Filing Number: 804502
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| Filing Accepted: 1/31/2025 |
| Last/Business Name
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CORTINA GROUP LLC, CONCORD TRUST LLC, AND COLONIAL INVESTMENT LLC
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First Name |
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| Street Address
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4520 WEST COLONIAL DRIVE |
| City, State Zip
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ORLANDO,
FL
32808
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| Email Address
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CORTINAGROUPLLC@GMAIL.COM |
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Insured |
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| Last/Business Name* |
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CORTINA GROUP LLC, CONCORD TRUST LLC, AND COLONIAL INVESTMENT LLC |
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First Name |
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| Policy # * |
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AMR-77591 |
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Claim #* |
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CLM-46171 |
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Attorney is Applicable
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| Last Name* |
OLADIPO
First Name *
ABIDEMI
Initial
A.
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| Street Address* |
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15257 AMBERLY DRIVE |
| City, State Zip* |
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TAMPA
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FLORIDA
33647
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| Email Address * |
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AOLADIPO@MSO.LAW |
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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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UNDERWRITERS AT LLOYD'S, LONDON
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NAIC Company Code |
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| Name of individual responsible for violation (if any):*
CERTAIN UNDERWRITERS AT LLOYD’S, LONDON; QBE SPECIALTY INSURANCE COMPANY; SEDGWICK DELEGATED AUTHORITY, NICOLE HAWTHORNE, ABRAHAM HANZE; SDII GLOBAL, LLC, STEFAN L. GREEN, P.E.; ALONG WITH ALL ADJUSTERS, SUPERVISORS, MANAGERS, AND INDIVIDUALS ASSOCI
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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)(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)(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)(e) |
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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.
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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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
BUILDING AND PERSONAL PROPERTY
COVERAGE FORM
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered.
Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations.
The words "we", "us" and "our" refer to the company providing this insurance.
Other words and phrases that appear in quotation marks have special meaning. Refer to Section H.
Definitions.
A. Coverage
We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss.
Covered Property, as used in this Coverage Part, means the type of property described in this section, A.1., and limited in A.2. Property Not Covered, if a Limit Of Insurance is shown in the Declarations for that type of property.
a. Building, meaning the building or structures described in the Declarations, including:
(1) Completed additions;
(2) Fixtures, including outdoor fixtures;
(3) Permanently installed:
(a) Machinery; and
(b) Equipment;
(4) Personal property owned by you that is used to maintain or service the building or structure or its premises, including:
(a) Fire-extinguishing equipment;
(b) Outdoor furniture;
(c) Floor coverings, and
(d) Appliances used for refrigerating, ventilating, cooking, dishwashing or laundering;
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b. Your Business Personal Property consist of the following property located in or on the building or structure described in the Declarations or in the open (or in a vehicle) within 100 feet of the building or structure or within 100 feet of the premises described in the Declarations, whichever distance is greater:
(1) Furniture and fixtures;
(2) Machinery and equipment;
(3) “Stock”;
(4) All other personal property owned by you and used in your business;
(5) Labor, materials or services furnished or arranged by you on personal property of others;
(6) Your use interest as tenant in improvements and betterments. Improvements and betterments are fixtures, alterations, installations or additions:
(a) Made a part of the building or structure you occupy but do not own; and
(b) You acquired or made at your expense but cannot legally remove;
(7) Leased personal property for which you have a contractual responsibility to insure, unless otherwise provided for under Personal Property Of Others.
c. Personal Property Of Others that is:
(1) In your care, custody or control; and
(2) Located in or on the building or structure described in the Declarations or in the open (or in a vehicle) within 100 feet of the building or structure or within 100 feet of the premises described in the Declarations, whichever distance is greater.
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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 January 4, 2022, Certain Underwriters at Lloyd’s, London (“Lloyd’s”) issued policy number AMR-77591 (the “Policy”) to Cortina Group LLC Concord Trust LLC, and Colonial Investment LLC (“Insureds”) for their commercial property located at 4520 West Colonial Drive, Orlando, FL 32808 (“Insured Property”) for the period of January 4, 2022 to January 4, 2023. The Policy establishes a Total Insurable Value of $3,585,000.00, subject to the sublimits and conditions outlined therein.
On September 28, 2022, Hurricane Ian, a catastrophic Category 5 storm, made landfall in Florida, causing widespread devastation to numerous communities, including Maitland. Hurricane Ian’s intense rainfall and relentless winds directly damaged the Insured Property, a two-story commercial structure. The damage was particularly severe on the roof, resulting in significant interior water intrusion. As a consequence, the Insured Property continues to experience water leaks during heavy rainfall, and black stains have become visible on the decking and framing throughout the structure.
In order to restore the Insured Property to its pre-loss condition and mitigate further damage, the Insureds retained Claims Advocate Resolutions Experts, LLC (“C.A.R.E.”) to assist in presenting their claim to Lloyd’s. Through C.A.R.E., the Insureds reported the claim to Lloyd’s on August 30, 2024. Lloyd’s acknowledged the claim on September 10, 2024, designating claim number CLM-46171, and assigned Sedgwick Delegated Authority as the third-party claims administrator. On September 10, 2024, Lloyd’s issued a reservation of rights letter, signed by desk adjuster Nicole Hawthorne, informing the Insureds that desk adjuster Abraham Hanze had been assigned to handle the claim. In the interim, Lloyd’s also appointed SDII Global, LLC to perform an engineering inspection and prepare a report to assist in evaluating the claim and determining coverage. Mr. Hanze conducted his inspection of the Insured Property on September 5, 2024, while Stefan L. Green, P.E., of SDII Global, LLC, performed his engineering inspection on October 7, 2024.
