Filing Number: 802856
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| Filing Accepted: 1/22/2025 |
| Last/Business Name
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FFC PROPERTY GROUP, LLC
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First Name |
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| Street Address
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2938 SANIBEL BLVD., ST. |
| City, State Zip
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JAMES CITY,
FL
33956
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| Email Address
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WITHHELD |
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Insured |
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| Last/Business Name* |
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FFC PROPERTY GROUP, LLC |
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First Name |
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| Policy # * |
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7166990679 |
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Claim #* |
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05000001172 |
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Attorney is Applicable
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| Last Name* |
WALLACE
First Name *
BLAKE
Initial
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| Street Address* |
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8635 W. HILLSBOROUGH AVE., STE. 401 |
| City, State Zip* |
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TAMPA
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FLORIDA
33615
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| Email Address * |
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BLAKE@KLINGLAW.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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FIRST PROTECTIVE 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 10897 |
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| Name of individual responsible for violation (if any):*
RYAN ALLUM & ALAN LEVESQUE
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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 Denial
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Claim Delay
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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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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)(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)(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)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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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.
The specific policy provisions the carrier violated are the loss payment provision, the loss settlement provision, and the coverage provisions. Specifically, the loss payment provision states “we will adjust all losses with you.” Yet, the carrier did not consult the homeowner in deciding who would investigate the cause or amount of damages, and what the ultimate payment should be. The other provisions are pasted on the pages following the signature block.
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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.
January 22, 2025
Sent Via E-Portal
First Protective Insurance Company d/b/a Frontline Insurance Company
RE: Insured : FFC PROPERTY GROUP, LLC (hereinafter, “Insured”)
Policy # : 7166990679
Claim # : 05000001172
Property Address : 2938 Sanibel Blvd., St. James City, FL 33956-2233
Persons most knowledgeable of facts giving rise to the Violations: Ryan Allum, Alan Levesque
Dear FRONTLINE INSURANCE COMPANY:
Please find enclosed the civil remedy notice filed for the above referenced claim. This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statute §624.155 As discussed in greater detail in the notice, the carrier has not attempted in good faith to settle the claimant’s claim when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its claimant and with due regard for its interests. The carrier has done everything possible to delay the claim and refuses to provide any sort of status of the claim. Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that burden upon the insured. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005) (“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insured…”).
The carrier was put on notice of the insured’s Hurricane Ian claim on October 3, 2022. Since the commencement of the claim the carrier has failed to timely communicate with the insured. It is obvious that the carrier is not attempting to pay for the clearly covered damages owed under the policy.
The carrier assigned Ryan Allum, who is neither an engineer nor a registered contractor, to inspect the loss and write an estimate of the damages to the property. On February 8, 2023, over one hundred and twenty-eight (128) days later the carrier issued its estimate stating the unilateral determinations that the damages were covered would total to the amount of $433,664.71 for full repairs to the property prior to the application of the deductible and recoverable depreciation.
In reaching those conclusions, Frontline failed to adopt and implement standards for the proper investigation of claims. There was no explanation whatsoever as to how Frontline determined the valuation of the damage caused by the covered peril. Moreover, the carrier’s failure to assign a qualified and experienced engineer further violates F.S. §626.9541(1)(i)(3)(a) and F.S. §626.9541(1)(i)(3)(d).
Additionally, the carrier failed to describe how it arrived at the amount it withheld for depreciation. The policy does not explain how depreciation or actual cash value is calculated, and the carrier did not explain the facts or applicable law in relation to the payment made. This is a violation of F.S. §626.9541(1)(i)(3)(f).
Florida Statute 627.70131(3)(e) requires the carrier to provide an estimate within 7 days after the estimate is generated by the insurer’s adjuster. However, it is clear that Frontline took from October 30, 2022, when the property was inspected, till February 8, 2023, to produce the estimate that was generated from its inspection. This is over one hundred and one (101) days from when the inspection took place. The insurer must send the policyholder a copy of any detailed estimate of the amount of the loss within 7 days after the estimate is generated by an insurer’s adjuster. The carrier’s failure to produce the estimate generated by Ryan Allum in a timely manner is in further violation of F.S. §626.9541(1)(i)(3)(c) as the carrier failed to acknowledge and act promptly upon communications with respect to the claim.
