Filing Number: 806760
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| Filing Accepted: 2/13/2025 |
| Last/Business Name
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DOUGLAS BROWN
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First Name |
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LYNN BROWN AND |
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| Street Address
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3706 WHIPPOORWILL BOULEVARD |
| City, State Zip
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PUNTA GORDA,
FL
33950
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| Email Address
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LYNNBROWN321@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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DOUGLAS BROWN |
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First Name |
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LYNN BROWN AND |
| Policy # * |
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2880849769 |
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Claim #* |
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01000086890 |
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Attorney is Applicable
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| Last Name* |
KRAPF
First Name *
GRANT
Initial
W
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| Street Address* |
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2790 SUNSET POINT RD |
| City, State Zip* |
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CLEARWATER
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FL
33759
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| Email Address * |
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GRANT@KRAPFLEGAL.COM |
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| Insurer Type
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Authorized Insurer
Unauthorized Insurer
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| Insurer Name |
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| Insurer Name* |
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FIRST PROTECTIVE INSURANCE COMPANY
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| Insurer Name* |
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| Street Address* |
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| City, State Zip* |
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,
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NAIC Company Code 10897 |
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| Name of individual responsible for violation (if any):*
CHRISTOPHER WYCHE, JAMES KELLER, HERBERT WASHINGTON, GRACE SIMONCA, ROBERT CARRILLO, GRACE SAPP, AND ANY OTHER INDIVIDUAL FROM, OR AGENT OF, FIRST PROTECTIVE INSURANCE COMPANY D/B/A FRONTLINE INSURANCE WHO WAS INVOLVED IN THE CLAIM.
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| Type of Insurance
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Residential Property & Casualty
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| Reason for Notice
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Claim Delay
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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Other
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Not treating the Insured with good faith claims conduct
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Other
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Looking for ways to deny full recovery to the Insured
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Other
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Looking for ways to delay full recovery to the Insured
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Other
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Failing to properly investigate the Insured's loss
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Other
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Failing to provide the Insured with the full benefits awarded under the contract of insurance in a t
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Other
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Not training, supervising, or managing adjusters properly so that prompt and full payments are made,
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Other
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Not adjusting claims and evaluating loss properly
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Other
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Shifting the burden of insuring the loss to the Insured
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Other
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Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured
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Other
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Failing to implement proper standards for the adjustment and investigation of claims
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Statutory provision(s) which the insurer allegedly violated.
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| 624.155(1)(b)(1) |
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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.
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| 626.9541(1)(i)(3)(a) |
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Failing to adopt and implement standards for the proper investigation of claims.
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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
627.444(2)(a) Notwithstanding any other law, an insurer shall provide to an insured within 15 calendar days after an individual or entity designated by the insurer receives the insured's written request, either: A loss run statement.
627.4137(1)(e) - Each insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the claimant, a statement, under oath, of a corporate officer or the insurer's claims manager or superintendent setting forth the following information with regard to each known policy of insurance, including excess or umbrella insurance: a copy of the policy.
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Reference to specific policy language
The violations alleged are statutorily based and do not rely on any specific policy language.
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Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
First Protective Insurance Company d/b/a Frontline Insurance ("Insurer") has committed the following in handling the Insured's claim: 1) failure to act in due diligence and good faith to resolve claims; 2) placing the financial interest of Insurer before that of the policyholder and the Insured; 3) looking for ways to deny benefit payments and otherwise "low ball" or "stone wall" claims; 4) not adjusting the claims promptly and fairly; 5) not attempting in good faith to settle claims; 6) conducting inadequate investigations; 7) failing to employ policies and procedures to conduct adequate investigations; 8) failing to provide an estimate that complies with the Florida Building Codes; 9) failing to provide a loss run statement; and 10) failing to provide a copy of the insurance policy within 30 days.
On or about September 28, 2022, while the subject policy was in full force and effect, the Insured's property was severely damaged by Hurricane Ian. The areas impacted include but are not limited to the roofing system and screen enclosure. The Insured timely submitted a claim on October 30, 2022, to the Insurer for hurricane damage and the ensuing damage therefrom. Thereafter, the Insurer assigned claim number 01000086890 to the loss and sent a field adjuster to inspect the property on November 5, 2022. Then in a letter dated November 8, 2022, the Insurer notified the Insured that it was extending coverage for the loss. However, the Insurer wrongfully determined that it would only require $8,990.28 to restore the insured property to its pre-loss condition. The Insurer's lowball estimate is that of a classic under scope and under value of the claim.
