Filing Number: 800498
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| Filing Accepted: 1/10/2025 |
| Last/Business Name
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| Street Address
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11844 LAKE MINNEOLA SHORES |
| City, State Zip
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MINNEOLA,
FL
34715
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| Email Address
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STEVEN@PLG.LAWYER |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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SIDES |
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First Name |
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RUTH S. |
| Policy # * |
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80-CN-Q606-8 |
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Claim #* |
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59-69C6-73W |
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Attorney is Applicable
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| Last Name* |
HOFFMAN
First Name *
STEVEN
Initial
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| Street Address* |
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1790 HIGHWAY A1A, SUITE 209 |
| City, State Zip* |
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SATELLITE BEACH
,
FL
32937
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| Email Address * |
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STEVEN@PLG.LAWYER |
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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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STATE FARM FLORIDA 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 10739 |
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| Name of individual responsible for violation (if any):*
STATE FARM FLORIDA INSURANCE COMPANY’S ADJUSTERS, EMPLOYEES, REPRESENTATIVES, AGENTS, VENDORS, AND/OR ENGINEERS AND CONTRACTORS WHO HANDLED THE CLAIM, SPECIFICALLY THE DESK ADJUSTER.
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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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Cancellation
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Unfair Trade Practice
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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)(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)(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)(o)(11) |
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No insurer shall cancel or issue a non-renewal notice on any insurance policy or contract without complying with any applicable cancellation or non-renewal provision required under the Florida Insurance Code.
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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 Policy language relevant to the violations includes all applicable loss payment, duties after loss, and coverage provisions of Policy Number believed to be 80-CN-Q606-8, including the declarations page and all endorsements to the Policy.
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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.
Claim #59-69C6-73W; DOL: April 25, 2023
Ruth S. Sides (“Insured”) is the owners of a property with a policy of insurance issued by State Farm Florida Insurance Company (“Carrier”). The Insured’s residence is located at 11844 Lake Minneola Shores, Minneola, FL 34715 (the “Property”). On April 25, 2023, a wind loss caused extensive damage to the Property. The Insured timely reported an insurance claim for this damage to the Carrier and fully cooperated with all requests for inspection and information. Insured provided all requested documentation and complied with all post loss policy conditions reasonably and timely requested. The Insured obtained representation from a public adjuster and an estimate for repair of dwelling and other structures for $89,362.52, with supporting documentation and photographs.
Upon reporting the loss, the Carrier assigned a field adjuster who advised the Carrier they did not observe any wind or hail damage and issued a denial letter. The Insured requested a copy of the Carrier’s estimate of damages, but said estimate was never provided.
On or about January 5, 2024, the Insured received a letter from the Carrier’s underwriting department requesting she perform the following activities around the Property or her insurance coverage would be cancelled:
• Remove inoperable untagged vehicle
• Clean around home
• Repair or replace porch roof
• Attention to the pool
The Insured performed the requested activities and provided proof to the Carrier that each item and been resolved. The Carrier never responded to the Insured, nor did they acknowledge receipt of any of the proof and the Carrier is still threatening to cancel the Insured’s insurance coverage. Upon information and belief, this is retaliation by the Carrier against the Insured for filing a claim and filing a lawsuit, which is in violation of Florida law.
Before sending the non-renewal letter, the Carrier inspected the roof at the Property and upon noticing damage, failed to notify the Insured of said damage. Failure to act fairly and honestly toward the Insured and with due regard for her interests.
Section 624.02, Florida Statutes, defines insurance as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. The Carrier has breached this duty by refusing to properly and timely adjust the loss. The Carrier has more than enough information and is still refusing to accept full coverage for this claim. This continued and repeated reckless claim delay, unfair claim handling, failure to communicate, and denial of full coverage will result in a significant punitive damage award.
The Carrier can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy and by paying the Insured $82,070.52, minus deductible. Further, the Carrier should pay the interest accrued from notice of the claim until the date that the Carrier pays $82,070.52, minus deductible, per Section 627.70131 Florida Statutes.
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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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