Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 802779

Filing Accepted: 1/22/2025

Print Filing

Complainant

Last/Business Name *

OTTENDORF

First Name

GEORGE

Street Address *

210 COUNTRY CIRCLE DR. W

City, State Zip *

PORT ORANGE, FL 32128

Email Address *

EAGLEISLANDFL@GMAIL.COM

Complainant Type: *

Insured

Last/Business Name*		OTTENDORF		First Name		GEORGE
Policy # *		SJ30341224		Claim #*		SL22218630

Attorney

Attorney is Applicable

Last Name*	BROWNLEE First Name * JOSHUA Initial R
Street Address*		7700 CONGRESS AVE, SUITE 1103
City, State Zip*		BOCA RATON , FL 33487
Email Address *		JOSH@JTLAWFIRM.NET

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		SLIDE INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 17227

Name of individual responsible for violation (if any):* CHARLES MACE, STORII KNOX, JEFF GRAHAM
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Denial
	Claim Delay
	Unsatisfactory Settlement Offer
	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.
	624.155(1)(b)(3)		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.
	626.9541(1)(i)(2)		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.
	626.9541(1)(i)(3)(a)		Failing to adopt and implement standards for the proper investigation of claims.
	626.9541(1)(i)(3)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.
	626.9541(1)(i)(3)(d)		Denying claims without conducting reasonable investigations based upon available information.
	626.9541(1)(i)(3)(f)		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.
	626.9541(1)(i)(3)(g)		Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
	626.9541(1)(i)(3)(h)		Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
	626.9541(1)(o)(1)		Knowingly collecting any sum as a premium or charge for insurance, which is not then provided, or is not in due course to be provided, subject to acceptance of the risk by the insurer, by an insurance policy issued by an insurer as permitted by this code.
	626.9541(1)(i)(4)		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).
	626.9541(1)(i)(3)(j)		Altering or amending an insurance adjuster’s report without: (I) Providing a detailed explanation as to why any change that has the effect of reducing the estimate of the loss was made; and (II) Including on the report or as an addendum to the report a detailed list of all changes made to the report and the identity of the person who ordered each change; or (III) Retaining all versions of the report, and including within each such version, for each change made within such version of the report, the identity of each person who made or ordered such change;