Given the vastly underestimated cost of repairs, the Insured's disagreement with the coverage decision, and the scope and nature of the damage resulting from Hurricane Ian, the Insured retained a roofing contractor. After assessing the damage and the true scope of repairs, the roofing contractor produced an estimate identifying $71,722.70 for just a roof replacement. The foregoing estimate and photographs were sent to the Insurer. The Insurer continues to undervalue the loss claiming the Insured's roof simply requires a few replaced tiles rather than a roof replacement.
Upon receiving notice of the loss, the Insurer had the duty to provide the full benefits under the policy. This includes providing the Insured with a proper investigation and the funds necessary to return the home to its pre-loss condition. However, when the Insurer conducted its inspection of the insured property, the Insurer's adjuster failed to conduct a thorough and adequate investigation, or the adjuster intentionally ignored the damage observed and failed to make truthful and unbiased reports of the facts after investigating. As a result, the Insurer breached the policy by failing to fully indemnify the Insured for the covered loss.
Rather than the Insurer pay for a roof replacement consistent with all laws and ordinances, the Insurer contends the roof is repairable which is not true. All repairs to the roofing system must be done in accordance with applicable Florida Building Codes which require all repairs be done consistent with the manufacturer's specifications and warranties which this Insurer clearly did not account for.
The Insurer continued to delay and frustrated the Insured's ability to have his claim adjusted promptly to begin restoring his property by failing to timely provide the Insured with the policy after requested by the Insured through his representatives. The Insured, through his representatives, first requested the policy on January 12, 2023, and sent several follow-up emails to no avail. The policy was not received within 30 days of the first written request of the Insured. Each Insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the Insured, a statement, under oath, of a corporate officer or the insurer's claims manager or superintendent, a copy of the policy. Fla. Stat. Ann. 627.4137(1)(e).
Lastly, the Insurer and its agents failed to comply with Fla. Stat. 627.444 by not providing the Insured and the Insured's representatives with a loss run statement. On January 12, 2023, the Insured's legal counsel provided the Insurer with a letter of representation. Within the letter, legal counsel requested a copy of a loss run statement. The Insurer and its agents have not acknowledged the request for a loss run statement nor has a loss run statement been provided. Upon an Insurer receiving a written request for a loss run statement, the Insurer is required, within fifteen (15) calendar days, to provide either a loss run statement or information on how to obtain a loss run statement at no charge through a consumer reporting agency. There has been no response within fifteen (15) calendar days of the Insured's written request and the Insurer has not provided information on how to obtain a loss run statement at no charge through a consumer reporting agency. This Insurer has breached its duty to settle claims in good faith when, under all the circumstances, it could and should have done so. The Insurer and its agents have not acted fairly and honestly toward the Insured and the Insured's representatives. Lastly, the Insurer has failed or refused to promptly acknowledge the Insured's communications in an attempt to frustrate and delay the resolution of the Insured's claim.
There may be further wrongful conduct which has not been made known to the Insured at this moment. Certain conduct or actions may be discovered throughout discovery or cannot be verified without a review of the Insurer's claim file and standards and procedures for the adjustment and investigation of claims.
In short, the Insurer is not acting with due regard for the Insured's interests or safety. In Florida the work of adjusting insurance claims engages the public trust. The Insurer has breached this trust and its duty to the Insured. The Insurer and its agents conducted cursory and inadequate investigations and wrongfully determined that it would only require $8,990.28 to restore the insured property to its pre-loss condition.
Moreover, the Insurer has engaged in bad faith practices designed to delay claims and prevent the Insured from recovering what is rightfully owed under the subject policy of insurance. The Insurer's actions and inactions have continued to frustrate and delay the resolution of the Insured claim.
The Insurer's actions amount to but are not limited to the following:
1. Claim delay
2. Not treating the Insured with good faith claims conduct
3. Looking for way to reduce recovery to the Insured
4. Looking for ways to deny recovery to the Insured
5. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the Insured
6. Not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company's interests before the Insured's interests
7. Placing the financial interest of the Insurer over that of the health and safety of the Insured
8. Failing to provide an estimate that complies with the Florida Building Codes
9. Shifting the burden of investigating onto the Insured
10. Conducting inadequate investigations
11. Failing to provide a loss run statement
12. Failing to provide a copy of the insurance policy within 30 days
Therefore, to cure the defects outlined in this civil remedy notice, the Insurer must:
(1) Admit full coverage for the Insured's loss.
(2) Tender full benefits owed to the Insured under the insurance contract.
A copy of this form submitted to the FDFS has been sent via Electronic Mail to the following parties providing them notice of the filing of the civil remedy notice. Please email any response to this civil remedy notice to badfaith@krapflegal.com
Via Electronic Mail:
Attorney for First Protective Insurance Company
d/b/a Frontline Insurance
Michael J. Kranzler, Esquire
mkranzler@chartwelllaw.com
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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.
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DFS-10-363
Rev. 10/14/2008
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