Filing Number: 798252
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| Filing Accepted: 12/26/2024 |
| Last/Business Name
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GOODBYE MOLD LLC
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First Name |
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| Street Address
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8300 NW 53RD ST SUITE 350 |
| City, State Zip
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DORAL,
FL
33166
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| Email Address
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INFO@GOODBYE-MOLD.COM |
| Complainant Type:
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Third Party |
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| Last/Business Name* |
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AIDA & CHRISTIAND MENDEZ MORALES - SANCHEZ |
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First Name |
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| Policy # * |
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04506373-2 |
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Claim #* |
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227264 |
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Attorney is Applicable
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| Last Name* |
GONZALEZ ESQ.
First Name *
ROBERT F.
Initial
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| Street Address* |
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8950 SW 74TH CT., STE 2267 |
| City, State Zip* |
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MIAMI
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FLORIDA
33152
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| Email Address * |
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INTAKE@FLINSLAW.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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FLORIDA PENINSULA 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 10132 |
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| Name of individual responsible for violation (if any):*
UNKNOWN
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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 Denial
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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)(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)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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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 1 - Perlis Insured Against Section 1 - Property Coverages 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.
Page 1 of 1On August 21, 2022, Aida & Christiand Mendez Morales - Sanchez suffered a loss due tocovered perils contemplated under the Policy; and timely reported the damage to Defendant.Aida & Christiand Mendez Morales - Sanchez contracted Goodbye Mold LLC in order toperform services to the Insureddirectly relating to the loss. In exchange for Goodbye Mold LLC'sservices Aida & Christiand Mendez Morales - Sanchez executed an assignment of benefits. Onor about September 14, 2022, Goodbye Mold LLC provided Florida Peninsula InsuranceCompany with notice of the Assignment of Benefits. Within the statutory period, Goodbye MoldLLC provide Florida Peninsula Insurance Company with a copy of its invoice, assignmentagreement, demand for payment of insurance benefits and supporting documentation. During theinvestigation of the claim, Florida Peninsula Insurance Company sent an unqualified person tomake determinations of causation of damage in violations of 626.9541(1)(i)(3)(d). Aftercompleting its deficient investigation Florida Peninsula Insurance Company should haveprovided coverage for the loss. Florida Peninsula Insurance Company has unduly delayed fullpayment and coverage over the claim in violation of the insurance contract and has done so in amanner which violates multiple Florida Statutes. Furthermore, Florida Peninsula InsuranceCompany failed to promptly provide a reasonable explanation in writing to the insured of thebasis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or forthe offer of a compromise settlement.The failure to issue payment when there was no applicable exclusion for the type of service orclaim in relation to the covered claim is a violation of 624.155(1)(b)(1) and 624.155(1)(b)(3).Florida Peninsula Insurance Company has been provided sufficient evidence to support coveragefor the subject claim and services. Despite making numerous payments in the past for these typesof services which were performed in relation to valid insurance claims, Florida PeninsulaInsurance Company has subsequently made it a business practice to deny these servicesirrespective of the facts for each claim in direct violation of 626.9541(1)(i)(3)(a) and626.9541(1)(i)(3)(b).Florida Peninsula Insurance Company has repeatedly and continuously acted in bad faith in thismatter and others like it. Despite the fact that these services are directly related to covered lossesand not excluded under the policy of insurance, Florida Peninsula Insurance Company refuses topay insurance benefits for same. In order to cure Florida Peninsula Insurance Company’scontinuous acts of bad faith, Florida Peninsula Insurance Company must issue payment for theinvoiced amount of $ 3,000.00 and which has a current balance of $ 3,000.00; as well as,statutory interest. In addition, Florida Peninsula Insurance Company must cease its unfair tradepractice of citing to irrelevant policy provisions in order to misrepresent the coverages affordedunder its policies of insurance.PDC22-113799
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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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