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

Homeowners 3 - Special Form HO 00 03 10 00 SECTION I – PROPERTY COVERAGES A. Coverage A – Dwelling 1. We cover: a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and E. Additional Coverages 1. Debris Removal a. We will pay your reasonable expense for the removal of: (1) Debris of covered property if a Peril Insured Against that applies to the damaged property causes the loss; or 2. Reasonable Repairs a. We will pay the reasonable cost incurred by you for the necessary measures taken solely to protect covered property that is damaged by a Peril Insured Against from further damage. SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure against risk of direct physical loss to property described in Coverages A and B. C. Loss Settlement - HO 00 03 10 00 - Subject to endorsement referenced below. D. Loss To A Pair Or Set In case of loss to a pair or set we may elect to: 1. Repair or replace any part to restore the pair or set to its value before the loss; or 2. Pay the difference between actual cash value of the property before and after the loss. I. Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable 60 days after we receive your proof of loss and: 1. Reach an agreement with you; 2. There is an entry of a final judgment; or 3. There is a filing of an appraisal award with u Screen Enclosure Endorsement - SIC HO HE 02 22 Special Provisions - Florida Endorsement SIC HO 100 02 22 SECTION I – PROPERTY COVERAGES COVERAGE A – DWELLING AND COVERAGE B OTHER STRUCTURES In form HO 00 03, the following is added: This coverage does not apply to damage to aluminum framed screened enclosures due to hurricane.The following is added to Forms HO 00 03 and HO 00 06 E. Additional Coverages. Paragraph 1.b. Debris Removal in form HO 00 03 (C.1.b. in form HO 00 04, D.1.b. in form HO 00 06) is replaced by: b. We will also pay your reasonable expense, up to $500, for the removal from the “residence premises” of: (1) Your tree(s) felled by the peril of Windstorm or Hail or Weight of Ice, Snow or Sleet; or (2) A neighbor's tree(s) felled by a Peril Insured Against under Coverage C; Provided the tree(s): (3) Damage(s) a covered structure; or (4) Does not damage a covered structure, but: (a) Block(s) a driveway on the “residence premises” which prevent(s) a “motor vehicle,” that is registered for use on public roads or property, from entering or leaving the “residence premises”; or (b) Block(s) a ramp or other fixture designed to assist a handicapped person to enter or leave the dwelling building. The $500 limit is the most we will pay in any one loss regardless of the number of fallen trees. This coverage is additional insurance. In form HO 00 06, 7. 11. Ordinance Or Law. Paragraph 11.a. in forms HO 00 03 and HO 00 04 (10.a. in form HO 00 06) is replaced by the following: a. You may use up to 25% of the limit of liability that applies to Coverage A for the increased costs you incur due to the enforcement of any ordinance or law which requires or regulates: (1) The construction, demolition, remodeling, renovation or repair of that part of a covered building or other structure damaged by a Peril Insured Against; (2) The demolition and reconstruction of the undamaged part of a covered building or other structure, when that building or other structure must be totally demolished because of damage by a Peril Insured Against to another part of that covered building or other structure; or (3) The remodeling, removal or replacement of the portion of the undamaged part of a covered building or other structure necessary to complete the remodeling, repair or replacement of that part of the covered building or other structure damaged by a Peril Insured Against. (With respect to form HO 00 04 the words Coverage A, refers to Additional Coverages item 10.) C. Loss Settlement. In Form HO 00 03: Paragraph C.1.d. is deleted. The first paragraph of C.2.d is replaced by the following: We will initially pay the actual cash value of the loss, less any applicable deductible. We will then pay any remaining amounts necessary to perform the actual repair or replacement as work is performed and expenses are incurred subject to C.2.a. and b.. If a total loss occurs, we will pay the full replacement cost without reservation or holdback of any depreciation in value. In form HO 00 06, Loss Settlement paragraph 2. is replaced by the following: 2. Coverage A – Dwelling: Is provided at the actual cost to repair or replace. We will initially pay the actual cash value of the loss, less any applicable deductible. We will then pay any remaining amounts necessary to perform the actual repair or replacement as work is performed and expenses are incurred. If a total loss occurs we will pay the full replacement cost without reservation or holdback of any depreciation in value. In this provision the terms “repaired” or “replaced” do not include the increased cost incurred to comply with enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in D.10. Ordinance Or Law under Section I – Property Coverages.

