Filing Number: 798601
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| Filing Accepted: 12/30/2024 |
| Last/Business Name
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| Street Address
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236 MARK TWAIN LN |
| City, State Zip
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ROTONDA WEST,
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33947
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| Email Address
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TODDSALMON@HOTMAIL.COM |
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Insured |
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| Last/Business Name* |
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SALMON |
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First Name |
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TODD |
| Policy # * |
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12106058602 |
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Claim #* |
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12300929722 |
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Attorney is Applicable
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| Last Name* |
ROSSO
First Name *
SCOTT
Initial
M
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| Street Address* |
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7171 NORTH FEDERAL HIGHWAY |
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BOCA RATON
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FL
33487
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| Email Address * |
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SROSSO@GEDLAWYERS.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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TYPTAP 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 15885 |
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| Name of individual responsible for violation (if any):*
BECKY STACEY, KWEI-LIN SHAU, IAN ARPKE-LONE, TUNDE FASORO, COURTNEY S. SMITH, BROOKE WEBB, AND ALL ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY TYPTAP INSURANCE COMPANY IN THE CLAIM.
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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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Unfair Trade Practice
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Claim Delay
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Other
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Failure to Properly Investigate Claim and with Due Regard to INSUREDS’ Interest
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Other
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Failure to Acknowledge and Act Promptly to Communications Regarding Claim
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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)(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)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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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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| 626.9541(1)(i)(3)(f) |
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Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
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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.
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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.
FLORIDA STATUTES VIOLATED (continued)
Florida Statute §627.70131(1)(a) – Upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 14 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer which reasonably prevent such acknowledgment. If the acknowledgment is not in writing, a notification indicating acknowledgment shall be made in the insurer’s claim file and dated. A communication made to or by an agent of an insurer with respect to a claim shall constitute communication to or by the insurer.
Florida Statute §627.70131(2) - Such acknowledgment shall be responsive to the communication. If the communication constitutes a notification of a claim, unless the acknowledgment reasonably advises the claimant that the claim appears not to be covered by the insurer, the acknowledgment shall provide necessary claim forms, and instructions, including an appropriate telephone number.
FLORIDA ADMINISTRATIVE CODE SECTIONS VIOLATED
69B-220.201(3) – Code of Ethics. The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters:
69B-220.201(3)(b)2. – An adjuster shall adjust all claims strictly in accordance with the insurance contract.
69B-220.201(3)(c) – An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the INSUREDS.
69B-220.201(3)(d) – An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation.
69B-220.201(3)(f) – An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim.
69B-220.201(3)(m) – An adjuster shall not knowingly fail to advise a claimant of the claimant’s claim rights in accordance with the terms and conditions of the contract and of the applicable laws of this state. An adjuster shall exercise care not to engage in the unlicensed practice of law as prescribed by the Florida Bar.
Section 4:
To enable the insurer to investigate and resolve your claim, describe the facts and circumstances giving rise to the insurer's violation as you understand them at this time.
1) failure to pay claim in full;
2) failure to promptly investigate claim;
3) failure to properly investigate claim;
4) failure to adjust loss; and
5) failure to act in due diligence and good faith to resolve claim;
6) Unfair Trade Practices.
This complaint is made on behalf of TODD AND BRITTANI SALMON (“THE INSUREDS”). In consideration of the premium paid to it by THE INSUREDS, TYPTAP INSURANCE COMPANY issued a Homeowners Insurance Policy, Policy No. 12106058602 (“the Policy”), for THE INSUREDS’ property located at 236 MARK TWAIN LN, ROTONDA WEST, FL 33947 (“the Property”). On or around September 28, 2022, while the Policy was in full force and effect, THE INSUREDS suffered significant damage to the Property as a result of Hurricane Ian.
Hurricane Ian’s wind forces and high wind velocity caused damage to the interior and exterior of the INSUREDS’ property. Specifically, damage to the roof, interior walls, flooring, electrical, doors, windows, and pool cage. The direct physical loss and ensuing damage sustained by the Property, exterior and interior damages, were the result of Hurricane Ian, a covered peril under the Policy, not subject to any Policy exclusions. The loss was sudden and accidental as a result Hurricane Ian, and therefore, a covered peril under the policy.
THE INSUREDS timely placed TYPTAP INSURANCE COMPANY on notice and TYPTAP INSURANCE COMPANY, in turn, had its Claims Department open a claim and assigned claim number 12300929722 to THE INSUREDS’ loss.
