Filing Number: 798984
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| Filing Accepted: 1/2/2025 |
| Last/Business Name
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| Street Address
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7220 CAPTAIN KIDD REEF |
| City, State Zip
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PENSACOLA,
FL
32507
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| Email Address
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N/A |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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WATSON |
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First Name |
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ROBERT |
| Policy # * |
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2687739226 |
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Claim #* |
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01000039870 |
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Attorney is Applicable
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| Last Name* |
ELIMELECH
First Name *
REBECCA
Initial
R
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| Street Address* |
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1500 N.E. 162ND ST. |
| City, State Zip* |
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MIAMI
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FLORIDA
33162
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| Email Address * |
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RELIMELECH@ILGPA.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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FIRST PROTECTIVE 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 10897 |
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| Name of individual responsible for violation (if any):*
N/A
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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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Non-renewal
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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)(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)(g) |
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Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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| 626.9541(1)(i)(3)(h) |
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Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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| 626.9541(1)(i)(4) |
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Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
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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.
COVERAGES
COVERAGE A – Dwelling
We cover:
1. The dwelling on the Described Location shown in the Declarations, used principally for dwelling purposes, including structures attached to the dwelling;
2. Materials and supplies located on or next to the Described Location used to construct, alter or repair the dwelling or other structures on the Described Location.
COVERAGE B – Other Structures
We cover other structures on the Described Location, set apart from the dwelling by clear space. This includes structures connected to the dwelling by only a fence, utility line, or similar connection.
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.
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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.
Robert Watson (hereinafter the “Insured”), paid for a policy of insurance with First Protective Insurance Company d/b/a Frontline Insurance (hereinafter, “Insurer”) bearing policy number 2687739226 (the “Policy”). The Policy provides coverage for damage to the Insured’s property located at 7220 Captain Kidd Reef, Pensacola, Florida 32507 (the “Property”), including the significant damage that occurred as a result of Hurricane Sally on or about September 16, 2020 (the “loss”). Specifically, the Insured’s Property sustained substantial damage to the roof, sliding glass door, boat hoist, and the interior of the home, including the tile floor. Additionally, the Insured incurred additional living expenses.
The Insured promptly reported their claim to the Insurer. On September 23, 2021, the Insurer sent a letter to the Insured advising that the damages to the Property totaled $10,977.46. On January 31, 2024, the Insurer issued a check to the Insured in the amount of $88,361.90. The Insured contacted Mendy Levy from Redemption Adjusters LLC (hereafter Redemption Adjusters), who conducted a thorough inspection of the property and compiled an estimate of damages. Redemption Adjusters, on behalf of the Insured, forwarded said estimate which fully detailed the Insured’s damages and total $190,187.86. However, the Insurer refuses to resolve the Insured’s claim and pay for all damages to the Property.
The Insurer’s conduct is in bad faith and violates Florida’s statutes concerning the adjustment of insurance claims. First, Florida Statute § 624.155(1)(B)(1) requires good faith in the settlement of claims. The Insurer is in violation of this Statute for failing to provide a reasonable repair estimate. The Insured incurred loss of rent income and was unable to rent out the property due to the damages. Moreover, the Insured’s tenant broke the lease because of the damages from the storm. The Insured could not fully repair the property because the Insurer did not provide enough funds to cover all the damages. What is more, the Insurer violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle the claim, when the obligation to settle the claim became reasonably clear. Again, the Insurer failed to make a good faith offer to settle this claim and failed to account for the full scope of the damages. They failed to respond to the estimate provided by Redemption Adjusters, on the Insured’s behalf, in a timely manner. They are obligated to provide coverage for all damages to the Insured’s Property, and not attempt to resolve this claim with lowball offers.
Additionally, the Insurer’s conduct violates Florida Statute § 626.9541, which prohibits unfair settlement practices. More specifically, the Insurer has violated Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. Further, the Insurer has violated Florida Statute § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly with the Insured and its counsel. The Insurer owes the Insured payment for loss of rental income beginning from the date of loss on September 16, 2020, until the appraisal, which occurred on December 16, 2023. Also, the Insurer failed to pay the recoverable depreciation owed to the Insured per the appraisal award. Moreover, the Insurer informed the Insured that they are unable to renew his insurance policy without providing any explanation. As mentioned above, the Insurer failed to account for the full scope of the damages and has additionally failed to respond to the estimate provided by Redemption Adjusters, on behalf of the Insured, in a timely manner, delaying the resolution of this claim. Had the Insurer done so, it would have immediately settled this claim on a fair and reasonable basis and provided full coverage to its Insured.
Therefore, to cure the defects outlined in this Civil Remedy Notice, the Insurer must: (1) create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations and avoid this from occurring in the future; (2) immediately tender all insurance proceeds due and owing its Insured under the Policy in the amount of $190,187.86 (less the deductible and any prior payments), plus all statutory interest; (3) act fairly and honestly towards its Insured and with due regard for his interests in attempting to settle their Insured’s claim; (4) hold the claim open in the event that its errors and delay does or may cause the Insured to suffer either further loss and/or damage; and, (5) stipulate to the Insured’s entitlement to attorney’s fees and court costs pursuant to Florida Statutes §§ 627.428 and 626.9373.
Acknowledgment
This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statutes section 624.155, should First Protective Insurance Company d/b/a Frontline Insurance fail to cure the violations set forth in this Civil Remedy Notice within the given cure period.
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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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