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

On September 28, 2022, Hurricane Ian caused direct physical damage to the insured property located at 210 Country Circle Dr. W Port Orange, FL 32128 (the "Property"). It is undisputed that the property sustained wind damage as the Defendant's own investigation found wind damage to the screen enclosure. The Defendant failed to provide any coverage for the screen enclosure despite SIC Ho HE 02 22 specifically providing for same and the insured issued a premium payment for $449.00 for the added coverage. The insured reported an insurance claim that was assigned Claim No. SL22218630 (the "Claim"). Slide sent a representative named Charles Mace to inspect the property on July 10, 2023 and Mr. Mace's report confirms specifically confirms wind and debris damage to 10 screen panels of the pool enclosure. Slide has altered the Mr. Mace's estimate or otherwise instructed him not to estimate the total amount of damage to the screen enclosure while also altering his report which contains different fonts and text. Mr. Mace has failed to appear for depositions and testify by ignoring duly issued subpoenas. Mr. Mace additional found damage to the roofing structure but erroneously concludes that he did not observe wind damage to any other areas of the property and failed to comply with his obligations as an adjuster to give the benefit of the doubt to the insured. Mr. Mace recommended $15,000 in reserves but failed to conduct any investigation into the repairability of the screen enclosure or estimate the cost to repair or replace same. Further, Slide engaged Joe Graham to investigate the availability of similar tiles on the insureds roof given the damage to the tiles that was observed. Mr. Graham noted in his report that the tiles are discontinued and cannot be purchased which was the reason Slide knew the roof could not be repaired and must be replaced. With this information, Slide improperly denied any damage to the roof in an effort to avoid have to replace what it knew was a hurricane damaged roof. Slide engaged Stori Knox to investigate the Claim and render Slides coverage position which was issued on or about July 19, 2023 where Slide denied all coverage and failed to issue payment. Ms. Knox similarly has refused to comply with subpoenas and will not testify to her involvement with the Claim. Ms. Knox thereafter refused to communicate with the insured and/or the insureds representatives who asked her to reconsider based on the documentation provided evidencing wind damage to the roof. Slide failed to acknowledge these communications, photographs and estimates provided in support of the claim and continued to maintain its denial of coverage. Slide failed to engage qualified representatives to make a cause and origin determination and Mr. Graham has multiple complaints against his licenses that are relevant to this action nor does he have any specific training in identifying wind derived damage to a tile roofing structure. Mr. Graham merely profits by attempting to sell what he determines are suitable replacement tiles through his business by representing in his reports that he has tiles of like quality or kind in his warehouse. Statutory Violations: 624.155(1)(b)(1)&(3) - Slide has violated the policy and this statute in numerous ways. Slide without question found damage to the aluminum enclosure and the insured paid a premium for the additional coverage. Slide failed to estimate the loss, acknowledge the loss to the enclosure or ever reference the endorsement to the insured thereby misrepresenting policy language. Slide knew the roof was damaged by wind and has withheld information attesting to same in an effort to avoid paying for direct physical damage to the roofing structure from Hurricane Ian because it knew the tiles were discontinued and would have to replace the entire roof. Slide withheld the information and knew it should have settled or paid the claim when the result of Mr. Mace's and Mr. Graham's investigation was provided. Slide failed to act fairly and honesty to the insured by misrepresenting the policy language and the damage to the roof. Slides complete failure to inform the insured about the screen enclosure endorsement and loss to the enclosure was intentional and payment should be made immediately with interest. 626.954(1)(i)(2) and 626.954(1)(i)(3)(b) - Slide has materially misrepresented that the policy does not provide coverage for the screen enclosure and it knows that the SIC HO HE 02 22 endorsement provides coverage for same. Slide has mispresented that the property sustained wind damage to the roofing structure because it knew that the tiles were discontinued and would have to replace the roof if any damage was covered under the policy. Ms. Knox misrepresented the available coverage in her coverage letter and failed to reference the undisputed damage to allow the insured to evaluate his options. Ms. Knox or someone else materially altered Mr. Mace's estimate regarding the damage he observed and made it a zero dollar estimate. 626.954(1)(i)(3)(a) - Slide's investigation failed to implement proper standards from the start by engaging unqualified representatives to make a cause and origin determination. Slide failed to take into account the undisputed damage from Hurricane Ian and apply the same investigation to the roof because it knew the tiles were discontinued and the roof would require replacement. Ms. Knox ignored the insureds request for reconsideration of the Claim decision and documents provided in support of the claim including photographs and estimates detailing the roof replacement and necessity of same. The failure to inform and acknowledge the screen enclosure endorsement was a failure on behalf of Slide. Slide failed to implement any proper investigation into pre-existing damages in an effort to distinguish between what was damaged before and after the Hurricane despite having the information available to it within the insureds underwriting file and historical photographs. Slides failure to adopt and implement standards for a proper investigation that acknowledge wind damage to the screen enclosure and numerous cracked and broken tiles only after the Hurricane was a deliberate effort to avoid having to issue payment under the policy. Slide has a contractual obligation to make a perfunctory investigation, not ignoring evidence that would support the Insured’s claim. This is a breach of the Policy. Slide has a contractual obligation not to look the other way when confronted with facts revealing the possibility of additional coverage and resisting reasonable interpretations of its policy. Slide has a continuing obligation to adjust the claim and has been presented with engineer opinions and additional documentation evidencing damage to the roofing structure and has continued to fail to issue payment under the terms and conditions of the policy. 626.954(1)(i)(3)(c) - Ms. Knox failed to acknowledge and act promptly to the insureds and the insureds representatives requests for reconsideration. Ms. Knox was contacted on multiple occasions after the initial coverage July 19, 2023 coverage letter and she did not respond or acknowledge the requests for reconsideration and the documents provided in support of the insureds claim. 626.954(1)(i)(3)(d) - The insured reincorporates all the facts cited above including but not limited to the summary and facts provided in support of 624.155(1)(b)(1)&(3) and 626.9541(1)(i)(3)(a) above resulting in an improper denial of the Claim when Slide knew there was coverage to the screen enclosure and roof. 626.954(1)(i)(3)(f) - The insured reincorporates all the facts cited above including but not limited to the summary and facts provided in support of 624.155(1)(b)(1)&(3) and 626.9541(1)(i)(3)(a) above resulting in an improper denial of the Claim when Slide knew there was coverage to the screen enclosure and roof. 626.954(1)(i)(3)(g) - Due to Ms. Knox's failure to acknowledge requests to reconsider or supplemental documentation provided in support of the Claim, Slide failed to provide any explanation or identify any additional information that could have or was needed to reconsider or reevaluate the coverage decision in July of 2023. 626.954(1)(i)(3)(g)&(i)&(h) - The insured reincorporates all the facts cited above including but not limited to the summary and facts provided in support of 624.155(1)(b)(1)&(3) and 626.9541(1)(i)(3)(a) above resulting in an improper denial of the Claim when Slide knew there was coverage to the screen enclosure and roof. 626.9541(1)(i)(3)(j) - Slide altered Mr. Mace's estimate and report without providing any information to the insured as to why it was changed or that the screen enclosure was found damaged by Mr. Mace nor did Slide ever inform the insured as to whether the screen enclosure was considered covered or not covered under the terms of the policy. 626.9541(1)(o)(1) - Slide accepted a premium payment for the property and screen enclosure and failed to issue payment while knowing the risk given the condition of the roof at the time of issuance. Slide has failed to provide insurance proceeds when the premium was collected and subsequent damage was not paid under the terms and conditions of the policy. 626.9541(1)(i)(4) - The insured reincorporates the above facts and reasserts that Slide as failed to issue payment at all times outside the time permitted by the policy and Florida Statutes. Despite Slides continuing obligation to adjust this claim, it has continued to fail to issue payment.

