Civil Remedy Notice of Insurer Violations
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Filing Number:     802843
Filing Accepted:  1/22/2025
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Complainant
Last/Business Name *  
HAUFF   First Name   PAMELA
Street Address * 56 FOX VALLEY DR
City, State Zip * ORANGE PARK, FL 32073
Email Address * PPAMTHER@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   HAUFF   First Name   PAMELA
Policy # * W017155578 Claim #* 3300532831
Attorney
Attorney is Applicable
Last Name* DRAKE First Name * VICTORIA Initial
Street Address* 2300 MAITLAND CENTER PKWY STE. 106
City, State Zip* MAITLAND , FL 32751
Email Address * VDRAKE@SERRANOCAGAN.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   TOWER HILL INSURANCE EXCHANGE
NAIC Company Code 17179
 
Name of individual responsible for violation (if any):* N/A
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)(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)(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.
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)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* 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 – PROPERTY COVERAGE A. Coverage A – Dwelling (Entire Section) B. Coverage B – Other Structures (Entire Section) C. Coverage C – Personal Property (Entire Section) D. Coverage D – Loss of Use (Entire Section).
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about 10/07/2024, PAMELA HAUFF ("Insured"), sustained a covered direct physical loss to Insured's property due to a 10/07/2024. Insured reported the loss thereafter to TOWER HILL INSURANCE EXCHANGE ("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy # W017155578 which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect on the date of loss. The Insured promptly notified Insurer of the loss, who then assigned the loss claim # 3300532831. Insurer was fully afforded any and all opportunity to inspect the loss and document the loss. To date, Insurer has paid $0 to Insured on this claim even after numerous attempts by the Insured to provide documentation of additional damages and compensation owed. Insured had no choice but to retain legal representation on or about 12/18/2024, as the Insurer refused to pay the full amount due and owed to its Insured. Insurer has continually failed to negotiate this claim with Insured’s attorney and/or failed to provide a satisfactory settlement offer to resolve the subject claim. This has severely harmed the Insured's ability to remedy their losses and continue with repairs to the property. The only purpose for Insurer's refusal to negotiate the claim is to increase profits and harm their insured. This is either done intentionally as a pattern and practice of Insurer to deny coverage and harm their insureds, or Insurer has failed to properly train and supervise its adjusters to the harm and detriment of their insureds. This pattern and practice is done for only one reason, which again, is to maximize profits and harm their insureds. Insurer has violated the following statutory provisions: 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)(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)(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; 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)(i)(3)(i): Unfair claim settlement practices, and any other applicable statutes to the factual allegations included herein. To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $45,687.00 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property. The payment shall be tendered to the Insured’s attorneys, Serrano Cagan & Cagan at 2300 Maitland Center Parkway, Suite 106, Maitland, Florida 32751.
Comments
User Id Date Added Comment
nweber@thig.com 03-14-2025 March 14, 2025 Department of Financial Services Insurance Consumer Assistance Civil Remedy Section Larson Building 200 Gaines Street Tallahassee, FL 32399-0322 RE: Company: Tower Hill Insurance Exchange Company Insured: Pamela Hauff Claim Number: 3300532831 Policy Number: W017155578 Date of Loss: 10/07/2024 DFS File Number: 802843 Acceptance Date: 01/22/2025 Dear Florida Department of Financial Services: Tower Hill Insurance Exchange Company (hereinafter “Tower Hill”) is in receipt of the Civil Remedy Notice of Insurer Violation (hereinafter the “CRN”) filed on behalf of our insured, Pamela Hauff. The CRN is identified as filing number 802843. This shall serve as Tower Hill’s response to the CRN. Tower Hill hereby notifies the Florida Department of Financial Services that all allegations and issues raised in the CRN have been completely and fully resolved by agreement of the parties. In compliance with Florida Statute §624.155 (e), Tower Hill states that the circumstances giving rise to the alleged violations have been resolved, and this matter has been fully disposed of by settlement. Pursuant to the terms of the settlement, the parties have agreed to and Pamela Hauff has executed a Release which resolves the claims against Tower Hill, including those claims and allegations which form the basis for the CRN against Tower Hill. Furthermore, under the terms of the settlement agreement, Pamela Hauff has released Tower Hill from all claims for extra-contractual liability or damages. The release has been signed by Pamela Hauff and is intended to fully and finally resolve all claims made by them against Tower Hill. The Release further provides that the negotiations leading to the Release, and all related matters, shall not be construed to be an admission on the part of Tower Hill, or evidencing or indicating in any degree, any admission of the truth or correctness of any claims asserted. Sincerely, Tower Hill Claims Services, LLC claims@thig.com
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.

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DFS-10-363
Rev. 10/14/2008