Civil Remedy Notice of Insurer Violations
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Filing Number:     797635
Filing Accepted:  12/19/2024
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Complainant
Last/Business Name *  
PALM SPRINGS INVESTMENT GROUP, INC.   First Name  
Street Address * 1930 PALM AVENUE
City, State Zip * HIALEAH, FL 33012
Email Address * GELSINGER@MINEOLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   PALM SPRINGS INVESTMENT GROUP, INC.   First Name  
Policy # * AMR-59434-04 Claim #* 4194345
Attorney
Attorney is Applicable
Last Name* ELSINGER First Name * GARRETT Initial
Street Address* 5600 DAVIE ROAD
City, State Zip* DAVIE , FL 33314
Email Address * GELSINGER@MINEOLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNDERWRITERS AT LLOYD'S, LONDON
NAIC Company Code
 
Name of individual responsible for violation (if any):* ALL ADJUSTERS, SUPERVISORS, MANAGERS, ATTORNEYS, AND INDIVIDUALS ASSOCIATED WITH AND/OR RETAINED BY CERTAIN UNDERWRITERS AT LLOYD’S LONDON AND/ OR SEDGWICK CONCERNING THE CLAIM AT ISSUE
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
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)(2) 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.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

• In addition to the breach of the above statutory duties, see Coverage A, Building and Personal Property Coverage Form, Causes of Loss - Special Form, and Loss Payment Provisions
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Certain Underwriter’s at Lloyd’s London Subscribing to Policy Number AMR-59434-04 (“the Insurance Company”) issued a commercial property insurance policy to its insured Palm Springs Investment Group, Inc.(the “Insured”), for the insured property located at 1930 Palm Avenue, Hialeah, FL 33012. The subject Policy afforded various types of coverages including coverage for damage to dwelling, and for loss of use. On or about March 24, 2022, while the subject Policy was in full force and effect, the Insured’s property was damaged as a result of a cast iron plumbing backup from within its plumbing system that caused ensuing interior water damage. The Insured promptly notified the Insurance Company of the loss. Thereafter, the Insurance Company acknowledged the loss and assigned claim number 4194345 to the loss. The Insured complied with all policy conditions and cooperated with the Insurance Company’s investigation efforts. The Insurance Company performed an inspection of the property during its investigation of the claim and confirmed that the property had both sustained interior water damage and that the property’s plumbing system was damaged and needed to be replaced however, despite the insured’s cooperation, the insurance company, in bad faith, denied coverage for the overwhelming majority of the covered damages and instead in bad faith, issued a token payment that the insurer knew was contrary to the policy and would not be enough to restore the property to pre-loss condition. The insurance company has been provided with an estimate for the amount of damages necessary to restore the insured’s property to its pre-loss condition, expert reports confirming the cause of damage however despite this knowledge, the insurance company continues to refuse requests for payment and instead is attempting to low ball the plaintiff into accepting an amount of money that can’t possible allow it to repair the subject property. The insurer, in bad faith, has raised defenses to paying the full value of the claim that the insurer knows are inapplicable to the subject loss and which the insurer’s own experts do not agree with based upon a plain reading of the expert’s reports. Accordingly, the Insurance Company has misrepresented facts and policy language related to the coverages provided under the policy, and has accordingly collected a premium for insurance that has not been provided in full. The obligation to pay the full value of the Insureds’ claim has been made clear based on the facts and evidence available, yet the Insurance Company has failed to pay the full value of the Insureds’ claim. This is caused in part by the Insurance Company’s failure to adopt and implement standards for the proper investigation of claims. The Insureds provided the Insurance Company with documentation evaluating the loss, and rather than issuing the proper payment or attempting to reach an agreement with its Insureds, the Insurance Company is delaying and denying the claim. Upon information and belief, the Insurance Company performs the subject actions as a business practice, including delaying the claim and/or denying the claim in an attempt to dissuade its insureds from pursuing the claim to the detriment of its insureds to increase financial profits. In order to remedy the above defects, the Insurance Company must do the following: 1. Immediately admit coverage and pay the Insureds the full value of the claim. 2. Pay statutory interest on the amount of unpaid damages from the date of loss. 3. Act fairly and honestly toward its Insureds with due regard for her interests in attempting to resolve the claim. 4. Cease and desist all present and future bad faith actions with regard to this claim. 5. Implement standards for the property investigation of claims. 6. Stipulate to the Insureds’ entitlement to attorney’s fees and court costs pursuant to section 627.428, or 626.9373, Florida Statutes, and pay the amount of fees and costs incurred.
Comments
User Id Date Added Comment
gelsinger@mineolaw.com 02-12-2025 On behalf of Plaintiff, the Plaintiff officially withdraws the Civil Remedy Notice. All issues have been amicably resolved. Garrett Elsinger, Esq. on behalf of Palm Springs Investment Group, Inc.
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