Upon being notified of the loss, TYPTAP INSURANCE COMPANY assigned adjuster Ian Arpke-Lone (“Arpke-Lone”) to adjust the damage to THE INSUREDS’ property on TYPTAP INSURANCE COMPANY’s behalf. On October 11, 2022, Arpke-Lone inspected THE INSUREDS’ property and prepared an estimate. It was clear that the damages were the result of a sudden and accidental event, as well as, an ensuing loss from a covered loss. TYPTAP INSURANCE COMPANY prepared an estimate for the cost of the damages to the PROPERTY were $66,002.66 (Replacement Cost Value) and $60,756.97 (Actual Cost Value) based on Arpke-Lone’s scope of damage. TYPTAP INSURANCE COMPANY sent a letter, dated October 5, 2022, with a payment of $53,596.97 for Coverage A. TYPTAP INSURANCE COMPANY’s purported valuation of the amount needed to properly repair and remediate the conditions at THE INSUREDS’ property is patently grossly inadequate and fails to account for the costs that THE INSUREDS have incurred or will incur to repair the damages sustained from Hurricane Ian.
Due to TYPTAP INSURANCE COMPANY’s failure to properly adjust the claim, THE INSUREDS’ trust in TYPTAP INSURANCE COMPANY to help wore out, and had no other choice, but to retain an attorney to aid in pursuing contractual rights to obtain due and owing benefits under the Policy. THE INSUREDS’ counsel sent TYPTAP INSURANCE COMPANY a Letter of Representation on September 20, 2023 and requested copies of photos, estimates, and/or expert reports related to the claim; a certified copy of the Policy; a copy of claim related correspondence; and any statements or other documents related to the claim most of which had been previously provided to TYPTAP INSURANCE COMPANY by THE INSUREDS.
THE INSUREDS retained Sheegog Contracting (“Sheegog”) to prepare a full and adequate estimate of damages as a result of Hurricane Ian to determine the cost of reasonable and necessary repairs to return the property to its pre-loss condition. Sheegog inspected THE INSUREDS’ Property and prepared an estimate, which estimated the cost of the damages incurred to be $341,585.86 as the bring the home back to its pre-loss condition, as a direct result of this loss.
Moreover, the home was properly dried out and mold remediation was performed by Restopro after the initial inspection by TYPTAP INSURANCE COMPANY. The invoices for water and mold remediation services were provided to the insurance company during pre-suit and a settlement was reached with said company. However, no additional monies were provided to the Insured for the majority of the home being torn down to studs. The carrier failed to further investigate despite the Insured and their representatives multiple attempts requesting for additional funds or investigation.
Following the inspections by THE INSUREDS’ agents, and based upon the investigation and analysis of all information then available, THE INSUREDS’ agents issued their estimate as to the amount of reasonable and necessary repairs attributable to Hurricane Ian damages to the loss on the subject Property, which exceeded the estimate of damages prepared by TYPTAP INSURANCE COMPANY. THE INSUREDS promptly submitted Sheegog’s estimate to TYPTAP INSURANCE COMPANY. Despite all the information available to TYPTAP INSURANCE COMPANY, TYPTAP INSURANCE COMPANY offered a minimal amount to settle the claim, forcing THE INSUREDS to move this matter into the court system, forcing further delay and THE INSUREDS to incur additional, unnecessary costs.
TYPTAP INSURANCE COMPANY’s handling and adjustment of its INSUREDS’ claim of loss and the conduct of the adjusters, supervisors, management, and individuals associated with or retained by TYPTAP INSURANCE COMPANY in this claim to date evidences that TYPTAP INSURANCE COMPANY failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSUREDS’ insurance claim for damages. As of the date of the filing of this CRN and immediate reporting of said loss, notwithstanding the INSUREDS’ pleas for assistance, TYPTAP INSURANCE COMPANY has refused to pay the full amount of its INSUREDS’ claim. TYPTAP INSURANCE COMPANY’s failure to make a coverage determination since THE INSURED’s immediate reporting of the loss is in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f), and 626.9541 (1)(i)(3)(i); and Florida Administrative Codes §§69B-220.201(3)(b), 220.201(3)(c), 220.201(3)(d), 220.201(3)(f), and 220.201(3)(m).
Despite the aforementioned failures by TYPTAP INSURANCE COMPANY, THE INSUREDS were hopeful that the claim would be resolved quickly, but despite their efforts TYPTAP INSURANCE COMPANY failed to provide the INSUREDS with the funds necessary to bring their home back to its pre-loss condition or even issue a coverage decision.
In sum, TYPTAP INSURANCE COMPANY has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate THE INSUREDS’ insurance claim for damages.
In Florida, the work of adjusting insurance claims engages the Public Trust. TYPTAP INSURANCE COMPANY has breached this duty by its adjustment of its INSUREDS’ claim of loss.
