Filing Number: 802728
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| Filing Accepted: 1/21/2025 |
| Last/Business Name
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LAMOUNTAIN
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First Name |
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RAYMOND |
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| Street Address
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845 JUNIPER CIR. |
| City, State Zip
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ROCKLEDGE,
FL
32955
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| Email Address
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VIDONI@VIDONILAW.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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LAMOUNTAIN |
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First Name |
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RAYMOND |
| Policy # * |
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P001941619 |
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Claim #* |
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245-879 |
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Attorney is Applicable
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| Last Name* |
VIDONI
First Name *
NICHOLAS
Initial
A
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| Street Address* |
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959 N. COCOA BLVD. #5 |
| City, State Zip* |
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COCOA
,
FL
32922
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| Email Address * |
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VIDONI@VIDONILAW.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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SECURITY FIRST 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 10117 |
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| Name of individual responsible for violation (if any):*
DAVID SMITH
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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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Other
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Failure to Defend and Failure to Idemnify
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Statutory provision(s) which the insurer allegedly violated.
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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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
ADDITIONAL COVERAGES
1. Debris Removal. We will pay your reasonable expense for the removal of:
a. Debris of covered property if a Peril Insured Against that applies to the damaged property causes the loss; or
....
2. Reasonable Emergency Measures.
...
SECTION II – ADDITIONAL COVERAGES
We cover the following in addition to the limits of liability:
1. Claim Expenses. We pay:
a. Expenses we incur and costs taxed against an "insured" in any suit we defend;
a. We will pay up to the greater of $3,000 or 1% of your Coverage A limit of liability for the reasonable costs incurred by you for necessary measures taken solely to protect covered property from further damage, when the damage or loss is caused by a Peril Insured Against.
...
13. “Fungi”, Mold, Wet or Dry Rot, Or Bacteria
a. We will pay up to the amount stated in the Declarations for Limit of Liability for “Fungi” Coverage for:
(1) The total of all loss payable under Section I – Property Coverages caused by or resulting directly or indirectly from “fungi”, mold, wet or dry rot, or bacteria;
(2) The cost to remove “fungi”, mold, wet or dry rot, or bacteria from property covered under Section I – Property Coverages;
(3) The cost to tear out and replace any part of the building or other covered property as needed to gain access to the “fungi”, mold, wet or dry rot, or bacteria; and
(4) The cost of testing of air or property to confirm the absence, presence or level of “fungi”, mold, wet or dry rot, or bacteria whether performed prior to, during or after removal, repair, restoration or replacement. The cost of such testing will be provided only to the extent that there is a reason to believe that there is the presence of “fungi”, mold, wet or dry rot, or bacteria.
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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.
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3. Loss Settlement. Covered property losses are settled as follows:
a. Property of the following types:
(1) Personal property;
(2) Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings; and
(3) Structures that are not buildings;
at actual cash value at the time of loss but not more than the amount required to repair or replace.
b. Buildings under Coverage A or B at replacement cost without deduction for depreciation, subject to the following:
(1) If, at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more of the full replacement cost of the building immediately before the loss, we will pay the cost to repair or replace, after application of deductible and without deduction for depreciation, but not more than the least of the following amounts:
(a) The limit of liability under this policy that applies to the building;
(b) The replacement cost of that part of the building damaged for like construction and use on the same premises; or
(c) The necessary amount actually spent to repair or replace the damaged building.
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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.
Mr. Lamountain suffered a loss associated with his home. The loss involved water damage that necessitated the restoration of Mr. Lamountain’s kitchen and floors, among other things. Security First Insurance Co. determined that coverage existed for the loss.
Mr. Lamountain hired Water & Mold Insurance Restoration, Inc. to address the damage. Security First Insurance Co. and Water & Mold Insurance Restoration, Inc. disputed the value of the claim and the work performed. This disagreement between the insurer and contractor as to the compensable value of the Mr. Lamountain’s loss resulted in Water & Mold Insurance Restoration, Inc. filing a lawsuit against Mr. Lamountain seeking their claimed value of the work.
Security First Insurance Co. later determined that they had a duty to defend Mr. Lamountain, and had their appointed attorney represent him. For reasons unknown to Mr. Lamountain, Security First Insurance Co. later withdrew representation of Mr. Lamountain, forcing him to incur attorney’s fees and costs.
Because the costs sought by Water & Mold Insurance Restoration, Inc. were covered by Mr. Lamountain’s policy - either in full or in part - Security First Insurance Co. had a duty to defend Mr. Lamountain and a duty to indemnify him for any amounts that exceed the insurance proceeds already provided. Security First Insurance Co. is in breach of its obligations under the policy because it withdrew its defense of Mr. Lamountain.
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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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