Filing Number: 801388
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| Filing Accepted: 1/15/2025 |
| Last/Business Name
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SHREE INVESTMENTS OF FLORIDA, LLC
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First Name |
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| Street Address
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3914 E. 11TH STREET |
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PANAMA CITY,
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32404
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| Email Address
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HARIBADDIGAM@GMAIL.COM, BINITAAMIN@YAHOO.COM, ESAW |
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Insured |
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| Last/Business Name* |
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SHREE INVESTMENTS OF FLORIDA, LLC |
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First Name |
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| Policy # * |
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ORAMPR014231-00 |
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Claim #* |
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4205223 |
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Attorney is Applicable
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| Last Name* |
PETTINATO
First Name *
DAVID
Initial
J
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| Street Address* |
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1000 W. CASS STREET |
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TAMPA
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FLORIDA
33606
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| Email Address * |
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DPETTINATO@OLDERLUNDYLAW.COM, DJP-PARALEGALS@OLDER |
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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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OLD REPUBLIC UNION 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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NAIC Company Code 31143 |
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| Name of individual responsible for violation (if any):*
ANDREA MATHURIN, CHRISTINE DEPPE, PATRICIA CARSON, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY OLD REPUBLIC UNION INSURANCE COMPANY INVOLVED IN THE CLAIM.
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| Type of Insurance
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Commercial Property & Casualty
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| Reason for Notice
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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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Failure to properly investigate claim and with due regard to Insured’s interest
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Other
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Failure to acknowledge and act promptly to communications regarding claim
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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)(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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| 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.
ADD’L STATUTES VIOLATED
§627.70131(1)(a)
§627.70131(2)
§627.70131(7)(a)
POLICY LANGUAGE
The Insured may not be in possession of a complete copy the applicable policy of insurance, however, the specific policy language relevant to the violations outlined below is contained within certain Underwriters at Lloyds, London subscribing to Certificate No. AMR-78953, QBE Specialty Insurance Company, Lexington Insurance Company, and Old Republic Union Insurance Company’s Commercial policy, Policy No. AMR-78953 / MSP-38965 / LEX-049440657-00 / ORAMPR014231-00, issued to the Insured including, but is not limited to, the following:
Coverage - Real Property and Business Income/Rents provision
- Additional Living Expenses
Additional Coverages provisions (AROL PE 04 20)
- Debris Removal
- Reasonable Repairs
- Ordinance Or Law
- Property Abandoned, Condemned Or In A State of Disrepair
CAT Covered Property endorsement (AR CCP 01 17)
Property endorsement (AROL PE 04 20)
Lloyd’s of London Amendatory Coverage endorsement (LLOYDS – SOS 10 19)
The Declarations Page (CERTCO 01 19)
Loss Payment or Loss Settlement provisions
Duties in Event of Loss Policy provisions
The insurance policy's definition sections (AROL PE 04 20)
The insurance policy's exclusion of coverage provisions (AROL PE 04 20)
Please advise if there are other applicable policy provisions that are not cited above but would provide coverage to the Insured for the April 14, 2023, property damage (building struck by vehicle) loss.
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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 work of adjusting insurance claims engages the Public Trust. CERTAIN UNDERWRITERS AT LLOYDS, LONDON SUBSCRIBING TO CERTIFICATE NO. AMR-78953, QBE SPECIALTY INSURANCE COMPANY, LEXINGTON INSURANCE COMPANY, AND OLD REPUBLIC UNION INSURANCE COMPANY (“UNDERWRITERS”) has breached this duty by its failure or refusal to acknowledge its Insured’s claim of loss.
OLD REPUBLIC UNION has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations as set forth above. OLD REPUBLIC UNION has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insured’s insurance claim for damages.
To date, notwithstanding the Insured’s pleas, OLD REPUBLIC UNION has continued to refuse to acknowledge its obligation to acknowledge and pay the full amount of its Insured’s claim.
This complaint is made on behalf of the Insured, Shree Investments of Florida, LLC (“SHREE INVESTMENTS”). Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy authorized and pursuant to Florida Statute §624.155.
In consideration of the premium paid to it by SHREE INVESTMENTS, OLD REPUBLIC UNION issued an Commercial policy, Policy No. ORAMPR014231-00 (hereinafter referred to as “the Policy”), to SHREE INVESTMENTS wherein the insurance policy provided coverage for all losses, including property damage (building struck by vehicle), except those losses which were expressly excluded.
The policy was in full force and effect at the time the damage occurred as a result of property damage (building struck by vehicle), and the ensuing damages as a direct result thereof, to the insured premises located at 3914 E. 11th Street, Panama City, FL 32404, on or about April 14, 2023.