The entire purpose of insurance is to indemnify THE INSUREDS for a covered loss. Despite the fact that TYPTAP INSURANCE COMPANY knows, or should know, that further insurance proceeds and benefits are owed based upon the information provided by THE INSUREDS, to date, TYPTAP INSURANCE COMPANY, failed and/or refused to promptly adjust THE INSUREDS’ claim to the detriment of THE INSUREDS. TYPTAP INSURANCE COMPANY’s delay in this matter exacerbated the harm and hardship sustained by THE INSUREDS in connection with this loss. TYPTAP INSURANCE COMPANY’s failure to attempt in good faith to settle THE INSUREDS’ Windstorm claim when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward THE INSUREDS and with due regard for its interest, is a violation of Fla. Stat. §624.155(1)(b)(1), in addition to several other applicable Statutes and Administrative Codes as cited and referenced throughout this Notice, which prohibit TYPTAP INSURANCE COMPANY from approaching claims or treating INSUREDS in the manner in which it has here.
Notwithstanding THE INSUREDS’ repeated pleas and the ample opportunity TYPTAP INSURANCE COMPANY had to fully investigate the loss since it was timely reported, to date, TYPTAP INSURANCE COMPANY failed and/or refused the provide THE INSUREDS with all the insurance proceeds and benefits due and owing, undisputed or otherwise, and has not tendered the full amount needed to repair the Property despite knowing that THE INSUREDS has sustained covered damages.
As TYPTAP INSURANCE COMPANY must admit, it is implied within every insurance policy a duty of good faith and fair dealings. In an insurance contract, each party is prevented from interfering with the other’s right to benefit from the contract. The obligations of good faith and fair dealings encompass qualities of decency and humanity inherent in its responsibilities as a fiduciary. TYPTAP INSURANCE COMPANY is bound to conduct itself with the utmost good faith for the benefit of THE INSUREDS. However, TYPTAP INSURANCE COMPANY failed to comply with its obligations in connection with this claim and has not looked at the claim or the contract for insurance with good faith and fair dealing. Instead, TYPTAP INSURANCE COMPANY looked for ways to either delay or avoid paying the claim in full and these actions have been to the detriment of THE INSUREDS.
The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim, TYPTAP INSURANCE COMPANY has engaged in a pattern of delay, denial, and reckless disregard for THE INSUREDS’ rights. The actions of TYPTAP INSURANCE COMPANY listed herein have been continuing in nature and given the totality of the circumstances, TYPTAP INSURANCE COMPANY’s adjustment, actions, and/or omissions post the filing of this Civil Remedy Notice. THE INSUREDS contend that given their past experience in this matter with TYPTAP INSURANCE COMPANY, it is reasonably foreseeable that TYPTAP INSURANCE COMPANY’s current actions will extend to its entire conduct in the handing of their claim, including the acts or omissions of TYPTAP INSURANCE COMPANY and/or its representatives, until the final resolution of their claim. As such, THE INSUREDS contend adequate notice has been given should TYPTAP INSURANCE COMPANY’s actions and violations listed herein continue after the expiration of this notice.
The representatives on behalf of TYPTAP INSURANCE COMPANY have approached this investigation in a manner prejudicial to THE INSUREDS. TYPTAP INSURANCE COMPANY in using either untrained or improperly trained adjusters in connection with this claim. TYPTAP INSURANCE COMPANY should have been adjusting the loss with THE INSUREDS but instead, it looked for ways to delay the adjustment of the claim and/or not to pay the claim at all or in full.
TYPTAP INSURANCE COMPANY’s conduct has been reckless, unfair, and prejudicial to THE INSUREDS and has caused and continues to cause damage to THE INSUREDS, including unrepaired damages throughout the Property. This is a direct result of the delay and avoidance in investigating and paying the claim and the failure of TYPTAP INSURANCE COMPANY to fairly and adequately evaluate THE INSUREDS’ claim.
TYPTAP INSURANCE COMPANY refused and/or failed to comply with the Policy’s cooperation and/or “Loss Payment” provision(s) (see below for full language of “Loss Payment”). Under the Policy, TYPTAP INSURANCE COMPANY was to timely tender undisputed insurance proceeds and benefits to THE INSUREDS. TYPTAP INSURANCE COMPANY failed and/or refused to timely tender owed insurance proceeds and benefits, undisputed or otherwise. This is a breach of the Policy.
TYPTAP INSURANCE COMPANY has failed and/or refused to settle the claim when it could and should have done so had it acted fairly and honestly towards THE INSUREDS and has failed to take into account the information and evidence provided that contradict its decisions.
TYPTAP INSURANCE COMPANY’s conduct has been reckless, unfair, and prejudicial to THE INSUREDS and has caused and continues to cause additional damages throughout the property. This is evidenced by the delay in paying the claim and the failure of TYPTAP INSURANCE COMPANY to evaluate the claim in total.
To date, TYPTAP INSURANCE COMPANY has failed and/or refused to provide THE INSUREDS with all the necessary insurance benefits due and owing and has not tendered the full amount needed to repair the Property despite knowing that THE INSUREDS have sustained covered damages to their insured property.