The carrier’s decision came only after the delay that it had caused and it was solely responsible for. Pursuant to F.S. § 627.70131(7)(a), within 60 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer. The carrier’s failure to come to a timely decision was in violation of F.S. §626.9541(1)(i)(4) as the carrier has failed 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, 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 F.S. 627.70131(5). Furthermore, this undue continual delay and failure to inspect is in violation of F.S. §624.155(1)(b)(1), as the delay was in direct disregard of the insured’s interests and F.S. §624.155(1)(b)(3), as the carrier has failed to promptly settle the claim.
The insured has been compelled to obtain an independently adjusted estimates, invoices, and other documentation totaling in the amount of $531,000.00 that would be needed to repair the property back to its pre-loss condition. The insured has complied with all the carrier’s requests to date. The carrier has still refused to pay the fully covered amount owed under the policy, instead electing to stand by its unilaterally determined deficient valuation of the loss. This is in violation of F.S. 624.155(1)(b)(1) and 624.155(1)(b)(3) as the carrier is clearly placing the company’s interests before the claimant’s interests and not attempting in good faith to settle claims.
It is clear that the carrier is not treating the claimant with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the claimant; failing to implement proper standards for the adjustment and investigation of claims and placing the company’s interests before the claimant’s interests; not training, supervising or managing adjusters properly so that prompt and full payments are made; refusing to pay the full amount owed to the insured despite the fact that the damages are covered under the policy; looking for ways to delay full recovery or any recovery to the insured; and refusing to provide coverage for the claimant’s loss in a timely manner. The Carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(d), 627.4137(1), and Fla. Stat. §627.70131.
The actions taken by Frontline in the handling/adjustment of the insured’s claim were willful, wanton, malicious, and in reckless disregard for the rights of any insureds and occur with such frequency as to indicate a general business practice, and further are in violation of Florida Statutes §624.155 and F.S. §626.954. Indeed, when performing a search on the Florida Department of Financial Services website’s Civil Remedy Notice of Insurer Violation page the results of searches of violations of the statutes referenced herein by the carrier returned the following results thereby indicating that the number of times they occur rise to the level of a general business practice, and warrant punitive damages:
§624.155(1)(b)(1) = 5,573
§624.155(1)(b)(3) = 3,809
§626.9541(1)(i)(3)(a) = 5,393
§626.9541(1)(i)(3)(c) = 3,818
§626.9541(1)(i)(3)(d) = 2,879
§626.9541(1)(i)(3)(f) = 2,986
§626.9541(1)(i)(4) = 732
Based upon the above-referenced acts and omissions, the carrier has breached the insurance contract by failing to pay the amount due to the insured, by denying coverage which existed under the insurance contract with the insured in the instant dispute, by failing to adjust the loss with the insureds, and by failing to perform and adequate investigation. These are violations and breaches of the policy language cited above.
Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1) Pay the complete covered loss in the amount of $531,000.00 less any applicable policy deductible and prior payment(s); and 2) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been emailed to the carrier.
The specific policy provisions the carrier violated are the loss payment provision, the loss settlement provision, and the coverage provisions. Specifically, the loss payment provision states “we will adjust all losses with you.” Yet, the carrier did not consult the homeowner in deciding who would investigate the cause or amount of damages, and what the ultimate payment should be. The other provisions are pasted on the pages following the signature block.
If you have any questions or concerns, please send all correspondence via email to Blake@klinglaw.com and Jorlyn@KlingLaw.com to ensure a prompt response. We ask that all correspondence be done via email rather than regular mail. Should you need to send something regular mail, please advise us prior to sending same via the emails above.
Sincerely,
Blake M. Wallace, Esq.
Blake M. Wallace
Attorney at Law
Enclosed: Civil Remedy Filing
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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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