SHREE INVESTMENTS timely notified OLD REPUBLIC UNION of the damages and opened a claim pursuant to the terms and conditions of the Policy.
As a result of the loss, SHREE INVESTMENTS had to relocate its tenant, as the unit was uninhabitable.
In addition, SHREE INVESTMENTS retained Fix’N More LLC to perform repairs on its insured property.
In response, OLD REPUBLIC UNION assigned the claim to its representative to adjust and investigate the loss, as well as a field adjuster to inspect the damages.
OLD REPUBLIC UNION’S representative visited the insured property and performed a cursory and inadequate investigation of the damaged property.
On or about May 2, 2024, OLD REPUBLIC UNION submitted a Payment Letter to SHREE INVESTMENTS, in which it tendered $40,532.00 for ALE (Business Income) damages and $2,268.08 in Building 5 (Real Property) damages.
Concerned that OLD REPUBLIC UNION had no intention to fairly investigate and adjust its claim, SHREE INVESTMENTS retained the services of an insurance claim professional, Jeffrey Pellet from PIEA, LLC., to assist in submitting its claim to OLD REPUBLIC UNION which would adequately and fairly detail all the damages sustained as a result of the loss.
In contrast to OLD REPUBLIC UNION damage estimate, SHREE INVESTMENT’S estimate from PIEA, LLC. totaled a loss of $50,792.83 in Dwelling (Real Property) damages.
In addition, SHREE INVESTMENTS calculated its Business Income loss totaled $447,750.92.
With regards to SHREE INVESTMENTS’ claim determination process, OLD REPUBLIC UNION has misrepresented the true extent of damages sustained to their home. OLD REPUBLIC UNION has also failed to re-evaluate the damages to their home and has such, delayed SHREE INVESTMENTS from their owed insurance benefits.
To date, SHREE INVESTMENTS has not received any reinspection requests from OLD REPUBLIC UNION.
To date, OLD REPUBLIC UNION has failed to tender any supplemental insurance benefits. OLD REPUBLIC UNION has admitted that SHREE INVESTMENTS sustained covered damages as a result of the property damage (building struck by vehicle) loss that occurred on or about April 14, 2023 but has denied tendering all owed insurance benefits to SHREE INVESTMENTS. Pursuant to Florida Statute §626.9541(1)(i)(4), OLD REPUBLIC UNION is required to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after OLD REPUBLIC UNION received notice of the residential property insurance claim, determine the amounts of partial or full benefits, and agree 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). As OLD REPUBLIC UNION has failed to do so, OLD REPUBLIC UNION has wrongfully denied coverage.
Since the beginning of the claim, OLD REPUBLIC UNION has engaged in a pattern of delay, denial, and reckless disregard for SHREE INVESTMENTS’ rights. The actions of OLD REPUBLIC UNION listed herein have been continuing in nature and given the totality of the circumstances, which includes OLD REPUBLIC UNION’S adjustment, actions and/or omissions post the filing of this CRN. SHREE INVESTMENTS contends that given the past experience in this matter with OLD REPUBLIC UNION, it is reasonably foreseeable that OLD REPUBLIC UNION’S current actions will extend to its entire conduct in the handing of its claim, including the acts or omissions of OLD REPUBLIC UNION and/or its representatives, until the final resolution of its claim. As such, SHREE INVESTMENTS contends adequate notice has been given should OLD REPUBLIC UNION’S actions and violations listed herein continue after the expiration of this notice.
OLD REPUBLIC UNION has failed and/or refused to settle the claim when it could and should have done so had it acted fairly and honestly towards SHREE INVESTMENTS, and has failed to take into account the information and evidence provided that contradict its decisions.
Even upon receipt of additional and supporting evidence to the contrary, OLD REPUBLIC UNION has continued to stand by its claim denials. As such, SHREE INVESTMENTS does not anticipate OLD REPUBLIC UNION will rescind its denial of its claim.
OLD REPUBLIC UNION’S conduct has been reckless and unfair to SHREE INVESTMENTS, and has caused and continues to cause additional damages throughout the property. This is evidenced by the delay in paying the claim and the failure of OLD REPUBLIC UNION to evaluate the claim in total.
To date, OLD REPUBLIC UNION has failed and/or refused to provide SHREE INVESTMENTS with all the insurance benefits due and owing and has not tendered the full amount needed to repair the Property despite knowing that SHREE INVESTMENTS has sustained covered damages to its insured property.
