Civil Remedy Notice of Insurer Violations
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Filing Number:     805815
Filing Accepted:  2/7/2025
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Complainant
Last/Business Name *  
JACKSON   First Name   ROBERT AND ABAGAIL
Street Address * 9901 SWEETLEAF STREET
City, State Zip * ORLANDO, FL 32827
Email Address * JACKSONSHOUSE22@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   JACKSON   First Name   ROBERT AND ABAGAIL
Policy # * MN-000022581-01 Claim #* HO0522396851
Attorney
Attorney is Applicable
Last Name* KELLY First Name * JOHN Initial M
Street Address* 300 N. RONALD REAGAN BLVD.# 316
City, State Zip* LONGWOOD , FL 32750
Email Address * JMKELLY@PLGFL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   MONARCH NATIONAL INSURANCE COMPANY
NAIC Company Code 15715
 
Name of individual responsible for violation (if any):* FIELD ADJUSTER, DESK ADJUSTER
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unsatisfactory Settlement Offer
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)(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)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Entire Monarch Policy
 
* 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 January 31, 2022, Robert and Abagail Jackson (the “Insureds"), sustained a covered direct physical loss to Insured's property located at 9901 Sweetleaf Street, Orlando, Florida 32827 due to a slab leak (the “Loss”). Insured promptly reported the loss thereafter to their carrier Monarch National ("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy # MN-000022581-01 which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect on the date of loss. The Insured promptly notified Insurer of the loss, who then assigned the loss claim # HO0522396851 (the “Claim”). After reporting the claim to Monarch the loss was apparently transferred by Monarch to FedNat Florida for adjustment without legal authority and without notice to or consent from the Insureds. FedNat Florida and Monarch National are both subsidiaries of FedNat Holding Company. At the time of the Loss and apparent transfer of the Claim, FedNat Florida was in financial distress. During the adjustment of the loss, FedNat Florida was restructured and ultimately went into receivership while the Claim was still open. The Insureds were fraudulently misled that the Claim had been transferred to FIGA and no further payment was forthcoming. This fraudulent action prevented the Insureds from being fully indemnified for the loss. The Jackson’s made repeated inquiries about their claim had been transferred to FedNat Florida when their policy was with Monarch and were repeatedly advised that their coverage had always been with FedNat. These material misrepresentations violated Fla. Stat. 626.9541(1)(i)(2): A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy. After reporting the claim to Monarch, an adjuster from FedNat Florida Insurance Company was assigned the loss and sent to the Jackson’s Property to inspect the loss. Monarch never acknowledged coverage. Accordingly, Monarch violated Fla. Stat. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims, and Fla. Stat. 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. To date, FedNat has made approximately $67,000 in payments. However the insurer has not made any payments to the Insureds on this claim even after numerous attempts by the Insured to provide documentation of additional damages and compensation owed. Insured had no choice but to retain legal representation on or about March 30, 2023, as the Insurer refused to pay the full amount due and owed to its Insured. The only purpose for Insurer's refusal to negotiate the claim is to increase profits and harm their insured. This is either done intentionally as a pattern and practice of Insurer to deny coverage and harm their insureds, or Insurer has failed to properly train and supervise its adjusters to the harm and detriment of their insureds. This pattern and practice is done for only one reason, which again, is to maximize profits and harm their insureds. Insurer has violated the following statutory provisions: 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)(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)(i): Unfair claim settlement practices, and any other applicable statutes to the factual allegations included herein. To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $172,414.40 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property. The payment shall be tendered to the Insured’s attorneys, Property Loss Group at 300 N. Ronald Reagan Blvd., Suite 316, Longwood, Florida 32750.
Comments
User Id Date Added Comment
tacham@hpmanaging.com 04-08-2025 April 8, 2025 Via E-mail & Posting on DFS Website John M. Kelly, Esq. 300 N. Ronald Regan Blvd. #316 Longwood, FL 32750 jmkelly@plgfl.com RE: Complainant(s): Robert and Abagail Jackson Insured(s): Robert and Abagail Jackson Claim No: HO0522396851 Policy No: MN-000022581-01 DFS Filing Number: 805815 Acceptance Date: February 7, 2025 Insurer: Monarch National Insurance Company To Whom it May Concern: Please allow this correspondence to serve as Monarch National Insurance Company’s (“Monarch”) official response to the Civil Remedy Notice of Insurer Violations (“Notice”). Monarch maintains that it has not been in any violation of the law and that the Notice is defective on its face and fails to comply with the specificity requirements under Florida Statute 624.155. As such, Monarch objects to the Department’s acceptance of the above-referenced Notice. Monarch has acted in good faith and with due regard for the insureds’ interests, and denies each and every allegation contained in the Notice. Monarch denies any wrongdoing in the adjustment and handling of the above-referenced claim, and denies any and all allegations that it committed any acts or violated any Florida statutes or law. Monarch has acted in good faith and in accordance with the terms and provisions of the applicable policy of insurance as well as with the law. Please note that nothing herein should be deemed as a waiver by Monarch. Monarch hereby expressly reserves all rights without exception or limitation. If you require additional information, please contact me. Sincerely, /s/ Tyler Acham, Esq. Tyler Acham In-House Counsel Monarch National Insurance Company
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