Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 806650

Filing Accepted: 2/13/2025

Print Filing

Complainant

Last/Business Name *

BERARDINELLI

First Name

LUIGI AND LUCIA

Street Address *

8447 SHERMAN RD

City, State Zip *

CHESTERLAND, OH 44026

Email Address *

NICKB.LBINC@GMAIL.COM

Complainant Type: *

Insured

Last/Business Name*		BERARDINELLI		First Name		LUIGI AND LUCIA
Policy # *		ARK10659		Claim #*		1122991-221013-092101

Attorney

Attorney is Applicable

Last Name*	SAVAGE First Name * SHELBY Initial L
Street Address*		1700 W. MAIN ST., SUITE 100
City, State Zip*		PENSACOLA , FL 32502
Email Address *		SSAVAGE@TWWLAWFIRM.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		ASI PREFERRED INSURANCE CORP.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 13142

Name of individual responsible for violation (if any):* BRANDI BROWN; STEED GRIFFIN; KEN STILWELL; STEPHEN DAVIS; ZACH POLK; CHARLIE GAUTIER; WILLIAM MARULANDA
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Delay
	Unfair Trade Practice
	Unsatisfactory Settlement Offer

* 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)(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.
	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)(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.

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

Coverage A – Dwelling We cover: The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; Loss Settlement 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 pay the cost to repair or replace, after application of deductible and without deduction for depreciation, 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 actually spent to repair or replace the damaged building. 4. SPECIAL PROVISIONS – FLORIDA: We will pay at least the actual cash value of the damage, less any applicable deductible, until actual repair is performed. We will pay any remaining amounts necessary to perform such repairs as the work is performed and the expenses are incurred and according to the provisions of b.(1) and b.(2) above. Loss Payment – SPECIAL PROVISIONS – FLORIDA: 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 upon the earlier of the following: a. 20 days after: (1) We receive your proof of loss and reach written agreement with you; or (2) Written executed mediation settlement with you according to the terms of the written mediation settlement; or b. 60 days after we receive your proof of loss, and: (1) There is an entry of a final judgment or, in the case of an appeal from such judgment, within 60 days from and after the affirmance of the same by the appellate court; or (2) There is a filing of an appraisal award or, in the case of an appeal from such award, within 60 days from and after the affirmance of the same by the appellate court; or c. Within 90 days after we receive notice from you of an initial, reopened, or supplemental property insurance claim, we shall pay or deny such claim or a portion of the claim unless the failure to do so is caused by factors beyond our control which reasonably prevent such payment. ORDINANCE OR LAW COVERAGE – FLORIDA a. We will provide up to the amount of coverage shown above for the increased costs you incur due solely to the enforcement of an ordinance or law which requires or regulates: (1) The construction, demolition, or repair of that part of a covered building or other structure damaged by a Peril Insured Against; (2) The demolition and reconstruction of the undamaged part of a covered building or other structure, when that building or other structure must be totally demolished because of damage by a Peril Insured Against to another part of that covered building or other structure; or (3) The modification, removal or replacement of the portion of the undamaged part of a covered building or other structure necessary to complete the repair or replacement of that part of the covered building or other structure damaged by a Peril Insured Against. b. You may use all or part of this ordinance or law coverage to pay for the increased costs you incur to remove debris resulting from the construction, demolition, modification, repair or replacement of property as stated in a. above. c. The ordinance or law must have been in effect at the time the covered loss occurs. This Civil Remedy Notice is also grounded in ASI Preferred Insurance Corp.’s statutory duty to act in good faith and deal fairly with its insured when handling claims.