Regrettably, Lloyd’s and its representatives, including Abraham Hanze and Stefan L. Green, either lacked the necessary qualifications to properly assess the damage to the Insured Property or willfully disregarded the full extent of the loss, seemingly to further Lloyd’s financial interests. This was evident in the inadequate denial of coverage letter dated November 4, 2024, signed by Nicole Hawthorne, which failed to fairly account for the full scope, cause, and origin of the damages sustained. Such actions constitute a misrepresentation of material facts or insurance policy provisions relevant to the coverages at issue, in violation of Section 626.9541(1)(i)(3)(b), Florida Statutes.
Lloyd’s denied coverage based on the engineer’s conclusions that the claimed damage resulted from age-related deterioration, deferred maintenance, and foundation movement, thereby excluding Hurricane Ian as a contributing factor. However, this determination is inconsistent with the widespread and well-documented devastation caused by Hurricane Ian in the surrounding area. Moreover, these justifications align with a pattern Lloyd’s has repeatedly employed across Florida to wrongfully deny coverage to its insureds. Regrettably, Lloyd’s and its representatives have established a practice of producing results-driven reports designed to minimize claim payouts and maximize financial gain, at the expense of their insureds. This conduct demonstrates a systemic failure to adopt and implement proper standards for claims investigations, as well as a pattern of denying claims without conducting reasonable investigations based on available evidence, in direct violation of Sections 626.9541(1)(i)(3)(a) and 626.9541(1)(i)(3)(d), Florida Statutes.
As a result, the Insureds were forced to adjust their own claim, a responsibility that lies with Lloyd’s, not them. Through C.A.R.E., the Insureds submitted an itemized estimate of damages, dated November 18, 2024, totaling $250,703.16 in replacement cost value, reflecting the necessary expenses to restore the Insured Property to its pre-loss condition, including current prices of materials, labor, and permits in the area. Unfortunately, despite the Insureds’ repeated requests for assistance and their own efforts to adjust the loss, Lloyd’s has failed to respond or acknowledge this opposing opinion, thus violating 626.9541(1)(i)(3)(c) of the Florida Statutes by neglecting to act promptly on communications regarding claims. Due to Lloyd’s continuous mishandling of the claim and inadequate investigation, the Insureds were left with no choice but to retain legal representation in an effort to present their claim to Lloyd’s. This decision reflects their continued good faith attempt to resolve the matter, even though Lloyd’s had every opportunity, under the circumstances, to act fairly and honestly toward its insured and in due regard for their interests.
In Florida, the work of adjusting insurance claims engages the public trust. Lloyd’s has breached the public’s trust by its adjustment of the Insureds’ claim of loss. Lloyd’s has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. Lloyd’s has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insureds’ claim for damages. Lloyd’s has failed to promptly settle the Insureds’ claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the Insureds’ pleas otherwise, Lloyd’s has continued to refuse to acknowledge its obligation to conduct a proper investigation.
Moreover, Lloyd’s has not attempted in good faith to settle the Insureds’ claim when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for their interests. Lloyd’s has done everything possible to delay and/or deny the claim. Furthermore, Lloyd’s is required to properly investigate and adjust claims and cannot place that burden upon the insureds. 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 insureds…”). Lloyd’s was timely put on notice of the Insureds’ loss and claim for damages. The Insureds have complied with all of Lloyd’s’ requests to date and the carrier has still failed to treat this claim with good-faith. This intentional delay with the claim has led to direct prejudice of the Insureds, who continues to be held hostage unless/until Lloyd’s engages in good faith claims handling. To date, Lloyd’s has still refused to fully pay the amount owed under the Policy. To make matters worse, the Insureds have incurred incredible costs and efforts to adjust their own loss, with detailed and substantiated damages presented to Lloyd’s in the form of a repair estimate evidencing $250,703.16 in Replacement Cost Valuation. Lloyd’s’ stubborn and/or negligent refusal to fully indemnify the Insureds for the covered damages has resulted in a confluence of consequential damages including, but not limited to, excess damages stemming from Lloyd’s’ maladroit adjustment of the claim, the unaffordability of the Insured Property given the loss of utility and the indefinite delay to address the ongoing dispute, additional costs and expenses to adjust its own loss that include retaining a public adjuster and an attorney, among many other otherwise unnecessary consequences but for the negligence and nefarious business practices of Lloyd’s.
It is clear that Lloyd’s is not treating the Insureds 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 Insureds; and ignoring the Insureds’ pleas for assistance; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing Lloyd’s’ interests before the Insureds’ interests; refusing to pay the full amount owed to the Insureds despite the fact that Lloyd’s has been on notice of the damages and looking for ways to delay and/or deny full recovery to the Insureds, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. Lloyd’s’ actions are in violation of Sections 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)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(e), and 626.9541(1)(i)(3)(f) Florida Statutes.
All of the aforementioned are part of what appears to be an ongoing pattern and practice of behavior by Lloyd’s that demonstrates a wanton and reckless disregard for insureds’ 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, Lloyd’s must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of these type of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) Lloyd’s must create and implement adequate guidelines for the proper investigation and evaluation of these type of claims and for the training and supervision of employees with regard to these type of claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other insureds from being treated unfairly and wrongfully; (3) Lloyd’s must pay the Insureds $250,703.16 for all of the damages sustained as a result of the loss, less the applicable deductible, limitations, plus all contractual damages owed, attorney’s fees, costs and interest, under Sections 57.041 and 627.70131(5)(a) Florida Statutes; and (4) Lloyd’s must act fairly and honestly towards its Insureds and with due regard for their interests in attempting to settle its Insureds’ claim.
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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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