Filing Number: 798943
|
| Filing Accepted: 1/2/2025 |
| Last/Business Name
*
|
|
|
SKIBBINS
|
|
First Name |
|
MARLA & DAVID |
|
| Street Address
*
|
|
3728 ARAVA DRIVE |
| City, State Zip
*
|
|
GREEN COVE SPRINGS,
FL
32043
|
| Email Address
*
|
|
MARLA.SKIBBINS@GMAIL.COM |
| Complainant Type:
*
|
|
Insured |
|
| Last/Business Name* |
|
SKIBBINS |
|
First Name |
|
MARLA & DAVID |
| Policy # * |
|
ARK109180 |
|
Claim #* |
|
1418032-241013 |
|
Attorney is Applicable
|
| Last Name* |
CAMPIONE
First Name *
FRANK
Initial
J
|
| Street Address* |
|
501 W. BAY STREET, SUITE 100 |
| City, State Zip* |
|
JACKSONVILLE
,
FL
32202
|
| Email Address * |
|
JASON@CAMPIONELAWPA.COM |
|
|
| Insurer Type
*
|
|
 Authorized Insurer
 Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
ASI PREFERRED INSURANCE CORP.
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code 13142 |
|
|
| Name of individual responsible for violation (if any):*
LEIGH ANN HARDIE AND ALL OTHER CLAIMS HANDLERS OR REPRESENTATIVES RESPONSIBLE FOR HANDLING THE CLAIM
|
| Type of Insurance
*
Residential 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.
|
|
| 626.9541(1)(i)(3)(a) |
|
Failing to adopt and implement standards for the proper investigation of claims.
|
|
| 626.9541(1)(i)(3)(b) |
|
Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
|
|
| 626.9541(1)(i)(3)(c) |
|
Failing to acknowledge and act promptly upon communications with respect to 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.
SECTION I – PROPERTY COVERAGES AND SECTION I – PERILS INSURED AGAINST, INCLUDING BUT NOT LIMITED TO: COVERAGE A – DWELLING. ADDITIONAL COVERAGES INCLUDING BUT NOT LIMITED TO ORDINANCE OR LAW, AND ALL OTHER ADDITIONAL COVERAGES PROVIDED UNDER THE APPLICABLE POLICY. ALL OTHER APPLICABLE COVERAGE PROVISIONS, INCLUDING BUT NOT LIMITED TO ALL COVERAGE(S) PROVIDED BY ENDORSEMENT OR RIDER, THE DECLARATIONS PAGE, LOSS PAYMENT OR SETTLEMENT PROVISIONS, AND ALL OTHER PROVISIONS PROVIDING COVERAGE OF THE CLAIM AS PREVIOUSLY SUBMITTED TO THE INSURER.
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 INSURED. 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.
|
| |
*
Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
ASI Preferred Insurance Corp, (“Insurer”) has committed the following in handling the Insured’s claim: 1. Failure to act in due diligence and good faith to resolve claims; 2. Placing financial interest of Insurer before that of the Policyholder and Claimant; 3. Not adjusting the claims promptly and fairly; 4. Not attempting in good faith to handle claims; 5. Looking for ways to deny full recovery to the Insured. On or about May 10th, 2024, Claimant suffered substantial damage to the exterior of the dwelling, due to wind damages, a covered peril under the policy. The policy provides insurance coverage for all the losses, damages, and expenses that Claimant suffered and incurred. The Insurer was provided with an estimate; however, the Insurer still failed to properly evaluate this claim and promptly settle although it has become reasonably clear that it should do so. The Insurer’s improper handling and delay in paying this claim has caused insurmountable damage to the Insured’s home that needs to be remedied immediately. Claimant gave the Insurer prompt and timely notice of Claimant’s claim once damage was discovered. The Insurer has not responded to the claimant’s demand. (1) Estimate for repair as well as other supporting documentation was provided to handling adjuster on October 21, 2024, (2) There are no Invoices for repairs or previous work or maintenance to the roofing to provide, and (3) No EMS documentation in claimant’s possession at this time.
The Insurer’s actions amount to but are not limited to the following: 1. Not treating the policyholder with good faith claims conduct 2. Looking for ways to reduce recovery to the Insured 3. Not adjusting claims and evaluating loss properly, promptly, and fairly to provide full and prompt indemnity to the Insured 4. Not training, supervising, or managing adjusters properly so that prompt and full payments are made, but rather placing the company’s interests before the policyholder’s interests 5. Placing the financial interest of the Insurer over that of the Insured. Florida law imposes no requirement to specify a definite cure amount to a civil remedy notice. Talet Enterprises v. Aetna Casualty & Surety Co., 753 So. 2d 1278 (2000). To cure the defects outlines in this civil remedy notice, the Insurer needs to pay the full amount necessary to bring the Insured’s home back to its pre-loss condition. The Insurer must also pay for any statutory costs and fees to which the Insured is entitled. This includes, but is not limited to, attorney's fees and costs, IF INCURRED, pursuant to Florida Statute 627.428, plus a 2.5 multiplier in accordance with the principles of Rowe v. Patient's Compensation Fund.
|
|
|
*
|
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.
|
DFS-10-363
Rev. 10/14/2008
|