Civil Remedy Notice of Insurer Violations
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Filing Number:     805143
Filing Accepted:  2/4/2025
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Complainant
Last/Business Name *  
WITHERS   First Name   PATSY
Street Address * 604 CIMAROSA COURT
City, State Zip * OCOEE, FL 34761
Email Address * INTAKE2@THEKRFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   WITHERS   First Name   PATSY
Policy # * AGH0137935 Claim #* CHO-00176614
Attorney
Attorney is Applicable
Last Name* KADIR First Name * ALI Initial A.
Street Address* 986 DOUGLAS AVE, STE. 102
City, State Zip* ALTAMONTE SPRINGS , FL 32714
Email Address * INTAKE2@THEKRFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA
NAIC Company Code 12841
 
Name of individual responsible for violation (if any):* SEAN T. WOODARD, AMANDA L. SLATER, JASON LOCKRIDGE, STATEWIDE CLAIMS SERVICES INC., AND ALL AMERICAN INTEGRITY CLAIMS ADJUSTERS, EMPLOYEES, REPRESENTATIVES, AGENTS, VENDORS, AND/OR ENGINEERS WHO HANDLED THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Misrepresentation
* 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)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
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)(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)(4) 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).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

“We insure for sudden and accidental direct loss to property described in COVERAGE A -Dwelling and COVERAGE B - Other Structures only if that loss is a physical loss to covered property.” American Integrity possesses a complete copy of the subject insurance policy. Ms. Withers is not in possession of a complete copy of the subject policy and is requesting a copy from American Integrity. Thus, this CRN cannot cite subject policy language verbatim due to such. Notwithstanding, the subject policy is an all-risks insurance policy and the applicable policy language is the provision regarding coverage of all risks for the dwelling (Language such as “We insure against direct physical loss to property…”, “We insure against risk of direct loss to property…”, among other similar policy language etc. is typically used.) and provisions regarding exclusions or limitations to this all-risks provision.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Patsy Withers is a homeowner insured with an all-risks policy issued by American Integrity Insurance Company of Florida (“American Integrity”). The insured property or home is located at 604 Cimarosa Court, Ocoee, Florida 34761. In September of 2023, a wind and rainstorm caused extensive damage to Ms. Withers’ home. Ms. Withers timely reported an insurance claim for this damage to American Integrity and fully cooperated with all requests for inspections. She provided all requested documentation, if any, and complied with all post loss policy conditions. After reporting the claim, American Integrity retained an unqualified and biased field adjuster who has a financial relationship with American Integrity. This field adjuster inspected Ms. Withers’ home in an apparent effort to minimize American Integrity’s losses instead of adjusting the claim in good faith in due regard for Ms. Withers’ interests. Despite American Integrity finding coverage for her claim, it significantly undervalued Ms. Withers’ claim at only $705.56. Because this amount is less than the subject policy’s deductible, American Integrity did not issue any payment to Ms. Withers. Due to such, Ms. Withers has not been able to permanently repair her home. Indeed, an estimate for repair of all damages with respect to her claim was prepared on behalf of Ms. Withers for $68,354.20 and was submitted to American Integrity; well above the amount from American Integrity. Based on these facts, it is clear American Integrity unreasonably denied full coverage for Ms. Withers’ claim in bad faith through its extremely low and unreasonable undervaluation of her claim. Had American Integrity conducted a reasonable investigation based upon the available information, it would have been evident that affording greater coverage and issuing a substantially higher payment is warranted. Instead, it failed to adopt and implement standards for proper claim investigation as well as misrepresented pertinent policy provisions/facts rather than act fairly and/or honestly with Ms. Withers in due regard for her interests. American Integrity also delayed the claim and failed to timely respond to communications. This has become a common business practice of American Integrity. 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 based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. American Integrity has breached this duty by refusing to properly and timely adjust the loss. As a result, Ms. Withers will have no choice but to retain the undersigned counsel to file a lawsuit against American Integrity. American Integrity has more than enough information and is still refusing to accept coverage for this claim. This continued and repeated reckless claim delay and denial of coverage will result in a significant punitive damage award if a bad faith lawsuit is filed. American Integrity can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Ms. Withers based on her $68,354.20 estimate.
Comments
User Id Date Added Comment
swozniak@aii.com 02-20-2025 February 20, 2025 Via Electronic Submission Florida Department of Financial Services Consumer Assistance Civil Remedy Section Larson Building 200 E. Gaines Street Tallahassee, FL 32399-0322 Ali A. Kadir, Esq. 986 Douglas Avenue Suite 102 Altamonte Springs, Florida 32714 Intake2@TheKRFirm.com Re: DFS File No: 805143 Complainant: Patsy Withers Insured: Patsy Withers Policy No: AGH0137935 Insurer: American Integrity Insurance Company of Florida Claim No: CHO-00176614 To Whom It May Concern: We are in receipt of the Civil Remedy Notice (“CRN”) filed by Ali A. Kadir, Esq. on behalf of the above referenced Complainant and matter. The Florida Department of Financial Services (“DFS”) accepted the CRN on February 4, 2025 and assigned it DFS File No. of 805143. While American Integrity asserts that the subject CRN is legally insufficient and non-compliant with Florida law, American Integrity, without waiving any arguments regarding same, contends that it has at all times performed its obligations under the insurance policy in a prompt and diligent manner with due regard for the interest of its Insured, Patsy Withers. The CRN contains a list of purported violations which are alleged to have been committed by American Integrity. In fact, none of the listed violations/allegations have occurred and/or are irrelevant to the alleged violations and American Integrity categorically denies any violations of §624.155 and §626.9541, Fla. Stat., as well as any and all other statutes/regulations/codes/rules contained in the CRN. In addition, American Integrity denies any and all allegations of any kind and/or any inferences therefrom referenced and/or contained in the CRN. American Integrity believes this response adequately addresses the allegations and violations contained within the CRN. Sincerely, Michael S. Sperounes Michael S. Sperounes, Esq. Senior Vice President of Litigation American Integrity Insurance Group cc: Ali A. Kadir, Esq. via email at: Intake2@TheKRFirm.com CRN Response If this document contains an excerpt from an American Integrity Insurance Policy (“the Policy”) it is provided here for informational purposes only. This excerpt is not the official version of the Policy. The official version of the Policy is the policy issued to the Insureds on the policy effective date. In the event there is inconsistency between this document and the Policy, the Policy shall serve as the official version. Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. F.S. 817.234
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