Filing Number: 799808
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| Filing Accepted: 1/7/2025 |
| Last/Business Name
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| Street Address
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21440 BAY VILLAGE DR, APT 228 |
| City, State Zip
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FORT MYERS BEACH,
FL
33931
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| Email Address
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WITHHELD |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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FENTON |
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First Name |
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ALEX |
| Policy # * |
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KIN-CO-FL-299271932 |
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Claim #* |
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HO-0008200 |
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Attorney is Applicable
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| Last Name* |
ZATIK
First Name *
ALEX
Initial
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| Street Address* |
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4000 HOLLYWOOD BLVD, STE-685S |
| City, State Zip* |
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HOLLYWOOD
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FLORIDA
33021
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| Email Address * |
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AZATIK@CASSEL.LAW |
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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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KIN INTERINSURANCE NETWORK
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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 16603 |
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| Name of individual responsible for violation (if any):*
LATAVIA CAMERON CARTER, MARILYN WHITE, MARLIN CARTER, VICKI LEIS, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY KIN INTERINSURANCE NETWORK INVOLVED IN THIS 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 Denial
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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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Violation of Adjusters' Ethical Requirements
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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)(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)(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)(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)(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.
The violations asserted herein regarding Kin Interinsurance Network's bad faith actions are based heavily on the facts and circumstances asserted in the below section designated for same as well as violations of the portions of Florida Insurance Code and Florida Administrative Code upon which the bad faith statutes contained within Sections 624.155 & 626.9541, Florida Statutes, are based.
With that said, the following policy language is relevant to Kin Interinsurance Network's statutory violations and bad faith conduct:
AGREEMENT
We agree to provide the insurance coverages indicated on the Policy Declarations in return for payment of your premium when due and compliance with all policy terms and conditions. We make this agreement in reliance upon the information you have provided us and require that you inform us within 60 days of any change of title, use or occupancy of the “residence premises”.
COVERAGE A – Dwelling
We cover:
1. The alterations, appliances, fixtures and improvements which are part of the building contained within the "residence premises";
2. Items of real property which pertain exclusively to the "residence premises";
3. Property which is your insurance responsibility under a corporation or association of property owners agreement; or
4. Structures owned solely by you, other than the "residence premises," at the location of the "residence premises."
COVERAGE D – Loss Of Use
We will pay the additional expenses you incur, but no more than the limit of liability shown for Coverage D in the Declarations for the following:
1. Additional living expenses incurred by you so that your household can maintain its normal standard of living when a loss to covered property or the building containing the property covered under this policy makes that part of the “residence premises” where you reside not fit to live in.
Payment will be for the shortest time required to repair or replace the damage or, if you permanently relocate, the shortest time required for your household to settle elsewhere.
2. If a loss covered under Section I makes that part of the “residence premises“ rented to others or held for rental by you not fit to live in, we cover the fair rental value of that part of the “residence premises” rented to others or held for rental by you less expenses that do not continue while that part of the
“residence premises” rented or held for rental is not fit to live in.
Payment will be for the shortest time required to repair or replace that part of the premises rented or held for rental or, if you permanently relocate, the shortest time required for your household to settle elsewhere.
3. If civil authority prohibits you from use of the “residence premises” as a result of direct damage to neighboring premises by a Peril Insured Against in this policy, we cover the Additional Living Expense and Fair Rental Value as provided under 1. and 2. above for no more than two weeks.
SECTION I – PERILS INSURED AGAINST
COVERAGE A – Dwelling
We insure for sudden and accidental direct loss to property described in Coverage A, only if that loss is a physical loss to the property.
10. 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…
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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.
Form DFS-10-363, Rev. 10/14/2008, contains a field for the insured to include his email address. Prior to filing the CRN, said form contains an instruction that, in the event the insured does not with for certain information to become part of the public record, the insured must simply include the term “WITHHELD” to satisfy the filing requirement. This is further established through the following statement with appears on Civil Remedy Notices which have been filed:
Warning! Information submitted as part of this civil remedy notice is a public record. Data entered into this form will be displayed on the DFS website for public review. Please DO NOT enter Social Security Numbers, personal medical information, personal financial information or any other information you do not want available for public review.
