Civil Remedy Notice of Insurer Violations
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Filing Number:     805934
Filing Accepted:  2/10/2025
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Complainant
Last/Business Name *  
SWEIGERT   First Name   JOHN A. AND SHIRLEY
Street Address * 45 EMERSON DRIVE NW
City, State Zip * PALM BAY, FL 32907
Email Address * STEVEN@PLG.LAWYER
Complainant Type: * Insured
Insured
Last/Business Name*   SWEIGERT   First Name   JOHN A. AND SHIRLEY
Policy # * 55RBB499735 Claim #* Y3Z DP 96535
Attorney
Attorney is Applicable
Last Name* HOFFMAN First Name * STEVEN Initial
Street Address* 1790 HIGHWAY A1A, SUITE 209
City, State Zip* SATELLITE BEACH , FL 32937
Email Address * STEVEN@PLG.LAWYER
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HARTFORD INSURANCE COMPANY OF THE MIDWEST
NAIC Company Code 37478
 
Name of individual responsible for violation (if any):* HARTFORD INSURANCE COMPANY OF THE MIDWEST’S ADJUSTERS, EMPLOYEES, REPRESENTATIVES, AGENTS, VENDORS, AND/OR ENGINEERS AND CONTRACTORS WHO HANDLED THE CLAIM, SPECIFICALLY THE DESK ADJUSTER.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Other : Misrepresentation
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.
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)(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.

The Policy language relevant to the violations includes all applicable loss payment, duties after loss, and coverage provisions of Policy Number believed to be 55RBB499735, including the declarations page and all endorsements to the Policy.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Claim #Y3Z DP 96535; DOL: May 15, 2024 John A. and Shirley Sweigert (“Insureds”) are the owners of a property with a policy of insurance issued by Hartford Insurance Company of the Midwest (“Carrier”). The Insureds’ residence is located at 45 Emerson Drive NW, Palm Bay, FL 32907 (the “Property”). On May 15, 2024, a wind and hail event caused extensive damage to the Property. The Insureds timely reported an insurance claim for this damage to the Carrier and fully cooperated with all requests for inspection and information. Insureds provided all requested documentation and complied with all post loss policy conditions reasonably and timely requested. The Insureds obtained representation from a public adjuster and an estimate for repair of dwelling and other structures for $76,540.97, deductible subtracted, with supporting documentation and photographs. Upon reporting the loss, the Carrier retained an engineer who issued a report concluding the Property was not damaged due to wind or hail and the Carrier issued a denial letter based on their engineer’s report. Carrier's December 12, 2024 coverage determination letter states that there is "no physical damage present to your roof from wind or hail." This is a misrepresentation based on the carrier's own engineer report that states "Round dents up to ½ inch in diameter are on the roof vent" and "Round areas of granule loss with bruised or broken fiberglass mats are on the east and west-facing roof slopes in the northern portion of the roof. The areas measure ½ inch in diameter and do not deviate from that size." Further, upon information and belief, the carrier's engineer misrepresents or negligently fails to consider prevalent hailstorms that hit the insured's location both on the reported date of loss and April 26 and 27 of 2023, which are well document hail dates and easily verifiable with April 26 reporting confirmed hail at 1.75". The fact that the carrier's engineer did a weather data historical search and somehow left off these dates is either negligent or willful. Further, the carrier's engineer confirmed Canopy Weather reports that the potential for hail up to .75 inch in diameter occurred within 1 mile of this property on September 8, 2023. Given this information and the confirmed evidence of ½ inch dents on the roof and soft metals, the Carrier had an obligation to consider other dates of loss, including September 8, 2023 and April 26, 2023, but instead either willfully or negligently overlooked these dates, which exhibits a failure to implement and adopt standards for proper investigation of claims and failure to act fairly and honestly toward its insured and with due regard for her interest. Section 624.02, Florida Statutes, 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. The Carrier has breached this duty by refusing to properly and timely adjust the loss. The Carrier has more than enough information and is still refusing to accept full coverage for this claim. This continued and repeated reckless claim delay, unfair claim handling, failure to communicate, and denial of full coverage will result in a significant punitive damage award. The Carrier can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy and by paying the Insureds $76,540.97. Further, the Carrier should pay the interest accrued from notice of the claim until the date that the Carrier pays $76,540.97, minus deductible, per Section 627.70131 Florida Statutes.
Comments
User Id Date Added Comment
steven@plg.lawyer 02-12-2025 Due to full settlement agreement that the parties have reached, this civil remedy notice of insured violations is hereby withdrawn.
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