TYPTAP INSURANCE COMPANY refused and/or failed to cooperate and/or “Adjust the Loss” by failing to cooperate with THE INSUREDS during the claims adjustment process in compliance with the Policy’s “Loss Payment” provision. This is a breach of the Policy.
TYPTAP INSURANCE COMPANY has a contractual obligation not to make a perfunctory investigation and not to ignore evidence that would support THE INSUREDS’ claim. This is a breach of the Policy.
TYPTAP INSURANCE COMPANY has a contractual obligation not to look the other way when confronted with facts revealing the possibility of coverage and not to avoid coverage by misinterpreting its Policy. This is a breach of the Policy.
The concept of insurance is that insurance is the insurer’s granting of 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 specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly, so that THE INSUREDS may mitigate its damages and to put THE INSUREDS back into the position it was in prior to the loss as quickly as possible. TYPTAP INSURANCE COMPANY breached this duty.
TYPTAP INSURANCE COMPANY refused and/or failed to timely investigate the loss and tender all due and owing insurance proceeds to THE INSUREDS upon demand. TYPTAP INSURANCE COMPANY’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 INSUREDS is wrongful conduct. Furthermore, THE INSUREDS contends that TYPTAP INSURANCE COMPANY’s adjusters and/or representatives financially benefit by such wrongful conduct.
THE INSUREDS, their young children, and their two dogs currently reside in a home without proper insulation and drywall. As such, the summer months are brutal on a family that gave their trust and policy premiums to TYPTAP INSURANCE COMPANY believing that they would make their property whole after a catastrophic event such as Hurricane Ian. However, TYPTAP INSURANCE COMPANY continues to delay and fail to provide adequate payment for this claim.
Therefore, to cure the defects outlined in this Civil Remedy Notice, TYPTAP INSURANCE COMPANY must:
TYPTAP INSURANCE COMPANY must properly, thoroughly, and promptly investigate THE INSUREDS’ Property and tender payment to return the Property to its pre-loss condition;
TYPTAP INSURANCE COMPANY must immediately tender all undisputed insurance proceeds to THE INSUREDS, including any interest owed under applicable Florida law, while continuing to adjust the loss with THE INSUREDS;
TYPTAP INSURANCE COMPANY must act fairly and honestly towards THE INSUREDS and with due regard for its interest in attempting to settle THE INSUREDS’ claim;
TYPTAP INSURANCE COMPANY must immediately tender all insurance benefits due and owing to THE INSUREDS under the Policy, pursuant to the relevant Policy provisions provided therein that would reasonably place THE INSUREDS’ Property back to its pre-loss condition and any reasonable attorney’s fees and costs incurred.
TYPTAP INSURANCE COMPANY must pay THE INSUREDS $281,492.89, in new monies, excluding attorney’s fees and costs. The Replacement cost value of the damages to the home is $342,249.86, with a deductible of $7,160 and a prior payment of $53,596.97. Pursuant to the Loss Settlement provision, which states:
Buildings covered under Coverage A or B at replacement cost without deduction for depreciation, subject
to the following:
a. If, at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more
of the full replacement cost of the building immediately before the loss, we will pay the cost to repair
or replace, without deduction for depreciation, but not more than the least of the following amounts:
(1) The limit of liability under this policy that applies to the building;
(2) The replacement cost of that part of the building damaged with material of like kind and quality
and for like use; or
(3) The necessary amount actually spent to repair or replace the damaged building.
Here, it is clear from the estimate provided by Sheegog, which is the company that will actually provide the work to bring the home back to its pre-loss condition, that the damages exceed 80% of the full replacement cost to bring the home back to its pre-loss condition. The insurance company failed to perform any additional inspections and simply ignored the estimate provided by Sheegog. Therefore, it is a breach of contract for TYPTAP INSURANCE COMPANY’s failure to issue the monies owed to THE INSUREDS, as referenced above. Therefore the new monies owed is $342,249.86 plus fees and costs, which continue to increase as THE INSUREDS representatives continue to prosecute this matter.
TYPTAP INSURANCE COMPANY must pay THE INSUREDS the fair value of its insurance claim in relation to the damages sustained and the documents supplied by THE INSUREDS; and
THE INSUREDS continue to be open to a fair and reasonable settlement of all claims in an effort to avoid additional delay, costs, and expenses, and hereby request the same prior to the expiration of the statutory “cure” period. THE INSUREDS has provided TYPTAP INSURANCE COMPANY with all necessary estimates, invoices, receipts, etc., in support of all claims. TYPTAP INSURANCE COMPANY must act fairly and honestly in its response to THE INSUREDS’ request for a fair and reasonable settlement offer.
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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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