Filing Number: 797803
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| Filing Accepted: 12/20/2024 |
| Last/Business Name
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| Street Address
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199 SW 7TH TERRACE |
| City, State Zip
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HALLANDALE BEACH,
FL
33009
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| Email Address
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JEREMYTRIPP@PM.ME |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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TRIPP |
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First Name |
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JEREMY |
| Policy # * |
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647339 |
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Claim #* |
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943231 |
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Attorney is Applicable
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| Last Name* |
FANTETTI
First Name *
KELLY
Initial
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| Street Address* |
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109 S. EDISON AVENUE |
| City, State Zip* |
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TAMPA
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FLORIDA
33606
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| Email Address * |
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KFANTETTI@STOCKHAMLAWGROUP.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):*
JENNIFER SMITH, J.C. SOTO
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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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Unsatisfactory Settlement Offer
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Claim Delay
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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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
J. 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. Loss will be payable upon the earliest of the following:
1. 20 days after we receive your proof of loss and reach written agreement with you;
2. 60 days after we receive your proof of loss and:
a. There is an entry of a final judgment; or
b. There is a filing of an appraisal award or a mediation settlement with us; or
3. If payment is not denied, within 90 days after we receive notice of an initial, reopened or supplemental claim. However, this provision (J.3.) does not apply if factors beyond our control reasonably prevent such payment.
A. Coverage A – Dwelling.
1. We cover:
a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and
b. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises".
C. Replacement Cost Loss Settlement Condition
The following loss settlement condition applies to all property described in A. above:
1. We will pay no more than the least of the following amounts:
a. Replacement cost at the time of loss without deduction for depreciation;
b. The full cost of repair at the time of loss;
c. The limit of liability that applies to Coverage C, if applicable;
d. Any applicable special limits of liability stated in this policy; or
e. For loss to any item described in A.2.a. – f. above, the limit of liability that applies to the item.
2. We will settle the loss as noted in Paragraph C.1. above whether or not actual repair or replacement is complete.
All other provisions of this policy apply.
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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.
In Florida, the work of adjusting insurance claims engages the public trust. Homeowners Choice Property & Casualty Insurance Company (“HOMEOWNERS CHOICE) has breached the public’s trust by its adjustment of Jeremy Tripp’s (“Insured”) claim of loss. Homeowners Choice’s mailing address is 3802 Coconut Palm Drive, Tampa, FL 33619.
HOMEOWNERS CHOICE has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. HOMEOWNERS CHOICE has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insured’s insurance claim for damages.
HOMEOWNERS CHOICE has failed to promptly settle the Insured’s insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the Insured’s pleas otherwise, HOMEOWNERS CHOICE has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing to the Insured under the policy.
The Insureds’ house was damaged by a water loss on August 30, 2024. The Insured has obtained a rebuild estimate of $60,121.29 from National Restoration, and a mold remediation estimate of $9,713.18 from National Restoration.
On October 9, 2024, the Insured submitted a Proof of Loss to HOMEOWNERS CHOICE in the amount of $61,865.19 as follows:
Whole Loss & Damage $69,834.47
Less Refundable Depreciation $6,969.28
Less Deductible $1,000.00
Amount Claimed $61,865.19
HOMEOWNERS CHOICE has made a small payment for the dwelling damage, but has failed to pay for damaged kitchen cabinets among other things that had been removed by the mold remediation company. Oddly enough, HOMEOWNERS CHOICE paid for the replacement of the damaged walls behind the cabinets though.
The more pressing issue for the Insured is HOMEOWNERS CHOICE’s failure to reimburse the Insured for out-of-pocket ALE expenses in the amount of $15,064.09. The Insured is completely broke after having laid out every penny he could muster from friends and family to cover temporary living expenses. He depended on being reimbursed for these expenses by now in order to provide a Christmas for his kids. Instead, after 110 days since the date of loss, 88 days since submitting receipts for the first 6 weeks of rental receipts, 45 days since a reinspection, and 34 days since submitting receipts for the last 3 weeks of ALE, the Insured and his children find themselves homeless, and the Insured is unable to purchase gifts for his children. HOMEOWNERS CHOICE’s treatment of the Insured and his family is unconscionable.
HOMEOWNERS CHOICE must immediately reimburse the Insured for his out-of-pocket ALE expenses and for the remaining damage to his home so that he can move in.
The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the Insured may mitigate his damages and be put back into the position he was in prior to the loss as quickly as possible. HOMEOWNERS CHOICE has breached this duty.
The Insured was, and still is, forced to expend out of pocket monies to submit the insurance claim, e.g., retaining an attorney and other experts to force the Insurer to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to him.
HOMEOWNERS CHOICE has refused and/or failed to tender all the insurance proceeds due and owing to the Insured. HOMEOWNERS CHOICE’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the Insured is wrongful conduct. Furthermore, the Insured contends that HOMEOWNERS CHOICE’s adjusters and/or representatives financially benefit from such wrongful conduct.
Therefore, to cure the defects outlined in this Civil Remedy Notice, HOMEOWNERS CHOICE must tender to the Insured the full amount of ALE incurred to date, the full cost of repair, plus interest.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155.
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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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