Civil Remedy Notice of Insurer Violations
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Filing Number:     798017
Filing Accepted:  12/23/2024
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Complainant
Last/Business Name *  
DURAN   First Name   RAFAEL
Street Address * 4723 TRAVERTINE DR
City, State Zip * TAMPA, FL 33615
Email Address * LL@WEKLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   DURAN   First Name   RAFAEL
Policy # * HCPC-HO3-501693-3 Claim #* 931002
Attorney
Attorney is Applicable
Last Name* LIEB First Name * LORA Initial
Street Address* 800 E BROWARD BLVD #510
City, State Zip* FORT LAUDERDALE , FLORIDA 33301
Email Address * LL@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
NAIC Company Code 12944
 
Name of individual responsible for violation (if any):* FRANTZ G. JONASSAINT
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Homeowners Choice Property & Casualty Insurance Company Homeowners HO-3 Policy Declarations – Renewal Agreement We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. Definitions 6. "Insured location" means: a. The "residence premises"; 7. "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions, which results, during the policy period, in: a. "Bodily injury"; or b. "Property damage". 11. "Property damage" means physical injury to, destruction of, or loss of use of tangible property SECTION I – PROPERTY COVERAGES COVERAGE A – Dwelling We cover: 1. The dwelling on the "residence premises" shown in the Declarations, including attached structures and attached wall-to-wall carpeting if damage to the dwelling is caused by a covered loss; SECTION I – PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property. e. Accidental discharge or overflow of water or steam; unless loss to property covered under Coverage A or B results from an accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance on the "residence premises". Loss to property covered under Coverage A or B that results from an accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance on the “residence premises” includes the cost to tear out and repair only that part of a building, or only that part of an other structure, on the "residence premises", necessary to access and repair the system or appliance. The cost that we will pay for the tear out and repair of the part or portion of the building or other structure covered under Coverage A or B as specified above is limited to only that part or portion of the covered building or other structure which is necessary to provide access to the part or portion of the system or appliance that caused the covered loss, whether the system or appliance, or any part or portion of the system or appliance, is repairable or not. In no event will we pay for the repair or the replacement of the system or appliance that caused the covered loss. Section I – Conditions 10. 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
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Prior to September 30, 2022, Homeowners Choice Property & Casualty Insurance Company (hereinafter “Homeowners”) sold an insurance policy, identified by policy number HCPC-HO3-501693-3, to Rafael and Alda Duran for their home located 4723 Travertine Dr., Tampa, FL 33615 (hereinafter “Home”). Homeowners sold the Durans an H03 policy with broad coverages, including but not limited to coverage for water damage. On or about September 30, 2022, while the subject policy was in full force and effect a kitchen water leak caused substantial damage to the Home, which resulted in claim no. 931002 (hereinafter “Loss”). After receiving prompt notice of the loss, Homeowners inspected the home and photographed the property. As a result of the review, Homeowners issued its claim decision for the loss, providing $3,498.89 in payment. At the same time, Mr. and Mrs. Duran, through their Public Adjuster ICA, investigated and adjusted the loss, determining a value of the Loss under Coverages A at $20,629.87. Additionally, the Durans have incurred costs mitigating the damage in the property, totaling $6,300.91. Homeowners adjustment of the loss was not a fair or honest adjustment of the loss. Homeowners’ adjustment of the loss was intended to provide the illusion of a fair adjustment, to avoid full payment to the Durans. Homeowners knows or should know that its adjustment of the Loss is not a fair or honest assessment of the Loss, yet Homeowners has refused to attempt to settle the Loss with the Durans and their representatives. Homeowners has made the practice of denying and under valuing a claim in order to leverage more favorable claim settlements and to avoid having to fairly and honestly adjust and pay for losses. Further, Homeowners failed to assign an unbiased adjusting team to handle the loss. Homeowners does not have appropriate standards in place to be able to investigate claims such as the Loss at the Duran’s Home. Homeowners’ failure to have appropriate standards, led to the assignment of an inadequate inspection team, which ultimately led to Homeowners’ unfair and dishonest adjustment of the Loss. In total, and as exhibited above, Homeowners has implemented a strategy and approach to the Loss that is unfair, and Homeowners is unfairly attempting to settle the Loss. In order to remedy the above referenced violations, Homeowners must promptly fairly and honestly assess or reassess the Loss so that it may engage in good faith settlement negotiations with the Durans and their representatives.
Comments
User Id Date Added Comment
Legal@hcpci.com 02-17-2025 This is Homeowners Choice Property & Casualty Insurance Company’s (“HCPCI”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by Lora Lieb on behalf of Rafael Duran (“Insured”). After reviewing the CRN, HCPCI conducted a thorough review of the subject claim (“Claim”) and confirmed it handled the Claim properly. Ultimately, all issues regarding the Claim, including all issues raised in the CRN, have been resolved via a full and final settlement agreement (“settlement”). Pursuant to the settlement, the Insured signed or is in the process of signing a full, final and valid release that addresses all claims for bad faith in relation to the Claim. This response to the CRN in no way impairs or otherwise alters the full and final settlement of the Claim. Subject to the foregoing, HCPCI denies it committed a violation of any Florida statute prior to the settlement or at any time as alleged in the CRN. HCPCI also notes the CRN is deficient as, for instance, it fails to cite relevant statutory provisions along with supporting, specific insurance contract language and facts. Ultimately, as referenced above, HCPCI settled all issues regarding the Claim, including any and all issues raised in the CRN, as set forth in the release. Finally, upon request by the Department of Financial Services, HCPCI will provide to the Department of Financial Services detailed correspondence HCPCI provided to the Insured regarding HCPCI’s obligations for the Claim under the insurance contract and the facts of the Claim.
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