Filing Number: 799390
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| Filing Accepted: 1/6/2025 |
| Last/Business Name
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THOMPSON
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First Name |
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MICHAEL |
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| Street Address
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4428 ASHLAND ROAD |
| City, State Zip
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PANAMA CITY,
FL
32405
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| Email Address
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PCJAZZ@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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THOMPSON |
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First Name |
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MICHAEL |
| Policy # * |
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9975014821 |
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Claim #* |
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01000012789 |
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Attorney is Applicable
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| Last Name* |
COSTA
First Name *
LORI
Initial
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| Street Address* |
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220 ALHAMBRA CIRCLE |
| City, State Zip* |
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CORAL GABLES
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FLORIDA
33134
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| Email Address * |
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LCOSTA@MORGANLAWGROUP.NET |
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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):*
BRIAN CHOJNOWSKI, JOHN DOWNING, NICK MOSER, ANY OTHER ADJUSTERS HANDLING 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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Claim Delay
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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Other
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Failure to comply with Appraisal Award
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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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| 626.9541(1)(i)(2) |
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A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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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)(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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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-Conditions 3. Loss Settlement:
(4) we will settle the loss as noted in 3.a. of this provision. If 3.a is not applicable, we will settle the loss as follows:
(a) We will initially pay the actual cash
value of the building damage, minus any applicable deductible.
(b) We will then pay the necessary
amount actually spent to repair or
replace the damage building as work
is performed and expenses are
incurred.
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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.
1. The Thompsons filed their Complaint on April 4, 2023. They allege that due to First Protective’s Breach of Contract they are owed $17,384.93 in recoverable depreciation, $75,957.09 in matching costs and $192,474.00 in Ordinance and Law requirements to bring the subject windows up to code.
2. The subject policy’s applicable provision for the subject lawsuit is as follows:
Section I-Conditions 3. Loss Settlement:
(4) we will settle the loss as noted in 3.a. of this provision. If 3.a is not applicable, we will settle the loss as follows:
(a) We will initially pay the actual cash
value of the building damage, minus any applicable deductible.
(b) We will then pay the necessary
amount actually spent to repair or
replace the damage building as work
is performed and expenses are
incurred.
(Emphasis added).
3. Both the Thompsons and First Protective agreed that the home was damaged as a result of the subject hurricane; however, the parties disagreed on the price and scope of the damages. The parties entered into appraisal since they could not agree on the amount of the damages. The umpire Theodore Taylor, entered an award of:
Coverage RCV Amount Of Loss ACV Amount Of Loss
Coverage A - Dwelling: $366,267.27 $348,882.84
Coverage B - Other Structures: $17,293.90 $14,699.82
Coverage C - Personal Property: $0.00 $0.00
Coverage D - Loss of Use: As incurred, subject to policy provisions
FS 626.9744 - "Matching": $75,957.09 $0.00
Mold: As incurred, subject to policy provisions
Ordinance & Law: As incurred, subject to policy provisions
Total Award Amount: $459,518.26 $363,582.66
Additionally, along with the Appraisal Award Form, Mr. Taylor completed a detailed line by line estimate indicating what the depreciation was, if any, for each specific item.
4. On October 25, 2022, the insured sent First Protective Insurance Company an invoice indicating repairs to the music room had been completed. The total cost of the repairs was $2,140. First Protective breached the contract when it failed to pay the depreciation amount, despite First Protective’s Desk Adjuster, Nick Moser, admitting $62.62 was owed in recoverable depreciation. (Violation of 624.155(1)(b)(1) 626.9541(1)(i)(2); 626.9541(1)(i)(3)(b).
5. On December 7, 2022, First Protective sent correspondence to the Thompsons stating they needed the following before any replacement cash value will be released: Certificate of Completion, Paid in Full Invoice and Photographs of completed work. Said requirements, were in contradiction to the plain language of the policy which stated that replacement cash value would be released as work is performed and expenses are incurred. (Violation of 624.155(1)(b)(1); 626.9541(1)(i)(2); 626.9541(1)(i)(3)(b); 626.9541(1)(i)(3)(h)).
6. The Thompsons were forced to file suit due to First Protective’s breach and anticipatory breach of contract.
7. A certificate of completion dated June 19, 2024, indicating all work was done on the home. A copy of the certificate of completion was provided to First Protective.
8. As a result of the subject hurricane, the Thompsons had to replace windows in their home. The cost included the amount to bring the windows up to code. The total amount of the windows was $192,474. The umpire award allowed for the cost of the windows “as incurred, subject to the policy provisions.” Invoices regarding the total amount spent on the windows was provided via email to First Protective’s, Brian Chojnowski, on approximately October 14, 2024. Additionally, the window invoice was also provided between December 9, 2024, and December 18, 2024. First Protective has not paid the costs for law and ordinance as provided for in the appraisal award.
9. The Thompsons were also awarded matching costs in the amount of $75,957.09. To date, First Protective has not paid the matching costs as provided for in the appraisal award.
10. The Thompsons are owed $17,384.93, in recoverable Depreciation. To date, First Protective has not paid the recoverable depreciation provided for in the appraisal award.
11. Rather than pay any money owed to the Thompsons, First Protective filed a Motion for Summary Judgment. Said Motion argued in part that no ACV amounts were due until ALL of the repairs were completed and paid for. First Protective argued that the Thompsons were not due to be compensated for any RCV on a line by line basis. The Thompsons responded to the Summary Judgment and argued in part that First Protective was not required to have a Certificate of Completion since the plain reading of the policy indicates that money would be paid out as the insured incurred costs. The Court denied First Protective’s Motion for Summary Judgment on December 3, 2024, because the plain meaning of the policy requires the First Protective to pay the RCV as costs are incurred. Thus, the RCV is to be paid on a line by line basis.
12. Despite the Court ruling RCV was due on a line by line basis, First Protective has still not paid any RCV as of the date of the filing of this CRN.
13. The total amount due and owing is $285,826.02, excluding attorney fees and costs.
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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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