Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 805932

Filing Accepted: 2/10/2025

Print Filing

Complainant

Last/Business Name *

PERKINS

First Name

DIANE

Street Address *

1049 SAINT ANNE SHRINE RD

City, State Zip *

LAKE WALES, FL 33898

Email Address *

DLPERKINS9094@GMAIL.COM

Complainant Type: *

Insured

Last/Business Name*		PERKINS		First Name		DIANE
Policy # *		020640624/91A		Claim #*		20640624-004

Attorney

Attorney is Applicable

Last Name*	STAGGS First Name * KYLE Initial B
Street Address*		1715 W. CLEVELAND STREET
City, State Zip*		TAMPA , FLORIDA 33606
Email Address *		COURTDOCS@WILLIAMSPA.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		UNITED SERVICES AUTOMOBILE ASSOCIATION
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 25941

Name of individual responsible for violation (if any):* ALL ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY UNITED SERVICES AUTOMOBILE ASSOCIATION IN THIS CLAIM.
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Denial
	Claim Delay
	Unsatisfactory Settlement Offer
	Unfair Trade Practice
	Other : Failure to Properly Investigate Claim and with Due Regard to Insured's Interest
	Other : Failure to Pay the Claim in Full

* 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.
	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.

RELEVANT POLICY LANGUAGE The specific policy language that is believed to be relevant to the violations includes, but is not limited to, the following: See Subject Policy issued by USAA, Policy No.: 020640624/91A loss payment provision, policy definitions, and policy exclusions section.

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

This complaint is made on behalf of Diane & Charles Perkins ("Insured") and against United Services Automobile Association ("USAA" or "Insurer"). In consideration of the premium paid to it by the Insured, the Insurer issued to the Insured an insurance policy, Policy No.: 020640624/91A (the "Policy"). On or about September 28, 2022, while the Policy was in full force and effect, the Insured suffered a hurricane loss to the property located at 1049 Saint Anne Shrine Rd, Lake Wales, Florida, 33898 ("Subject Property"). The Insurer has engaged in a pattern of bad faith claim handling practices designed to minimize its payout obligations and delay rightful compensation to the Insured. Initially, USAA grossly underestimated the damages to the Subject Property by issuing an estimate of $17,029.86, of which only $3,009.86 would have been payable after accounting for the deductible of $14,020.00. This initial estimate was woefully inadequate given the extent of damage sustained by the Insured. Following subsequent inspections, USAA issued additional payments totaling approximately $14,000.00, but these payments still fall egregiously short of what is necessary to fully indemnify the Insured under the terms of the Policy. Despite repeated requests from the Insured's public adjuster, Ask An Adjuster, for a full break-down of all payments in the form of payment letters and supporting estimates, USAA has failed to provide this critical documentation. This lack of transparency is a clear violation of USAA’s duty to communicate and act in good faith towards its policyholders. Furthermore, USAA issued a payment for "mold" damages directly to the Insured without providing a payment letter, failing to notify Ask An Adjuster, and improperly excluding Ask An Adjuster as a payee on the check. Given that Ask An Adjuster submitted a mold remediation estimate of $12,852.13, it remains unclear what portion of this estimate USAA has even acknowledged, as they have deliberately withheld key documentation. USAA has engaged in egregious bad faith tactics by persistently undervaluing the claim. Ask An Adjuster's estimate for the necessary repairs stands at $239,164.79—an amount that USAA has unreasonably and unjustifiably refused to pay. By failing to conduct a thorough and unbiased investigation and instead issuing arbitrarily low estimates, USAA has knowingly and willfully acted against the interests of its policyholders. The insurer has denied or underpaid this claim without justification, failed to settle the claim in good faith, issued payments without a clear coverage determination, and engaged in intentional lowballing of damages. The Insurer's failure to properly and fairly evaluate the claim has caused significant financial hardship to the Insured, who has been forced to expend additional resources in an attempt to re-cover the insurance proceeds rightfully owed under the Policy. The Insurer’s repeated refusal to acknowledge the full extent of the damages and failure to issue timely and adequate payments has resulted in undue delays and further exacerbated the Insured's losses. These tactics violate Florida’s statutory requirements for good faith claims handling and demonstrate a clear disregard for the contractual obligations owed to the Insured. To cure these defects and rectify its bad faith conduct, USAA must immediately pay the full amount of the claim in accordance with the Policy terms and Florida law. Until such payment is made, USAA remains in violation of its obligations to act fairly and in good faith towards its policyholders.

Comments

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