Filing Number: 796555
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| Filing Accepted: 12/11/2024 |
| Last/Business Name
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HAGERSTROM
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First Name |
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JULIE |
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| Street Address
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661 NORTHWEST 66TH AVENUE |
| City, State Zip
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PLANTATION,
FL
33317
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| Email Address
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JULESONTHEFLY@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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HAGERSTROM |
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First Name |
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JULIE |
| Policy # * |
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12-1142323-02 |
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Claim #* |
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12-3024373-24 |
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Attorney is Applicable
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| Last Name* |
ELAZAR
First Name *
SAPIR
Initial
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| Street Address* |
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800 E BROWARD BLVD., STE. 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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SE@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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TYPTAP 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 15885 |
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| Name of individual responsible for violation (if any):*
N/A
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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 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)(2) |
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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.
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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)(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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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 Payment Provision. Loss Settlement Provision.
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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.
Julie Hagerstrom (the "Insured") purchased an insurance policy ("Policy") from TypTap Insurance Company ("TypTap"), effective as of the date of the loss, on or about September 11, 2024. The policy, bearing number 12-1142323-02, provided coverage for her home located at 661 Northwest 66th Avenue, Plantation, FL 33317 (the "Property").
On or about September 11, 2024, the Property sustained significant water damage caused by a leak in the air-conditioning system. The damage extended to various areas of the Property, including, but not limited to, the bathroom, attic, and interior spaces. The Insured promptly reported the loss to TypTap, which acknowledged the claim by assigning claim number 12-3024373-24.
After considerable stalling, TypTap went to inspect the property, as they are required to, and generated an estimate for the damages suffered. TypTap initially made a low-ball coverage decision that broadly ignored the damage sustained to the Property valuing the damage at $6,307.11 after the application of the deductible. It was clear that TypTap was trying to reduce their contractual obligation by undervaluing the damage to the Insured’s Property from the start, despite the fact that the Insured actively provided all proof of claim needed to have their claim evaluated fairly.
Despondent, the Insured retained Triumph Consulting Corporation (“Triumph”) to act as their public adjuster, to assist in the evaluation and inspection of damage to the property. Triumph investigated the property and generated an estimate for the damages. Triumph immediately sent their estimate to TypTap, which estimated the scope or damage to be $27,449.40 along with a request for supplemental payment. TypTap’s refusal to provide adequate coverage has left the Insured unable to restore the Property to its pre-loss condition. This failure has caused significant hardship for the Insured and their family, including displacement from the Property and incurring additional living expenses exceeding $5,000. Furthermore, the Insured was required to perform water mitigation services costing over $8,000, further compounding their financial burden.
TypTap’s actions represent a clear failure to adjust the loss in good faith and to fulfill its obligations under the Policy. Instead of engaging in a fair settlement process, TypTap’s conduct has caused prolonged distress and financial hardship for the Insured, who continues to endure considerable challenges as a direct result of TypTap’s insufficient response and refusal to properly indemnify the loss. Upon information and belief, TypTap, as part of its general business practice, initially low-balls its policyholders. TypTap does this in a calculated and systematic scheme that begins with manipulating the software system used in estimating its property damage claims. It appears that TypTap issues its adjusters estimating software which contains construction pricing below the fair market value. It also appears that TypTap trains its claim adjusters to overlook and/or turn a blind eye to a number of routine costs that TypTap knows most policyholders generally would not know to request but are actually covered under the insured’s policy. Moreover, as part of this scheme, after making one initial low-ball payment – TypTap stalls and intentionally delays the claim, all under the false pretense that it’s “investigating” the claim. TypTap has violated Florida Statute § 624.155(1)(b)(1) by continuously not attempting in good faith to settle this claim when it should have done so if it had acted fairly and honestly towards its Insured. TypTap has also violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle this obviously covered claim to influence settlement in its favor. Despite being presented all of the indisputable evidence of the amount of damage sustained by this Property, it is a disgrace that the Insured have been treated in this manner by their insurance company after sustaining an obviously covered loss, submitting to every demand of TypTap, and