Filing Number: 803931
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| Filing Accepted: 1/28/2025 |
| Last/Business Name
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| Street Address
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906 N. LAKE MINNEOLA DR. |
| City, State Zip
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MINNEOLA,
FL
34715
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| Email Address
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WITHHELD |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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RUBIN |
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First Name |
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BRETT |
| Policy # * |
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AGD10608679 |
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Claim #* |
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CDP-00185097 |
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Attorney is Applicable
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| Last Name* |
ZURITA
First Name *
PATRICK
Initial
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| Street Address* |
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924 DELANEY AVENUE |
| City, State Zip* |
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ORLANDO
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FLORIDA
32806
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| Email Address * |
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SERVICE@DGPALAW.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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AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA
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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 12841 |
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| Name of individual responsible for violation (if any):*
UNKNOWN
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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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Claim Denial
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Unfair Trade Practice
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Unsatisfactory Settlement Offer
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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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| 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)(b) |
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Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
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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)(g) |
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Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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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.
Please see page 5 from the DP 00 01 07 88 policy form, in the section titled GENERAL EXCLUSIONS.
We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss.
…
Please see pages 5 and 6 from the AIIC 01 DP1 SP 04 23 policy form, in the section titled GENERAL EXCLUSIONS:
The following Exclusions are added:
9. Hurricane Loss to:
d. Any structure not attached to the main residence unless constructed with the same or substantially the same materials as that of the main residence.
Please see page 5 from the DP 00 01 07 88 policy form, in the section titled GENERAL EXCLUSIONS:
We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss.
…
3. (Amended in AIIC 01 DP1 SP 04 23)
Please see page 5 from the AIIC 01 DP1 SP 04 23 policy form, in the section titled GENERAL EXCLUSIONS:
3. Water Damage is replaced by the following:
3. Water Damage, meaning:
a. Flood, surface water, waves, tidal waves, tsunami, tides, tidal water, storm surge, overflow of any body of water, or spray from any of these, whether or not driven by wind, including storm surge;
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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.
On or about October 10, 2024, Brett Rubin (hereinafter referred to the “Mr. Rubin”) sustained storm damage to his home and promptly reported it to their insurance company, American Integrity Insurance Company of Florida (hereinafter referred to as “Insurer”). Specifically, the roof, paver, driveway, tree, water, and dock were damaged.
The Insurer responded to the claim and inspected the damages. During the inspection, the Insurer’s representative found covered damages to the roof, driveway, shed, and pavers, but wrote an estimate severely below the obvious damages. The estimate was so low it did not eclipse the deductible and no payment was issued. This denial is despite the obvious evidence the damage exceeds the policy deductible.
On January 14, 2025, Mr. Rubin challenged the coverage decision and provided the Insurer with his estimate of covered damages. Instead of re-inspecting the loss or accepting coverage, the insurer simply provided no response to Mr. Rubin’s dispute. The lack of response is the functional equivalent of a denial pursuant to Florida Law.
It is clear that the carrier is not treating the Insureds with good faith claims conduct by failing to pay a claim clearly owed and not adjusting the claim and evaluating the loss properly. They have further failed to promptly and fairly provide full and prompt indemnity to Mr. Rubin. If any additional information was necessary from Mr. Rubin, then the Insurer has failed to promptly notify Mr. Rubin of any information necessary for further processing of the claim, which further exhibits their failure to implement proper standards for the adjustment and investigation of claims by its adjusters. This Insurer is placing the company’s interests before Mr. Rubin’s interests when a reasonable carrier in a similar position would have provided full coverage. In particular, it is a business practice of the Insurer to deny storm damage claims with their initial claim adjustment with the intent of effecting settlement of such claims on less favorable terms than those provided by the policy.
All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for Mr. Rubin’s rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Acknowledge coverage for the damages provided in Mr. Rubin’s estimate and 2.) Acknowledge Mr. Rubin’s entitlement to statutory interest on the amount of unpaid damages from the date the loss was reported to the date payment is finally made.
A copy of this form has been submitted to the FDFS and has been printed out and mailed to the following parties providing them notice of the filing of the Civil Remedy Notice:
AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA
5426 BAY CENTER DRIVE, SUITE 600, TAMPA FL 33609
Certified Return Receipt # 9589 0710 5270 1579 4213 16
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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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