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

The policyholders, Luigi and Lucia Berardinelli (collectively “Berardinelli”), sustained losses to their property located at 2617 Clairfont Court, Cape Coral, FL 33991 caused by and following Hurricane Ian as referenced in this Civil Remedy Notice. Berardinelli timely notified ASI Preferred Insurance Corp. (“ASI”) of the claim. In addition to the numerous statutory violations and wrongful conduct outlined in Berardinelli’s first Civil Remedy Notice (“CRN”)—DFS No. 740768, filed on February 5, 2024—and restated below, ASI has recently committed these additional statutory violations and wrongful acts since the filing of the first CRN: This matter went to appraisal for a determination of the amount of the loss. An Appraisal Award was entered granting Berardinelli, in part, $49,037.10 in ordinance and law (“O&L”) coverage under Florida’s “Match Statute” § 626.9744 for the replacement of their damaged roof. In order to undertake the necessary replacement of their roof promptly, Berardinelli engaged a reputable roofing contractor, Sabal Construction and Roofing, LLC (“Sabal”), to replace their roof. Berardinelli entered into a binding contract with Sabal and made a down payment so the necessary work and repairs could begin. Although Berardinelli sent the signed Sabal contract to ASI to prove the expense was incurred and that work was underway, ASI wrongfully refused to release the O&L as required by the policy, preventing Berardinelli from being able to pay the remaining amount owed on their roofing contract to complete the work. As a result, Berardinelli has had to continue to endure a damaged roof because of ASI’s wrongful refusal to release the O&L funds. In violation of the terms of the policy and Florida law, ASI demanded Berardinelli provide it with a Certificate of Completion and pictures of the completed repairs before it would release the O&L. It continued to maintain this position for more than two months while Berardinelli asked for the policy language requiring such payment, including the month it ignored all of Berardinelli’s communications regarding the matter. When ASI finally responded, it merely parroted its demand for a Certificate of Completion and photos of the repair. This is not what the policy requires. The policy does not state that a Certificate of Completion and photos of completed repairs are required before O&L must be released; nor does it state that the ASI is only required to reimburse Berardinelli for O&L costs they “have paid.” The policy states only that ASI is obligated to pay the “increased costs you incur due solely to the enforcement of an ordinance or law.” Under Florida law, to “incur” an expense “‘means to become liable for the expense, but not necessary to have actually expended it.’” State Farm Fla. Ins. Co. v. James, 374 So. 3d 934, 936 (Fla. DCA 2023) (citing Ceballo v. Citizens Prop. Ins. Corp., 967 So. 2d 811, 815 (Fla. 2007)). Hence, “where the amount of coverage depends on the amount of the loss, the insured must demonstrate the extent of the actual loss incurred but need not actually expend funds to be entitled to payment from an insurer.” James, 374 So. 3d at 936. Berardinelli provided proof of the incurred payment for the roof in November; ASI has yet to release the O&L funds provided for in the binding Appraisal Award. Accordingly, ASI’s conduct in refusing to release the O&L amount that Berardinelli has incurred according to Florida law is a breach of the policy and a violation of ASI’s numerous contractual and statutory obligations to Berardinelli. It is also an adjustment of this claim in bad faith, in ASI’s best interest, with the goal of saving ASI money. To cure the bad faith conduct outlined in this CRN, ASI must tender the $41,550.00 owed to Berardinelli for their roofing contract under their ordinance and law coverage pursuant to the terms of the policy within five (5) days of ASI’s receipt of this CRN and pay interest at a rate of 12% APR from February 13, 2025 until the date the settlement check is delivered to the undersigned’s office on Berardinelli’s behalf. As stated in Berardinelli’s first CRN (DFS No. 740768, filed on February 5, 2024), ASI also committed the following additional statutory and contractual violations during its initial evaluation and adjustment of this claim: From the outset of this claim, ASI has been presented with, or uncovered, evidence establishing the full scope of covered damage and the cost to repair it. Despite this, ASI has chosen to wrongfully ignore or dismiss this evidence and claim the damages were either not caused by a covered peril or they are limited, excluded, or not as extensive as the evidence shows so ASI could minimize the value of this claim and adjust the claim in its own best interest. This conduct has been in bad faith and has caused not only substantial delay of payment in full on this claim but also additional harms and losses to Berardinelli