making a good faith effort to resolve in an attempt to amicably come to a fair resolution. TypTap violated Florida Statutes § 626.9541(1)(i)(2) and § 626.9541(1)(i)(3)(b) by making material misrepresentations to the Insured for the purpose and with the intent to settle the claim on less favorable terms than those provided and contemplated by the policy. TypTap was informed multiple times of the discrepancies and inconsistencies of the low-ball payment issued to the Insured. While TypTap was made aware of this information for the purpose of obtaining the money contractually owed to the Insured under its insurance policy to attempt to return their home to its pre-loss condition in a timely fashion, TypTap accepted that information and has used it to play the delay game with the Insured, knowing all too well the additional damage and hardship that was being placed on the Insured by its actions. TypTap violated § 626.9541(1)(i)(3)(a) when it failed to adopt and implement standards for the proper investigations of claims. Under no circumstances is there an excuse for the lack of a proper investigation in this case. TypTap and their representatives are willfully blind and grossly underqualified to handle a loss such as the one sustained by the Insured. In addition, after being placed on notice as to the blatant underpayment of the Insured’ claim, TypTap has yet to rectify their actions and do right by the Insured by paying the money they are contractually owed. TypTap violated § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon the communications with respect to the claim. There still has yet to be significant action taken by TypTap to this date, despite TypTap being presented with the flawed rationale behind their underpayment of the Insured’ claim.? TypTap violated § 626.9541(1)(i)(3)(g) by failing to promptly notify the Insured of any additional information necessary for processing the claim. The Insured have more than complied with each and every request and there has still been no action by TypTap. In the event TypTap is in need of additional information, they have failed to promptly notify the Insured in a timely manner. This pattern of behavior is perpetuated by TypTap and their representatives undeterred by the Ethical Requirements that are imposed by law on all Adjusters. Fla. Admin. Code Ann. R. (3) explicitly states the adjustment of insurance claims engage the trust of the public, and therefore, an adjuster has a duty of fair and honest treatment of the Insured throughout the insurance claim process. Several duties and responsibilities to the Insured were violated in the handling of this claim, which are specifically listed responsibilities of an Adjuster in the Florida Administrative Code. These breached duties and responsibilities include adjusters from TypTap approaching the investigation and settlement in a manner prejudicial to the Insured, failing to allow a fair settlement with the Insured, and acting with due diligence in achieving a proper disposition of the claim. In contrast to the legislative intent motivating the enumeration of an Adjuster’s responsibilities outlined in the Administrative Code, the Insured were not afforded the professional duties entrusted on TypTap by the public. To date, TypTap has failed to adequately compensate the Insured for the damage that occurred on September 11th, 2024. As a direct result of TypTap’s delay, the Insured were forced to seek the help of legal counsel to assist them. Due to the amount of time that has passed since the date of loss, this acknowledgement is evidence that TypTap knowingly and intentionally are delaying the claims process in order to further disadvantage the Insured. The financial detriment caused to the Insured and their family is a direct result of TypTap’s reckless delay of the claim process. The Insured are dutiful customers who made it a priority to pay their insurance premiums to ensure that in such an event as this devastating incident, their home would be covered. The Insured timely filed their claim and fulfilled all of their post-loss obligations. All requested information and documentation has been turned over to TypTap and their representatives promptly by the Insured. However, TypTap failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim, failed to inform the Insured how they may remedy any deficiencies in their claim, and failed to provide them with qualified representatives to ensure the claim was initially adjusted, evaluated, and estimated properly. To deny the Insured the benefit of their bargain after they satisfied all of their obligations is morally and ethically reprehensible, and reeks of Unfair Trade Practice. Upon information and belief, the aforementioned actions complained of, among others, were made by TypTap so often as to constitute a general business practice, evidencing a motive to enhance TypTap’s profits, and designed to cause a detrimental effect to its policy holders. TypTap was aware that the Insured’ damages were covered and took advantage of its Insured in an attempt to force them into an irreparably disadvantaged position, which they hope will force the Insured to settle for less coverage than they are contractually entitled to under the policy. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should TypTap fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, TypTap must: (1) Immediately tender all insurance proceeds due and owing to the Insured that are fairly owed to the Insured under the insurance policy that would reasonably place the Insured back to a pre-loss condition; (2) Agree to reimburse the Insured’ reasonable attorneys’ fees and costs for having to become involved to resolve the claim; (3) Agree to reimburse the Insured for interest on the amount of benefits that was found to be due and owing to the Insured, relating back to the date of loss; (4) Although the Insured have made a demand herein and have previously provided TypTap with all the necessary estimates, invoices, receipts, etc. in support thereof, the Insured are still willing to consider and to potentially accept any reasonable counter-offer made by TypTap. Therefore, if TypTap is not in agreement with the Insured’ reasonable demand for payment of their rightfully-owed insurance benefits being submitted at this time, the Insured hereby request that TypTap now make a reasonable counter-offer before the expiration of the cure period.
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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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