Filing Number: 800492
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| Filing Accepted: 1/10/2025 |
| Last/Business Name
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RAYMOND HUDANICH AND BRIANNE HUDANICH
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First Name |
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| Street Address
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1207 FOSTERS MILL LANE |
| City, State Zip
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BOYNTON BEACH,
FL
33436
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| Email Address
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SHUDANICH@YAHOO.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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RAYMOND HUDANICH AND BRIANNE HUDANICH |
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First Name |
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| Policy # * |
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FLP44716 |
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Claim #* |
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407358-241013 |
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Attorney is Applicable
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| Last Name* |
SCHLOSSER
First Name *
BRADEN
Initial
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| Street Address* |
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925 S. FEDERAL HWY |
| City, State Zip* |
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BOCA RATON
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FL
33432
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| Email Address * |
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BSCHLOSSER@KPATTORNEY.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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ASI PREFERRED INSURANCE CORP.
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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 13142 |
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| Name of individual responsible for violation (if any):*
ABIGAIL S. HOLLADAY
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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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Unfair Trade Practice
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Claim Denial
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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)(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)(f) |
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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.
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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.
Loss settlement provision
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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.
In Florida, the profession of adjusting insurance claims involves a special relationship of trust with the public. As such, insurance adjusters and insurance company claims representatives are imposed with a duty of good faith claims conduct. The carrier in this matter – ASI Preferred Insurance Corp - has breached this duty by its adjustment of the Complainants’ claim in connection with the sudden and severe hurricane damage to the subject property.
An insurance policy is obtained by homeowners to protect against unknown disasters, catastrophes and misfortunes, which may, or may not, ever occur. The policyholder, after paying premiums and expecting protection against a loss, is in an especially vulnerable economic and personal position when the unexpected loss occurs. The entire purpose of insurance is defeated if those involved with insurance adjustment can refuse or delay the prompt and full payment of monies due under the contract. Insurance contracts are not like other contracts because insurers have an advantage in bargaining power. Insurers and their representatives are therefore held to a higher standard of care.
When an insurance company, such as ASI Preferred Insurance Corp, issues an insurance policy to an insured, it promises to provide financial security in the event of damage to the insured’s home. Claims representatives are the people responsible for fulfilling the insurance company’s promise. When a covered loss occurs, the insurance company’s obligation under its promise to pay is triggered. The policyholder is completely dependent on performance by the insurance company when the insured is at its most vulnerable position, after a loss, since the policyholder is an economically inferior party to the contract. Therefore, the claim representative’s chief task should be to seek and find coverage, not to seek and find coverage controversies or to delay, deny, dispute or underpay insurance benefits.
If the insurance company fails to fulfill its obligations, such as the insurer has done with regard to this claim, the policyholders not only suffers contractual damages but also extra-contractual damages. When an insurance company fails to pay claims it owes or engages in wrongful practices, contractual damages alone are inadequate. It is hardly a penalty to require an insurer to pay an insured (or the assignee of an insured) what it owed all along.
It is far more profitable for an insurance company to take in an insured’s premium and not pay, rather than to promptly and fully pay what is owed. This financial incentive conflicts with the extreme public trust placed in the insurance industry which is the reason that the State of Florida also implemented codes of ethics and good faith duties articulated in the Florida Administrative Code. Insurers and their representatives must follow these ethical duties. Insurer violated the following ethical requirements in its adjustment of the Complainant’s claim for insurance benefits.
The carrier was put on notice of the insureds’ property damage sustained due to water infiltrating the premises as a result of storm damage to the roof and storm created openings in the roof. Subsequently, the insured prepared a loss package in the amount of $82,508.20 needed to restore the property back to its pre-loss condition. The loss package, which included supporting documents such as photographs of the damage and a line items estimate, was seemingly ignored by the Carrier. Rather, the carrier retained its own contractor, DDA Forensics, to inspect the damages. The carrier’s chosen inspector(s) found that the damage present at the subject property was all conveniently excluded from coverage. However, despite the insure requesting a copy of the DDA Forensics report – the report upon which Defendant bases (at least in large part) its refusal to extend coverage – the carrier has also refused to provide a copy of that report to Plaintiff or Plaintiff’s representatives. Defendant is “hiding the ball” so to speak.
The insureds have complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insureds. More than one hundred and forty days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of the damage sustained by the insureds’ property and has not taken any meaningful ensuing action. In fact, the carrier’s continued delay an erroneous denial of coverage stands in stark contrast to both the facts and circumstances surrounding this loss as well as the insurer’s ethical and legal duties.
It is clear that the carrier is not treating the insureds with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insureds; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insureds’ interests; refusing to pay the full amount owed to the insureds despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insureds, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days.
All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $82,508.20, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier.
Please do not hesitate to contact the undersigned or Braden Schlosser at (561)-892-9928 if you have any questions or concerns.
Sincerely,
Braden Schlosser
Attorney at Law
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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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