As OLD REPUBLIC UNION must admit, it is implied within every insurance policy a duty of good faith and fair dealings. In an insurance contract, each party is prevented from interfering with the other’s right to benefit from the contract. The obligations of good faith and fair dealings encompass qualities of decency and humanity inherent in its responsibilities as a fiduciary. OLD REPUBLIC UNION is bound to conduct itself with the utmost good faith for the benefit of SHREE INVESTMENTS. However, OLD REPUBLIC UNION has failed to comply with the obligations in connection with this claim and has never looked at the claim or the contract for insurance with good faith and fair dealing. Instead, OLD REPUBLIC UNION has looked for ways not to pay the claim in full, or at all, and these actions have been to the detriment of SHREE INVESTMENTS.
The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim the representatives on behalf of OLD REPUBLIC UNION have approached this investigation in a manner prejudicial to SHREE INVESTMENTS. OLD REPUBLIC UNION is using either untrained or improperly trained adjusters in connection with this claim. OLD REPUBLIC UNION should have been adjusting the loss with SHREE INVESTMENTS but instead, it was looking for ways not to pay the claim at all, or pay the claim in full. If OLD REPUBLIC UNION handles all the claims in the manner in which SHREE INVESTMENTS’ claim was adjusted, then it is improperly handling all claims.
OLD REPUBLIC UNION has refused and/or failed to comply with The Policy’s cooperation and/or “Loss Payment” provision. Under The Policy, OLD REPUBLIC UNION was to timely tender undisputed insurance benefits to SHREE INVESTMENTS. OLD REPUBLIC UNION has failed and/or refused to timely tender owed insurance benefits, undisputed or otherwise. This is a breach of The Policy.
OLD REPUBLIC UNION has refused and/or failed to cooperate and/or “Adjust the Loss” by cooperating with SHREE INVESTMENTS during the claims adjustment process in compliance with The Policy’s “Loss Payment” provision. This is a breach of The Policy.
The concept of insurance is that insurance is the insurer’s granting of timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that SHREE INVESTMENTS may mitigate its damages and to put it back into the position it was in prior to the loss as quickly as possible. OLD REPUBLIC UNION has breached this duty.
OLD REPUBLIC UNION has refused and/or failed to tender all insurance proceeds to SHREE INVESTMENTS upon demand. OLD REPUBLIC UNION’S refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards SHREE INVESTMENTS is wrongful conduct. Furthermore, SHREE INVESTMENTS contends that OLD REPUBLIC UNION’S adjusters and/or representatives financially benefit by such wrongful conduct.
It is clear that OLD REPUBLIC UNION’S adjusters have also failed to adhere to insurance industry rules and guidelines when adjusting a first party claim. It is also evident that OLD REPUBLIC UNION violated the Florida unfair claims practices, the adjuster’s ethical code of conduct, and acted irresponsibly in the handling of its insured’s claims. In this case, SHREE INVESTMENTS paid a hefty premium for a service, the service is called claims adjusting (I encourage you to read the book titled, “The Claims Environment” written by James J. Markham, Kevin M. Quinley, and Layne S. Thompson-this book is taught in every first year AIC course).
The claim professional must dispense his or her knowledge and skill for the benefit of society. The general public expects claims representatives to pay all legitimate claims promptly and fairly. The claim professional must harness all of his or her knowledge and expertise to accomplish the objectives of the claim function. He or she must also adhere to the highest degree of ethical conduct. In addition to interacting with other insurance personnel and service providers in a professional manner, the claims professional must deal with public’s and regulator’s expectations. Insurance Companies provide such a vital and necessary service to society that the selling and servicing of insurance is imbued with a public trust. James J. Markham, Kevin M. Quinley, Layne S. Thompson, “The Claims Environment”, Insurance Institute of America, 1st ed., 1993.
Accordingly, OLD REPUBLIC UNION has a contractual and statutory obligation to investigate all possible bases which might support SHREE INVESTMENTS’ claim and cannot deny a claim without thoroughly investigating the foundation for its denial or basis for withholding insurance benefits. OLD REPUBLIC UNION violated its obligations here.
- OLD REPUBLIC UNION has a contractual and statutory obligation to make a perfunctory investigation, not ignoring evidence that would support SHREE INVESTMENTS’ claim. OLD REPUBLIC UNION violated its obligations here.
- OLD REPUBLIC UNION has a contractual and statutory obligation not to look the other way when confronted with facts revealing the possibility of coverage and resisting reasonable interpretations of its policy. OLD REPUBLIC UNION violated its obligations here.
- OLD REPUBLIC UNION has a contractual and statutory obligation not to deny the claim based on standards known to be impermissible or on an interpretation contrary to established law. OLD REPUBLIC UNION violated its obligations here.
