damages to be below the applicable policy deductible. Subsequently, the insured prepared a loss package in the amount of $33,633.92 needed to restore the property back to its pre-loss condition. Whereas, the carrier wrongfully represented the damages to the insureds’ property to be below the policy deductible. Additionally, the carrier did not appropriately address the need for the replacement of the insureds’ roof, allegedly relying on the wrongful findings of a representative who it is believed was instructed to look for any signs of damage that could be attributed to any causes of loss excluded under the policy and to disregard any evidence of wind damage to the roof for the purpose of wrongfully low-balling the claim as a whole. The insureds have complied with all of the carrier’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 insureds. About sixty days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insureds’ property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insureds 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 insureds; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insureds’ interests; refusing to pay the full amount owed to the insureds despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insureds, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 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) and 626.9541(1)(i)(3)(f), as well as Section I - Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I - Conditions requiring payment of a claim within 90 days. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the 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, the carrier must: 1.) Pay the complete covered loss in the amount of $33,633.92, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned or Devin Pruitt at (239)-488-6829 if you have any questions or concerns. Sincerely, Michael T. Masci, Esq Attorney at Law
Comments
User Id Date Added Comment
darryl_j_roles@progressive.com 12-17-2024 While ASI Preferred Insurance Corp believes that the Civil Remedy Notice fails to comply with the requirements of Florida Statute §624.155 and Florida Case law, it has responded to the notice in writing to The Law Office Of Kanner & Pintaluga, PA, on December 17, 2024.
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