Comments

User Id		Date Added		Comment
josh@jtlawfirm.net		02-26-2025		The civil remedy notice bearing filing number 802779 is hereby withdrawn.
josh@jtlawfirm.net		01-22-2025		Therefore, Slide has violated some of the most basic adjustment principles in its adjustment of the Insured’s claim, including: 1) failure to pay claim in full 2) failure to properly investigate claim 3) failure to adjust loss 4) failure to act in due diligence and good faith to resolve claim 5) placing financial interest of the Insurer before that of the policy holder and claimant(s) 6) failure to properly train, evaluate and manage adjusters 7) looking for ways to deny coverage, pay less, delay payment and otherwise “low ball” or “stone wall” the insured from seeking relief, whether presuit or through the course of a lawsuit 8) the reasons for this may be attributed to improper training, supervision, and/or motivation of adjusters and claims supervisors to investigate, adjust and pay full benefits available to all beneficiaries promptly and fairly. The insurer may have failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because full payment and prompt payment for the loss is not occurring. REQUESTED ACTIONS TO CURE: To summarize, the Insureds were dutiful customers who made it a priority to pay all insurance premiums and to ensure that in such an event as the one here, their home would be covered. The Insured timely filed this claim and fulfilled all post-loss obligations. The Insurer acknowledged the loss by assigning a claim number, conducting an inspection, and has since taken bad faith action to deny paying this claim. Slide has grossly failed to adequately establish or identify the basis of its gross and willful ignorance of the claim, and failed to provide the Insured with qualified representatives to ensure the claim was initially adjusted, evaluated, and paid properly. Therefore, to cure the defects outlined in this civil remedy notice, Slide must (1) create and implement adequate guidelines for proper investigation and evaluation of claims; (2) create and implement adequate guidelines for investigation and evaluation as to claims handling and for the training and supervision of employees which will avoid future statutory violations as set forth above; (3) act fairly and honestly towards the Insured, with due regard for the insureds’ interests as the Insurer attempts to settle the claim; (4) tender all insurance monies due and owing for the claim submitted totaling $277,811.11; (5) ensure that payment made would be adequate to place the Insured back to his pre-loss condition, minus all appropriately applicable deductibles; (6) pay any and all interest owed and (7) reimburse the Insured’s attorney’s fees and costs, since the Insured was forced to hire legal counsel in order to receive adequate payment. Should the Insurer fail to comply with the demands set forth in this civil remedy notice, the Insurer must prepare to pay the full cost of its failure to rightfully indemnify the Insured, including all future damages that come about as a result of the Insurer’s failure to comply with the demands set forth in this civil remedy notice.

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