over and above the amount owed on the policy of insurance. ASI’s initial inspection of the property did not result in a thorough, accurate identification of all the covered damage and a complete cost to repair. Either the field adjuster that ASI sent to conduct the inspection was not sufficiently trained or experienced enough to identify all the damage caused by wind or his initial estimate was wrongfully adjusted by ASI to result in an inaccurate, inadequate estimate. Specifically, ASI’s determination that the entirety of the covered damage amounted to only $2,118.53, replacement cost value on the dwelling, was grossly inadequate, contrary to ample evidence at the property showing the covered damages were much greater, and constituted an active effort by ASI to ignore credible evidence of the damage and undermine the value of the claim. ASI’s decision to prepare and rely on an inadequate and incomplete estimate, which did not uncover all damage to the structure caused by wind that would allow for continued water intrusion, shows a lack of consideration for the safety and/or health of the insured and an intentional adjustment of this claim in bad faith. ASI’s decision to rely on its inadequate estimate—which ASI knew, or should have known, was grossly insufficient and would not allow Berardinelli to fully restore the property—put Berardinelli at risk for further damage both to their home and potentially their health because ASI’s wrongful coverage determination prohibited Berardinelli from fully restoring the integrity of their property to its pre-loss condition. This conduct was in bad faith and showed an intent by ASI not to adjust this claim in the best interest of Berardinelli as it is required by the policy and applicable Florida law but, rather, to adjust the claim in its own best interest to save money. As a result of wind during the storm, Berardinelli’s roof suffered multiple broken, chipped, and missing tiles on all slopes of the roof requiring a full replacement. As far back as February, 2023 Berardinelli disputed ASI’s coverage determination and advised ASI they had a roofer inspect their property and inform them the damage their roof sustained during the storm required a roof replacement. ASI ignored this information. As a result of ASI’s failure to accurately and timely adjust and pay this claim, and its grossly inadequate and wrongful determination of the damages, Berardinelli was forced to incur costs in hiring a reputable, skilled public adjuster to prepare an estimate of the cost to repair the covered damage. Berardinelli’s public adjuster inspected the property and estimated the cost to repair the covered damage at $113,883.97, replacement cost value on the dwelling, which represents a far more accurate estimate of the cost to repair the entirety of the damage caused to Berardinelli’s home and other structures by wind during the storm. Had ASI adjusted the claim initially in good faith and in Berardinelli’s best interest, ASI’s inspection and estimate would have resulted in a fair amount of compensation that would not have forced Berardinelli to have to hire a public adjuster to protect their interests and right to be paid in full on the claim. Comparing ASI’s initial estimate of $2,118.53 to Berardinelli’s public adjuster’s estimate of $113,883.97 ASI’s estimate amounts to less than two percent (2%) of the actual claim value. An estimate this offensively and inexplicably low could only have been prepared in bad faith with the goal of undermining the claim value so ASI could pay less on this claim. ASI’s conduct in this regard—showing a lack of concern for its inadequate adjustment of this claim and its failure and/or refusal to pay Berardinelli what it knows is the true amount required to repair the property—has been in bad faith. Although Berardinelli submitted a sworn proof of loss for $113,883.97 replacement cost value on the dwelling and $500.00 in food spoliation, which was supported by Berardinelli’s public adjuster’s detailed estimate and photo report, ASI did not give this evidence any meaningful consideration by immediately offering to pay more money on the claim. Instead, ASI decided to deploy its usual tactics of giving the policyholders the run-around and causing more delay by requesting a re-inspection of the property, although it had been provided complete, unfettered access to the property during the initial inspection. As a result of ASI’s request, Berardinelli was required to open their property a second time to allow ASI a second opportunity to inspect and—this time—identify all covered damage and accurately estimate the cost to repair. In addition to a second inspection of the property, ASI also requested a second inspection of the roof, requiring Berardinelli to open their property a third time to give ASI access to conduct this additional inspection. Despite these three opportunities to accurately assess the damage and adjust this claim in good faith, ASI failed on