As any information contained herein becomes part of the public record, the insured has withheld his email address so as not to make same available for public review and indicated same accordingly. Furthermore, as the insured is represented by counsel, it would be improper for any representative of Kin Interinsurance Network to contact the insured directly for any reason utilizing his email address and, as such, the information is neither material to Kin Interinsurance Network’s ability to correct the violations contained herein nor required by the Department of Financial Services. Kin Interinsurance Network should direct all follow-up correspondences to the attorney listed above.
Furthermore, as the above section requesting people with knowledge as to the allegations in the instant CRN often gets cut off, the following are those responsible for the violations alleged herein:
Latavia Cameron Carter, Marilyn White, Marlin Carter, Vicki Leis and all other adjusters, supervisors, management and individuals associated with or retained by Kin Interinsurance Network involved in this claim.
The facts and circumstances giving rise to the insurer's violation as the insured understands them at this time:
Alex Fenton (hereinafter the “insured”) purchased an all-risk property insurance policy, policy number KIN-CO-FL-299271932 (hereinafter the “Subject Policy”) from Kin Interinsurance Network (hereinafter “Kin”) which, at all times material hereto, provided property insurance for the property located at 21440 Bay Village Dr, Apt 228, Fort Myers Beach, FL 33931 (hereinafter the “Subject Property”).
On or about September 28, 2022, Hurricane Ian caused direct physical loss and resultant ensuing damages to the Subject Property.
The insured timely notified Kin of the loss. Kin assigned claim number HO-0008200 to the loss (hereinafter the "claim") and assigned adjustment of the claim to Marlin Carter who, in turn, enlisted the assistance of Vicki Leis a field adjuster employed by Kin, to perform an inspection of the Subject Property.
From October 2022 to April 2024, the Subject Property and building did not have power as a result of the damages sustained by Hurricane Ian. On April 5, 2024, FPL restored power to the building.
In August 2023, Kin assigned a new adjuster to the claim, Marilyn White. Ms. White helped the insured with the loss of rental income claim, and advised the insured that the insured should wait until they have all the invoices for the remaining repairs to submit the final repair claim.
In April of 2024, the building and SMC notified owners that they are not allowed to be stay in the units until the restoration is completed.
In the summer of 2024, SMC notifies owners that they can re-enter the units of specific buildings. As a result, in August of 2024, the insured had contractors come out to provide proposal for repairs. The insured provided the invoices to the carrier, and put down deposits with the respective builders to complete the repairs.
In September of 2024, the insured submitted their final claim of repairs to Kin for the completed repairs, with supporting documentation. The carrier failed to timely and substantively respond to the same.
On October 9, 2024, Marilyn White responds to the September submission and advises that the attached documents did not come through in the email.
On October 10, 2024, the insured resends the respective documentation to adjuster White.
On October 14, 2024, the insured follows up with the carrier to confirm the documents were received, as they did not hear back from the carrier.
On October 17, 2024, a new adjuster (4th), Latavia Cameron responds to the insured and advises that they received the documentation.
As a result of no communication from the carrier, the insured followed up on December 2, 2024 with adjuster Cameron. Ms. Cameron finally responded to the insured via cell phone, not in email, and advised the claim was denied. Later that afternoon, the carrier calls the insured and advised that the claim is not denied, but now the carrier needs a bunch of additional documents. The request for documents correspondence is a pattern and practice delay tactic the carrier uses to avoid adjustment of the claim, in hopes the insured will not comply. If no compliance, the carrier can then allege a denial and avoid the contractual coverages due and owing. The insured requested this request be in writing from the carrier.
On December 4, 2024, the insured followed up with the carrier and again requested the request for information letter be in writing.
