Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 799719

Filing Accepted: 1/7/2025

Print Filing

Complainant

Last/Business Name *

MCDOUGALL

First Name

DARREN

Street Address *

1915 HARBOUR CIR.

City, State Zip *

CAPE CORAL, FL 33914

Email Address *

DARRENMCDOUGALL@MCDOUGALLENERGY.COM

Complainant Type: *

Insured

Last/Business Name*		MCDOUGALL		First Name		DARREN
Policy # *		FPH5419850		Claim #*		FPI228147

Attorney

Attorney is Applicable

Last Name*	RUDDOCK First Name * OMARI Initial S
Street Address*		4770 BISCAYNE BLVD, STE 600
City, State Zip*		MIAMI , FL 33137
Email Address *		OMARI@WARDRUDDOCK.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		FLORIDA PENINSULA INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10132

Name of individual responsible for violation (if any):* JOSHUA, JONES, ABIGAIL SMITH, MARCEL OGUNMWONYI
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Unsatisfactory Settlement Offer
	Unfair Trade Practice
	Claim Delay
	Claim Denial

* 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.
	624.155(1)(b)(3)		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.
	626.9541(1)(i)(2)		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.
	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.
	626.9541(1)(i)(3)(d)		Denying claims without conducting reasonable investigations based upon available information.
	626.9541(1)(i)(3)(e)		Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
	626.9541(1)(i)(3)(f)		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.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Dwelling Coverage Provisions All Additional Coverages Provisions All Coverages Provided by Endorsement Loss Payment or Settlement Provision Duties in Event of Loss Provision

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about September 28, 2023, the Insured, Darren McDougall, suffered property damage at his property located at 1915 Harbour Circle, Cape Coral, Florida 33914. The property suffered extensive damage to the roof and collateral damage throughout the property. Florida Peninsula Insurance Company (hereinafter “Florida Peninsula”) issued an insurance policy for the Insured’s property, Policy Number FPH5419850, which was in full force and effect on the date of the loss. The loss was the result of a significant windstorm, Hurricane Ian. Mr. McDougall timely notified Florida Peninsula of the damages sustained to the property and provided a report of the cost of repairs amounting to $156,331.00. Despite demand for payment, Florida Peninsula provided an insufficient adjustment of the claim in the amount of $2,382.10, failing to restore the property to pre-loss conditions despite having evidence via photographs and prior reports showing the properties condition prior to Hurricane Ian's impact. On July 21, 2023 and September 23, 2023, Florida Peninsula inspected the property for the purpose of insuring the property. There they request spot repairs be conducted on the roofing structure, to which no prior damage caused interior damage, and those repairs were commenced by the insured upon request. The insurance company insured the property. This is notable because it makes clear the prior damages and the current damages and makes easy for the carrier to quantify pre-loss damage to the damage inflicted by the storm which made the roof, on its own merit, irreparable. Florida Peninsula’s refusal to make adequate payment for covered damages, constitutes a breach of contract. As a result of Florida Peninsula’s aforementioned breach of contract, it has become necessary for Mr. McDougall to retain the services of counsel. The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute 634.02 defines "insurance" as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. Insurer has breached this duty. Florida Peninsula has engaged in a customary business practice and a deliberate course of conduct to hinder resolution of its claims until they enter litigation. It has become a pattern of practice for Florida Peninsula to not settle claims when it has the ability to do so, and these dilatory tactics serve no purpose other than to increase profits. Florida Peninsula has violated the following statutory provisions: §624.155(1)(b)(1) - Not attempting in good faith to settle claims when, under all circumstances, it could and should have done so, had it acted fairly and honestly towards its insured and with due regards for her or his interests; §624.155(1)(b)(3) – Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonable clear, under one portion of the insurance policy coverage in order to influence settlement under other provisions of the insurance policy coverage; §626.9541(1)(i)(2) – 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; §626.9541(1)(i)(3) – Committing or performing with such frequency as to indicate a general business practice any of the following: (a) Failing to adopt and implement standards for the proper investigation of claims; (b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (c) Failing to acknowledge and act promptly upon communications with respect to claims; (d) Denying claims without conducting reasonable investigations based upon available information; (e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured with 30 days after proof-of-loss statements have been completed; (f) 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. To remedy this Civil Remedy Notice and to cure the conduct giving rise to the violations described herein, Florida Peninsula must immediately: (i) tender the full payment to the insured which is 156,331.00 less deductible and prior payment; (ii) make payment of any pre-judgment interest owed under Florida law, including §627.70131(5)(a), which is accruing daily; (iii) make payment for the additional expense incurred by the insured in hiring an attorney; and (iv) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this Claim. The aforementioned payments should be tendered to the insured’s attorneys at Ward Ruddock, PLLC, 4770 Biscayne Blvd., Ste. 600, Miami, Florida 33137.

Comments

User Id		Date Added		Comment
hgoldman@klaubergoldman.com		02-18-2025		This firm represents Florida Peninsula Insurance Company (FPI). This letter is their response to the Civil Remedy Notice filed with the Department of Financial Services on behalf of Darren McDougall (the “Insured”) under filing number 799719 (the “CRN”). THE CRN IS MOOT BECAUSE THIS CLAIM HAS BEEN SETTLED IN EXCHANGE FOR A FULL RELEASE FROM THE INSURED Within sixty (60) days after the CRN was filed, counsel for FPI reached a settlement with you, on behalf of the Insured, regarding claim number FPI228147. That settlement included a payment from FPI to the Insured in exchange for the Insured’s complete release of FPI including, among other things, a release of all bad faith claims, and any other claims related to this CRN. FPI performed all of its obligations under the insurance policy promptly, diligently and with due regard for the interest of the Insured. The CRN includes a list of alleged violations by FPI with respect to the handling of claim number FPI228147, with insufficient detail about any of those allegations. However, none of those alleged violations occurred and FPI denies that there was a violation of any of the Insured’s rights. We trust that this response adequately addresses any concerns that the Insured may have concerning this matter and the issues raised in the CRN. Please contact me if you need any additional information.

Acknowledgement
*	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