all three accounts. Following the roof reinspection, ASI went silent for weeks and failed to provide its insureds with an update as to its coverage determination. Berardinelli’s public adjuster’s inquiries and messages to Desk Adjuster Stephen Davis often went unanswered and/or ignored during this time. This occurred during a time when Berardinelli was stressed, worried, and anxious to get repairs underway so the integrity of the structure could be restored. ASI’s willful or careless failure to respond timely to communications, emails, and inquiries from its insured violated both its duty under the policy to timely adjust this claim and its duty under Fla. Stat. § 626.9541(1)(i)(3)(c) to acknowledge and act promptly upon communications with respect to claims. More than two months after the property reinspection, and almost six weeks after the roof reinspection, ASI finally advised Berardinelli of its coverage decision, i.e., that it had determined Berardinelli’s roof could be repaired because it had found tiles available to affect the repair. After prodding from Berardinelli’s public adjuster, Berardinelli was eventually informed this tile would take seven (7) months to procure, leaving the property open and exposed to further damage during this time. This decision and callous treatment of its insureds by ASI was in bad faith and did not fulfill ASI’s statutory and contractual obligations to Berardinelli to timely and fully pay this claim in full and allow the policyholders to timely restore their property to its pre-loss condition. ASI’s decision to issue a miniscule payment on the claim following the reinspections, of only $1,369.08—an amount that would in no way allow Berardinelli to undertake the necessary repairs—also evidenced an intent by ASI to bully and exhaust Berardinelli in hopes that they would eventually tire of ASI’s delay and stall tactics and accept less than the full and fair payment to which they are entitled on this claim. ASI’s decision to ignore Berardinelli’s advisement that they needed a roof replacement, ignore the sworn proof of loss, ignore Berardinelli’s public adjuster’s detailed estimate, and take further steps to delay full payment on this claim shows ASI is intent on adjusting this claim in its own best interest with the goal of paying as little as possible on this claim. This conduct has been in egregious bad faith, to Berardinelli’s detriment. Overall, ASI’s dilatory and unacceptable adjustment of this claim shows ASI has failed to implement and follow adequate guidelines for the proper investigation to evaluate claims and the appropriate training and supervision of its employees and adjusters resulting in the statutory violations identified in this Civil Remedy Notice above. ASI’s failure and/or refusal to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards Berardinelli is wrongful conduct. As a result of ASI’s wrongful conduct, Berardinelli was and still is forced to expend out of pocket monies to submit their insurance claim, e.g., retaining a public adjuster to prepare an accurate estimate and legal counsel to file this Civil Remedy Notice in hopes of finally forcing ASI to honor its obligations under the insurance policy to pay the entirety of the insurance proceeds due and owing to Berardinelli. ASI is obligated to Berardinelli to tender all insurance proceeds owing and due so that the necessary repairs can commence. ASI’s refusal to tender the appropriate amount due has been in bad faith and is a breach of the insurance agreement which requires ASI to pay timely and promptly so that Berardinelli can mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. To date, ASI has failed to timely pay or deny the claim in full in direct violation of Fla. Stat. § 627.70131. ASI’s actions, in this regard, have been in bad faith. It is clear from ASI’s failure to issue the benefits owed and its intentional attempt to avoid its full obligations to Berardinelli, that ASI has engaged in a pattern of fraudulent and dilatory tactics to the prejudice and harm of Berardinelli. To cure the defects outlined in this Civil Remedy Notice, ASI must: (1) Immediately tender all undisputed insurance proceeds to Berardinelli with statutory interest owed; (2) Act fairly and honestly towards Berardinelli and with due regard for their interest in attempting to settle this claim; (3) Immediately tender all insurance monies due and owing to Berardinelli with statutory interest; and (4) Pay Berardinelli the fair value of their insurance claim. ASI Preferred Insurance Corp.’s address is 1 ASI Way, St. Petersburg, FL 33702.

Comments

User Id		Date Added		Comment
darryl_j_roles@progressive.com		02-14-2025		While ASI Preferred Insurance Corp believes that the Civil Remedy Notice fails to comply with the requirements of Florida Statute §624.155 and Florida Case law, it has responded to the notice in writing to Shelby Savage, on February 14, 2025.

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