On December 9, 2024, the insured received the request for information correspondence from the carrier, with the insured promptly complying with the same. To date, the carrier has failed to substantively respond to the damages due and owing, and continues to look for excuses to deny a covered loss. The carrier requested photographs of the unit prior to repairs and technical reports regarding appliances. It must be noted, that the insured advised the carrier in August of 2024 that they would begin repairs, yet the carrier waited 3 months to request photographs of the unit prior to repairs. The request by the carrier is not in good faith, nor is it reasonable. Additionally, it is unknown what the carrier mean by “technical” reports on appliances, as this appears to be an extracontractual post lost condition being imposed. The insured reported damages to the appliances as a result of the loss, it is the duty of the carrier to adjust. Upon information and belief, the carrier has a pattern and practice of imposing extracontractual conditions upon the insureds to their detriment. As a result, the insured has been prejudiced and continues to suffer damages.
The insured has been left with no choice but to hire an attorney in order to file a notice of intent to initiate litigation subject to Fla. Stat. § 627.70152. Based on the documentation previously submitted, and the coverage afforded, Kin could have requested participation in alternative dispute resolution in line with the terms and conditions of the Subject Policy and governing Florida law or, at a minimum, engaged in settlement negotiations with the insured in order to allow him to move on from this chapter and effectuate the necessary repairs to the Subject Property; instead, Kin chose to sit back and wait before Kin ever thought to act in a manner inconsistent with their own self-interest, forcing the insured into hiring an attorney, thereby coming further out of pocket and leaving less of the outstanding due and owing insurance proceeds for actual repairs. This delay in claims adjustment constitutes a pattern of de facto bad faith conduct.
To date, the carrier has failed to adjust the loss in good faith for the repair costs incurred and fulfill their obligations under the Subject Policy.
Through its actions/inactions, subject to the facts and circumstances understood at this time as outlined herein, Kin has violated the following sections of Florida Statutes:
§624.155(1)(b)(1)
Not attempting in good faith to settle claims when, under all circumstances, it could have and should have done so, had it acted fairly and honestly toward its Insured and with due regard.
§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)(g)
Failing to promptly notify the insured of any additional information necessary for the processing of a claim;
§626.9541(1)(i)(3)(h)
Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
§626.9541(1)(i)(4)
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 an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed.
Additionally, through its actions/inactions, subject to the facts and circumstances understood at this time as outlined herein, Kin has failed to comply with the following sections of Florida Administrative Code:
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)(e)
An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any compensation or remuneration to himself or herself except that to which he or she is legally entitled.
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)(k)
An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise.
As a direct result of Kin's actions, the insured has sustained irreparable harm. Upon information and belief, the aforementioned actions complained of herein, among others, are effectuated by Kin so often as to constitute a general business practice evidencing a motive to enhance Kin's profits and cause a detrimental effect to its policyholders. Kin clearly failed to adopt and implement standards for the proper investigations of claims. As a direct and proximate result of Kin's handling of the claim, the insured sustained extra-contractual damages, including, but not limited to, attorneys’ fees and costs. Kin's implemented claims programs and practices that were improper which directly resulted in additional losses to its insured. Kin, as part of its routine business pattern and practices, employs outcome-oriented adjusters/vendors/experts who purposely looked for ways to minimize coverage instead of affording coverage to its policyholders. In contrast to the legislative intent which motivated the enumeration of an insurance adjuster’s responsibilities outlined in the Florida Administrative Code, the insured were not afforded the professional duties entrusted and imposed on Kin by the Public Trust. The outcome-oriented claim adjustment practices undertaken by Kin led to Kin's failure to adequately adjust the Claim.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Kin fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. In order to cure the defects outlined in this Civil Remedy Notice, Kin must act as follows: immediately deliver payment of all insurance proceeds due and owing to the insured which would reasonably place the Subject Property back in its pre-loss condition; and keep the claim open for the adjustment of any supplemental claim and payment of any as of yet unincurred costs. If Kin disagrees with the extent of the cure requested or asserts that the payment of any of the above cure categories may not be required, Kin should cure to the extent it believes it must under the Subject Policy and governing laws to correct the allegations of bad faith contained herein. While it is not being requested as a cure for the bad faith alleged herein, the insured remains willing to entertain any reasonable counteroffer of settlement.
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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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