Civil Remedy Notice of Insurer Violations
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Filing Number:     800230
Filing Accepted:  1/9/2025
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Complainant
Last/Business Name *  
SOLBERG   First Name   ERIK
Street Address * 817 E. CHERRY STREET
City, State Zip * PERRY, FL 32347
Email Address * VICKING53@HOTMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   AMERICAN INTEGRITY INSURANCE COMPANY   First Name  
Policy # * AGD30485815 Claim #* CDP-00177302
Attorney
Attorney is Applicable
Last Name* KASSEL First Name * MATTHEW Initial
Street Address* 4016 HENDERSON BLVD. STE. E
City, State Zip* TAMPA , FLORIDA 33629
Email Address * MATT@KASSELLAWGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA
NAIC Company Code 12841
 
Name of individual responsible for violation (if any):* ALL ADJUSTERS AND REPRESENTATIVES WHO WORKED ON THE CLAIM ON BEHALF OF ASI PREFERRED INSURANCE CORPORATION.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Claim Denial
Unsatisfactory Settlement Offer
Other : Failure to investigate claim in consultation with the insured on a timely manner
Other : Failure to keep the insured informed as to the status of claim investigations
Other : Failure to respond or act promptly to insured communications
Other : Failure to act on claim
* 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.
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)(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 factors beyond the control of the insurer as defined in s. 627.70131(5).
* 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 & Extensions -All Additional Coverages provisions -All Coverages provided by Endorsement or Rider -The Declarations Page -Loss Payment or Settlement provision -Duties in Event of Loss provision -The insurance policy's definition section -Debris Removal -Claim Expenses -Coverage for Other Structures -Coverage for Trees, Shrubs and Landscaping -Coverage for Loss of Use -Coverage for Contents -Fire & Lightning -Temporary Repairs -Replacement Cost Provisions -Ordinance and Law Coverage -Provisions governing roof damage -Provisions governing windstorm/hail damage -Provisions governing hurricane/named storm damage FLORIDA ADMINISTRATIVE CODE SECTIONS & OTHER STATUTES VIOLATED: 69B-220.201(3)(a) Adjuster shall disclose all financial interests and any direct or indirect aspect of an adjusted transaction. 69B-220.201(3)(e) An adjuster shall handle every adjustment and settlement with honesty, integrity, and allow fair adjustment or settlement to all parties without any remuneration to himself except to that which he 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 thereof. 69B-220.201(3)(m) An adjuster shall not knowingly fail to advise a claimant of their rights in accordance with the terms and conditions of the contract and applicable laws of the state of Florida. 627.70131 Regarding the acknowledgment of a claim. (2) Such acknowledgment shall be responsive to the communication. If the communication constitutes a notification of a claim, unless the acknowledgment reasonably advises the claimant that the claim appears not to be covered by the insurer, the acknowledgment shall provide necessary claim forms, and instructions including an appropriate telephone number.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

