Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 804875

Filing Accepted: 2/3/2025

Print Filing

Complainant

Last/Business Name *

MARCHANT

First Name

BRAD

Street Address *

405 85TH AVENUE

City, State Zip *

ST. PETE BEACH, FL 33706

Email Address *

MARCHANT@GRACESLANDING.COM

Complainant Type: *

Insured

Last/Business Name*		MARCHANT		First Name		BRAD
Policy # *		462636		Claim #*		944757

Attorney

Attorney is Applicable

Last Name*	ROSS First Name * VANESSA Initial
Street Address*		2501 S. TAMIAMI TRAIL
City, State Zip*		SARASOTA , FLORIDA 34239
Email Address *		ESERVICE@ROSSLEGALFL.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 12944

Name of individual responsible for violation (if any):* JENNIFER SMITH, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC. INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Unsatisfactory Settlement Offer
	Claim Denial
	Claim Delay
	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.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Dwelling Coverage provisions We cover: 1. The dwelling on the "residence premises" shown in the Declarations, including attached structures and attached wall-to-wall carpeting if damage to the dwelling is caused by a covered loss; 2. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises"; and 3. In-ground swimming pools including related permanently installed equipment such as pumps and filters. Perils Insured Against We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property. Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable: a. 20 days after we receive your proof of loss and reach written agreement with you; or b. 60 days after we receive your proof of loss; and (1) There is an entry of a final judgment; or (2) There is a filing of an appraisal award or a mediation settlement with us. c. Within 60 days after we receive the notice of a property insurance initial, reopened or supplemental claim from you, where we shall pay or deny such claim or portion of such claim, unless there are circumstances beyond our control which reasonably prevent such payment. However, our failure to comply with this subsection shall not form the sole basis for a private cause of action against us.Loss Settlement Covered property losses are settled as follows: a. Property of the following types: (1) Personal property; (2) Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings; and (3) Structures that are not buildings; at actual cash value at the time of loss but not more than the amount required to repair or replace. b. Buildings under Coverage A or B at replacement cost without deduction for depreciation, subject to the following: (1) If, at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more of the full replacement cost of the building immediately before the loss, we will initially pay the actual cash value of the loss, less any applicable deductible. We will then pay any remaining amounts necessary to perform such repairs or replacement as work is performed and expenses are incurred, but not more than the least of the following amounts: (a) The limit of liability under this policy that applies to the building; (b) The replacement cost of that part of the building damaged for like construction and use on the same premises; or (c) The necessary amount to repair or replace the damaged building. In the event of a total loss to the dwelling we will pay the replacement cost without reservation or holdback of any depreciation in value. Subject to the limits of your policy. (2) If, at the time of loss, the amount of insurance in this policy on the damaged building is less than 80% of the full replacement cost of the building immediately before the loss, we will pay the greater of the following amounts, but not more than the limit of liability under this policy that applies to the building: (a) The actual cash value of that part of the building damaged; or (b) That proportion of the cost to repair or replace, after application of deductible and without deduction for depreciation, that part of the building damaged, which the total amount of insurance in this policy on the damaged building bears to 80% of the replacement cost of the building. (3) To determine the amount of insurance required to equal 80% of the full replacement cost of the building immediately before the loss, do not include the value of: (a) Excavations, foundations, piers or any supports which are below the undersurface of the lowest basement floor; (b) Those supports in (a) above which are below the surface of the ground inside the foundation walls, if there is no basement; and (c) Underground flues, pipes, wiring and drains. (4) If the dwelling where loss or damage occurs has been “vacant” for more than 30 consecutive days before the loss or damage, we will: (a) Not pay for any loss or damage caused by any of the following perils, even if they are Perils Insured Against: (i) Vandalism; (ii) Sprinkler leakage caused by or arising out of the freezing of a fire protective sprinkler system, unless you have protected the system against freezing; (iii) Dwelling glass breakage; (iv) Water damage; (v) Theft; or (vi) Attempted theft. (b) Reduce the amount we would otherwise pay for a covered loss by 15%. Dwellings under construction are not considered “vacant”.

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the public trust. Homeowners Choice Property & Casualty Insurance Company, Inc. (“INSURER”) has breached the public’s trust by its adjustment of Brad Marchant (“INSURED”) claim of loss. Homeowners Choice Property & Casualty Insurance Company, Inc.’s mailing address is 3802 Coconut Palm Drive, Tampa, FL 33619. INSURER 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. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages. INSURER has failed to promptly settle the INSURED’S insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED’S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy. This claim involves the INSUREDS’ property located at 405 85th Avenue, St. Pete Beach, FL 33706 which sustained significant damage from wind on or about September 26, 2024. The INSUREDS immediately reported the loss to INSURER and allowed for inspection. The INSUREDS suffered damage to the roof, exterior, and interior of the property. INSURER inspected the property and accepted coverage for the claim, however they estimated the loss to total just $30,545.81. After the INSUREDS’ hurricane deductible is $15,050.00 and recoverable depreciation of $2,870.55 were removed, payment was issued for $10,389.36. The INSUREDS retained Homeowner Claims Help to assist with determining the amount of damage sustained to the property. Homeowner Claims Help prepared an estimate in the amount of $69,544.85. The INSURED also sustained significant loss by water stemming from roof leaks to his book collection in the amount of $3,987.51. The INSURED is owed additional insurance benefits in order to return the property to pre-loss condition. Therefore, demand is hereby made as follows: Estimate $73,532.36 Less Prior Payments $10,389.36 Less Deductible $15,050.00 TOTAL $48,093.00 The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty. The INSURED was, and still is, forced to expend out of pocket monies to submit her insurance claim, e.g., retaining an attorney and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them. INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must: (1) Create and implement adequate guidelines for the proper investigation and evaluation 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) INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees with regard to these 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) INSURER must tender to the INSURED $48,093.00 as set forth above; and, (4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim. Attachments: PA estimate, contents list and proposed complaint

Comments

User Id		Date Added		Comment
Legal@hcpci.com		04-04-2025		This is Homeowners Choice Property & Casualty Insurance Company’s (“HCPCI”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed on behalf of Brad Marchant (“Insured”). HCPCI reviewed this CRN and conducted a thorough review of the subject claim (“claim”) and confirmed it handled the claim properly. Regarding an aspect of the claim, HCPCI issued payment for it on the information available to HCPCI and the circumstances at the time of such payment. Ultimately, HCPCI handled the claim in accordance with the policy and all statutory and regulatory requirements. HCPCI denies each allegation of bad faith and improper conduct in the CRN. At all times, HCPCI acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. Furthermore, the CRN fails to adequately describe the alleged violations and fails to provide sufficient information to have created an opportunity for the alleged violations to be corrected (although no violations exist). Instead of complying with Florida Statutes, Section 624.155, the Insured’s attorney in the CRN contained an inaccurate recitation of the facts, failed to reference specific, relevant insurance policy language; cited irrelevant statutes; failed to offer a valid cure, and relied on inaccurate and conclusory statements. The Insured’s laundry list of inapplicable statutes is insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). The CRN cannot serve as the basis of a bad-faith action against HCPCI. Finally, upon request by the Department of Financial Services, HCPCI will provide to the Department of Financial Services detailed correspondence HCPCI provided to the Insured regarding HCPCI’s obligations for the claim under the insurance contract and the facts of the claim.

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. 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