These actions and violations were either done intentionally or as the result of OLD REPUBLIC UNION’S failure to adopt and implement the proper standards of the investigation and adjustment of claims.
Overall, OLD REPUBLIC UNION’S investigation of the claim was inadequate and contrary to its obligations under the insurance policy and Florida law.
SHREE INVESTMENTS has done everything legally requested by OLD REPUBLIC UNION to date. To cure the violations set forth in this Civil Remedy Notice, OLD REPUBLIC UNION must now agree to acknowledge its duties and obligations under the law in adjusting its insured’s claim, and tender rightfully owed insurance benefits to return SHREE INVESTMENTS to its pre-loss condition.
Further, to cure the violations set forth in this Civil Remedy Notice, SHREE INVESTMENTS hereby requests that OLD REPUBLIC UNION tender at this time, or prior to the expiration of the statutory cure period, the amount of SHREE INVESTMENTS’ damage estimate and demand which accurately reflects the true nature and extent of SHREE INVESTMENTS’ damages. Therefore, OLD REPUBLIC UNION should tender $1,577,343.75 (less any prior payments, depreciation, excess policy limits, and/or deductible) in insurance benefits at this time.
Although SHREE INVESTMENTS has made a demand for payment in the amount of $1,577,343.75 (less any prior payments, depreciation, excess policy limits, and/or deductible) and has provided OLD REPUBLIC UNION with all the necessary documentation in support thereof, it is still willing to consider and to potentially accept any reasonable counter-offer made by OLD REPUBLIC UNION. Therefore, if OLD REPUBLIC UNION is not in agreement with SHREE INVESTMENTS’ reasonable demand for payment of its rightfully owed insurance benefits being submitted at this time, SHREE INVESTMENTS hereby requests that OLD REPUBLIC UNION now make a reasonable counter-offer before the expiration of the cure period. SHREE INVESTMENTS still hopes that its claim can be resolved amicably.
The concept of insurance is that insurance is the insurer’s granting of timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that SHREE INVESTMENTS may mitigate its damages and to put it back into the position it was in prior to loss as quickly as possible. OLD REPUBLIC UNION breached this duty.
This notice is given in order to perfect the right to pursue the civil remedy authorized and pursuant to Florida Statute §624.155, including any and all bad faith/extra contractual, should OLD REPUBLIC UNION fail to cure the violations set forth in this Civil Remedy Notice within the given cure period.
While no specific “cure amount” is required for this Civil Remedy Notice to be valid, SHREE INVESTMENTS will consider the allegations contained herein “cured” if OLD REPUBLIC UNION, without any requirement for a release:
(1) Immediately tenders the amount of SHREE INVESTMENTS’ damage estimate in the amount of $50,792.83 (less any prior payments, depreciation, excess policy limits, and/or deductible), which accurately reflects the true nature and extent of the damages to the Dwelling / Other Structures;
(2) Immediately tenders the amount of SHREE INVESTMENTS’ loss of rent that were submitted $447,750.92 (less any prior payments, depreciation, excess policy limits, and/or deductible);
(3) Immediately tenders the amount of SHREE INVESTMENTS’ loss in value damages that were submitted $1,078,800.00 (less any prior payments, depreciation, excess policy limits, and/or deductible);
(4) Agrees to reimburse SHREE INVESTMENTS for its expenses incurred by having to retain a loss consultant to present its claim; and
(5) Immediately tenders the amount of statutory interest due and owing to SHREE INVESTMENTS pursuant to Florida Statute §627.70131(5)(a).
(6) Immediately provides SHREE INVESTMENTS with the documentation OLD REPUBLIC UNION has used and/or continues to contend, supports the claim determination made by OLD REPUBLIC UNION in the adjustment of SHREE INVESTMENTS’ claim. Specifically, OLD REPUBLIC UNION must provide SHREE INVESTMENTS with its claim estimate(s), supporting photographs and/or videos, as well as any and all reports of any expert(s) or other individuals retained on behalf of OLD REPUBLIC UNION upon which OLD REPUBLIC UNION has relied on in reaching and/or further supporting its coverage determination in SHREE INVESTMENTS’ claim.
SHREE INVESTMENTS continues to remain open to a fair and reasonable settlement offer from OLD REPUBLIC UNION in an effort to avoid additional delay, costs and expenses, and hereby request the same prior to the expiration of the statutory “cure” period. SHREE INVESTMENTS has provided OLD REPUBLIC UNION with all necessary estimates, documentation, etc. in support of the claim. OLD REPUBLIC UNION must act fairly and honestly in its response to SHREE INVESTMENTS’ request for a prompt, fair and reasonable settlement offer and resolution of the claim.
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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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