Filing Number: 802829
|
| Filing Accepted: 1/22/2025 |
| Last/Business Name
*
|
|
|
NARAYANASAMY
|
|
First Name |
|
NARENDREN AND AVA |
|
| Street Address
*
|
|
1420 MARBLE CREST WAY |
| City, State Zip
*
|
|
WINTER GARDEN,
FL
34787
|
| Email Address
*
|
|
FIRM@FLORIDAINSLAW.COM |
| Complainant Type:
*
|
|
Insured |
|
| Last/Business Name* |
|
NARAYANASAMY |
|
First Name |
|
NARENDREN AND AVA |
| Policy # * |
|
7709HR042245 |
|
Claim #* |
|
080107-GQ |
|
Attorney is Applicable
|
| Last Name* |
CIOCCHETTI
First Name *
MICHAEL
Initial
|
| Street Address* |
|
125 NORTH RIDGEWOOD AVENUE, SUITE 100 |
| City, State Zip* |
|
DAYTONA BEACH
,
FLORIDA
32114
|
| Email Address * |
|
FIRM@FLORIDAINSLAW.COM |
|
|
| Insurer Type
*
|
|
Authorized Insurer
Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
NATIONWIDE PROPERTY AND CASUALTY INSURANCE COMPANY
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code 37877 |
|
|
| Name of individual responsible for violation (if any):*
LEWIS SESSOMS
|
| Type of Insurance
*
Residential Property & Casualty
|
|
|
| Reason for Notice
*
|
|
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.
|
| 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)(b) |
|
Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
|
|
*
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 Certified Policy has been requested by the Public Adjuster on behalf of the insured. The carrier has failed to provide the policy. We anticipate the “Coverage A-Dwelling” and “Perils Insured Against” sections being relevant to this claim.
|
| |
*
Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
This complaint is made on behalf of the insureds, NARENDREN NARAYANASAMY and AVA NARAYANASAMY. Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy pursuant to Florida Statute §624.155.
In consideration of the premium paid to it, the carrier, NATIONWIDE PROPERTY & CASUALTY INSURANCE COMPANY (“Carrier”), issued a policy, Policy No. 7709HR042245, to NARENDREN NARAYANASAMY and AVA NARAYANASAMY (“Insureds”) where the policy provided coverage for all losses, except those losses which were expressly excluded, for the property located at 1420 Marble Crest Way, Winter Garden, FL 34787 (“Insured Property”). The policy was in full force and effect at the time the damage occurred from Hurricane Milton, and the ensuing damages as a direct result thereof, to the Insured Property, on or about October 10, 2024.
Thereafter, the Carrier was timely notified of the Loss. In particular, the Carrier was put on notice of covered direct damages and ensuing damages and of the request that a claim be opened pursuant to the terms and conditions of the Policy. Claim number 080107-GQ (“Claim”) was assigned to the Loss.
The Carrier sent an adjuster to the Insured Property to perform an inspection. The Carrier performed a cursory inspection of the Insured Property and failed to retain unbiased experts necessary to scope the entirety of the Loss and covered repairs necessary to restore the Insured Property to its pre-loss condition. This was done deliberately by the Carrier to undervalue portions of the claim. The Carrier knows its aforementioned investigation is insufficient and that it has failed to provide proper payment to restore the property to its pre-loss condition. This inspection placed The Carrier on notice of the severity of the Loss.
Thereafter, the insureds sought the assistance of a public adjuster who ensured the proper estimating of the loss and compliance with all Policy conditions. The public adjuster submitted a comprehensive estimate to the Carrier for the full scope of damages to the Insured Property. In addition, a Sworn Statement and Proof of Loss (“SPOL”) was provided, on or about November 29, 2024. The Carrier disregarded this comprehensive estimate and SPOL and, instead, underpaid the Claim. The Carrier has refused to reassess its payment of benefits and the basis of the payment and has refused to properly adjust and settle the Claim.
The Carrier violated the provisions of Florida Statute §624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim when, under all circumstances, it could and should have done so had it acted fairly and honestly toward its insured with a due regard for their interest. When the Carrier was confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier chose to underpay the Insured’s valid Claim for extensive damages that exceed the amount paid.
The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(2) by materially misrepresenting to the Insured that Policy coverage was unavailable for the Insureds’ Claim and Loss to the Insured Property. This misrepresentation was made in an attempt to underpay the Insureds’ Claim and escape without paying for the full extent of substantial damage.
The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. When confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier apparently had no system or standards prepared or implemented which would allow it to evaluate the Claim as submitted by its Insureds.
The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or insurance policy provisions relating to the coverage at issue. This has been discussed fully hereinabove.
The Carrier can cure these violations by payment, within 60 days of the date hereof, of all funds contractual owed to the Insured under the terms and conditions of the Policy.
|
|
*
|
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
|