Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 801355

Filing Accepted: 1/15/2025

Print Filing

Complainant

Last/Business Name *

MARTINEZ

First Name

MIRIAM & REINALDO

Street Address *

603 GREGORY DR

City, State Zip *

CASSELBERRY, FL 32707

Email Address *

PRPRELUDE@AOL.COM

Complainant Type: *

Insured

Last/Business Name*		MARTINEZ		First Name		MIRIAM & REINALDO
Policy # *		FLP 537252		Claim #*		1438052-241013

Attorney

Attorney is Applicable

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		AMERICAN STRATEGIC INSURANCE CORP.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10872

Name of individual responsible for violation (if any):* DION GREGORY HARRIS
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Delay
	Unfair Trade Practice

* 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.
	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)(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.

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

SECTION I – PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property.

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

The insureds sustained significant damage to their property as a result of Hurricane Milton. The hurricane caused roof damage, leading to water intrusion that affected multiple rooms in the home. Additionally, the storm damaged an exterior shed, soffit, fascia, and a sliding glass door. On October 30, 2024, the field adjuster for the insurance company inspected the property. On the same date, an estimate totaling $67,652.20 was submitted to the insurance company via email. A Proof of Loss form was also provided to the insurance company on December 9, 2024. The insurance company has requested information regarding a prior loss from 2017. The insureds have explained that the previous loss involved cracks on the swimming pool deck and is unrelated to the current claim. Due to the prior insurer being out of business, no documentation regarding the previous loss is available. Despite the insureds’ explanation, the insurance company has withheld payment for the current loss, pending information about the unrelated 2017 loss. The insureds are requesting payment for the current claim per the Proof of Loss amount , less the applicable deductible, as this claim is distinct and unrelated to the prior incident.

Comments

User Id		Date Added		Comment
darryl_j_roles@progressive.com		02-17-2025		While ASI Preferred Insurance Corp believes that the Civil Remedy Notice fails to comply with the requirements of Florida Statute §624.155 and Florida Case law, it has responded to the notice in writing to Labrador Claims Consultants, INC, on February 17, 2025.

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