1)FAILURE TO PAY CLAIM IN FULL; 2) FAILURE TO PROMPTLY INVESTIGATECLAIM; 3) FAILURE TO PROPERLY INVESTIGATE CLAIM; 4) FAILURE TO ADJUSTLOSS; 5) FAILURE TO ACT IN DUE DILIGENCE AND GOOD FAITH TO RESOLVECLAIM; 6) PLACING FINANCIAL INTEREST OF INSURER BEFORE THAT OF POLICYHOLDERS AND CLAIMANTS; 7) FAILURE TO PROPERLY TRAIN, EVALUATE ANDMANAGE ADJUSTERS; 8) LOOKING FOR WAYS TO DENY COVERAGE, PAY LESS,DELAY PAYMENT AND OTHERWISE “LOW BALL” OR “STONE WALL” CLAIM; 9) THEREASONS FOR THIS MAY BE ATTRIBUTED TO IMPROPER TRAINING,SUPERVISION, AND/OR MOTIVATION OF ADJUSTERS AND CLAIMSSUPERVISORS. THE INSURER APPEARS TO HAVE FAILED TO ADOPT PROPERSTANDARDS OF INVESTIGATION AND ADJUSTMENT OF LOSSES OR ISOTHERWISE NOT IMPLEMENTING THOSE STANDARDS BECAUSE FULL PAYMENTAND PROMPT PAYMENT FOR THE LOSS IS NOT OCCURRING. THE INSURANCE COMPANY ISSUED A POLICY OF INSURANCE TO THE INSURED WHICH PROVIDED COVERAGE FOR CERTAIN LOSSES. DURING THE POLICY PERIOD, ON OR AROUND SEPTEMBER 26, 2024, THE INSURED PROPERTY SUFFERED WINDSTORM DAMAGE WHICH WAS AND IS COVERED BY THE INSURANCE POLICY. THE INSURED PROMPTLY REPORTED THE LOSS TO THE INSURANCE COMPANY AND HAVE COMPLIED WITH ALL CONDITIONS OF THE POLICY. THE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO PAY THE FULL BENEFITS TO WHICH THE INSUREDS ARE ENTITLED FOR THE LOSS. DUE TO CONCERNS WITH THE DELAY IN THE INVESTIGATION AND THE INSURANCE COMPANY’S FAILURE TO PAY THE FULL AMOUNTS NECESSARY TO RESTORE THE PROPERTY TO ITS PRE-LOSS CONDITION, THE INSURED RETAINED AN EXPERIENCED AND HIGHLY QUALIFIED CONTRACTOR NAMED FAIRWINDS CONSTRUCTION SERVICES, LLC TO PREPARE AN ESTIMATE OF DAMAGE. FAIRWINDS CONSTRUCTION SERVICES, LLC ESTIMATED THE DAMAGE TO THE INSURED’S PROPERTY AT $144,023.90 (RCV)/$138,564.29 (ACV). THE INSURED HAS PROVIDED THE INSURER WITH A SWORN STATEMENT IN PROOF OF LOSS, THE ESTIMATE OF DAMAGE, AND THE AMOUNT OF DAMAGED PROPERTY. THE INSURED HAS MADE AN APPLICATION FOR INSURANCE BENEFITS UNDER THE POLICY BUT THE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO PAY THE FULL BENEFITS TO WHICH THE INSURED IS ENTITLED FOR THE LOSS. THE INSURANCE COMPANY HAS BREACHED THE POLICY OF INSURANCE BY FAILING TO PAY ALL OF THE BENEFITS DUE UNDER THE POLICY. THE INSURANCE COMPANY HAS FAILED TO SATISFACTORILY SETTLE THIS CLAIM AND HAS DEPRIVED THE INSURED OF A PROPER RESOLUTION OF THIS CLAIM. THE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO PROPERLY INVESTIGATE THE LOSS AND HAS FAILED AND/OR REFUSED TO TENDER THE PROPER AMOUNT OF INSURANCE BENEFITS DUE AND OWING TO THE INSURED. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should American Integrity 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, American Integrity must act as follows: immediately deliver payment of all insurance proceeds due and owing to the insureds which would reasonably place the Subject Property back in its pre-loss condition or, alternatively, if appraisal is or has been requested, complete the appraisal process and deliver payment of the executed award; and keep the claim open for the adjustment of any supplemental claim and payment of any as of yet unincurred costs. If American Integrity disagrees with the extent of the cure requested or asserts that the payment of any of the above cure categories may not be required, American Integrity 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 insureds remain willing to entertain any reasonable counteroffer of settlement. Mailed To: America Integrity Insurance Company Attn: Claims Department P.O. Box 26349 Tampa, FL 33623 Emailed To: julie.lister@ameradjust.com & claimsmail@aiicfl.com
Comments
User Id Date Added Comment
swozniak@aii.com 02-03-2025 February 3, 2025 Via Electronic Submission Florida Department of Financial Services Consumer Assistance Civil Remedy Section Larson Building 200 E. Gaines Street Tallahassee, FL 32399-0322 Matthew Kassel, Esq. 4016 Henderson Boulevard Suite E Tampa, Florida 33629 Matt@KasselLawGroup.com Re: DFS File No: 800230 Complainant: Erik Solberg Insured: Erik Solberg Policy No: AGD30485815 Insurer: American Integrity Insurance Company of Florida Claim No: CDP-00177302 To Whom It May Concern: We are in receipt of the Civil Remedy Notice (“CRN”) filed by Matthew Kassel, Esq. on behalf of the above referenced Complainant and matter. The Florida Department of Financial Services (“DFS”) accepted the CRN on January 9, 2025 and assigned it DFS File No. of 800230. While American Integrity asserts that the subject CRN is legally insufficient and non-compliant with Florida law, American Integrity, without waiving any arguments regarding same, contends that it has at all times performed its obligations under the insurance policy in a prompt and diligent manner with due regard for the interest of its Insured, Erik Solberg. The CRN contains a list of purported violations which are alleged to have been committed by American Integrity. In fact, none of the listed violations/allegations have occurred and/or are irrelevant to the alleged violations and American Integrity categorically denies any violations of §624.155 and §626.9541, Fla. Stat., as well as any and all other statutes/regulations/codes/rules contained in the CRN. In addition, American Integrity denies any and all allegations of any kind and/or any inferences therefrom referenced and/or contained in the CRN. American Integrity believes this response adequately addresses the allegations and violations contained within the CRN. Sincerely, Michael S. Sperounes Michael S. Sperounes, Esq. Senior Vice President of Litigation American Integrity Insurance Group cc: Matthew Kassel, Esq. via email at: Matt@KasselLawGroup.com CRN Response If this document contains an excerpt from an American Integrity Insurance Policy (“the Policy”) it is provided here for informational purposes only. This excerpt is not the official version of the Policy. The official version of the Policy is the policy issued to the Insureds on the policy effective date. In the event there is inconsistency between this document and the Policy, the Policy shall serve as the official version. Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. F.S. 817.234
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.

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DFS-10-363
Rev. 10/14/2008