Filing Number: 796833
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| Filing Accepted: 12/13/2024 |
| Last/Business Name
*
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| Street Address
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88 8TH AVE E |
| City, State Zip
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HORSESHOE BEACH,
FL
32648
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| Email Address
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JOHNG1678@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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GREEN |
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First Name |
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JOHN |
| Policy # * |
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FSA175217 |
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Claim #* |
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1427241-241013 |
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Attorney is Applicable
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| Last Name* |
KANDELL
First Name *
SCOTT
Initial
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| Street Address* |
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2665 S BAYSHORE DRIVE, SUITE 500 |
| City, State Zip* |
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MIAMI
,
FLORIDA
33133
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| Email Address * |
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CRNREPLY@KKPFIRM.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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ASI PREFERRED INSURANCE CORP.
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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 13142 |
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| Name of individual responsible for violation (if any):*
AGENTS OF ASI PREFERRED INSURANCE CORP.
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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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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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
SECTION I:
A. Dwelling Coverage
$280,000
4798.50
B. Increase/Decrease Other Structures
$28,000
238.72
C. Contents Coverage
$25,000
528.00
D. Loss of Use
$28,000
Included
L. Personal Liability - Each Occurrence / M. Medical Payments to Others - Each Person
$300,000/5,000
80.00
Failure to provide specific policy language is not a fatal omission in complying with Fla. Stat. 624.155. Insureds are unsure and unaware of policy language that applies to the carrier's violation of Florida’s statutes. Insureds reserve the right to add applicable policy language at such time the policy is made available.
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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 or about September 26, 2024, the insured property located at 88 8th Ave E, Horseshoe Beach, FL 32648 (“Property”), owned by John and Zinnette Green (“Insureds”), suffered catastrophic damage resulting in a total loss due to Hurricane Helene.
Hurricane Helene struck Horseshoe Beach as a powerful Category 4 storm, leaving behind extensive destruction. The hurricane generated winds near 140 mph, devastating nearly 90% of homes and infrastructure. This event marks one of the most severe impacts on Florida’s Big Bend region in recent history. Specifically, this natural disaster devastated Horseshoe Beach, which was in the eye of the storm along with the surrounding areas.
At the time of loss, the Property was insured under a residential homeowner’s insurance policy, Policy No. FSA175217 (“Policy”), issued by ASI Group as an affiliate of The Progressive Corporation (“Progressive”). The Policy covers losses due to wind damage, a peril which indisputably affected the Property during Hurricane Helene.
Following the Insureds’ prompt reporting of the loss on October 3, 2024, Claim No. 1427241-241013 (“Loss”), Progressive arranged an inspection with their independent field adjuster and an engineer. At this time, Progressive is in possession of the engineer’s report but has not issued a coverage determination.
Weather data evidences that 140 mph winds hammered the Property for over six (6) hours. Thus, there is no dispute that the Property sustained intense wind forces from the hurricane, causing damage independently of flood-related forces. Progressive has failed to acknowledge the impact of the wind, despite receiving a Substantial Damage Estimate Form, which evidences a total loss of the Property.
Under Florida’s Valued Policy Law (“VPL”), Fla. Stat. 627.702, when a covered peril renders property a total loss, as in this case, the insurer must pay the full policy limits. It is undisputed that the Insureds’ Property is a total loss, and therefore they are entitled to the policy limits.
To cure these violations, Progressive must issue payment under Florida’s VPL for the Policy limits under Coverages A and B, compensating the Insureds fully for the total loss of the insured Property due to wind damage, as well as pay all statutory interest on overdue amounts.
Progressive has insisted via communications that it intends on promptly handling and resolving this claim but has substantially delayed said resolution. As a general business practice, Progressive has demonstrated, both throughout this claim, and others, that it has failed to adopt and implement standards for the proper investigation of claims, frequently delaying its insureds’ claims and leaving them to retain their own adjusters and attorneys to ensure proper handling.
It has not attempted in good faith to settle this claim when under all the circumstances it could and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for their interests. It has failed to promptly settle this claim when the obligation to settle has become reasonably clear.
As a result of Progressive’s lack of cooperation, the Insureds have been forced to exercise their only remaining option: retaining counsel and filing a lawsuit, costing them money and reducing their ultimate recovery, preventing them from being fully indemnified and denying them the opportunity to rebuild their Property.
Progressive has acted in bad faith by denying the Insureds’ claim without fully investigating or accounting for the wind damage sustained by the Property. In failing to provide the owed benefits, Progressive has neglected its duty to act fairly and in good faith toward the Insureds. Progressive must promptly pay the full policy limits for the total loss of the Insureds’ Property in accordance with Florida’s VPL to cure these violations.
In order to remedy these violations, Progressive must immediately issue an undisputed payment in connection with this claim as well as statutory interest under Fla. Stat. 627.70131 and undertake bilateral adjustment of the claim with the Insureds or their representatives per the terms and conditions of the Policy, at minimum outlining any disputes and setting forth the reasons in support of any position or compromise.
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*
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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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