Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 806951

Filing Accepted: 2/14/2025

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Complainant

Last/Business Name *

BOCA ROYALE COUNTRY CLUB LLC

First Name

Street Address *

1601 ENGLEWOOD RD

City, State Zip *

ENGLEWOOD, FL 34223

Email Address *

CLAIMS@ELITERESOLUTIONS.COM

Complainant Type: *

Insured

Last/Business Name*		BOCA ROYALE COUNTRY CLUB LLC		First Name
Policy # *		FSF16658583 001		Claim #*		KY22K2910523

Attorney

Attorney is Applicable

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		WESTCHESTER SURPLUS LINES INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10172

Name of individual responsible for violation (if any):* MICHAEL CONLEY, CONNOR FERRARO AND ALL CHUBB CLAIMS ADJUSTERS, EMPLOYEES, REPRESENTATIVES, AGENTS, VENDORS, AND/OR ENGINEERS WHO HANDLED THE CLAIM.
Type of Insurance * Commercial Property & Casualty

Reason for Notice *

	Unsatisfactory Settlement Offer
	Claim Delay
	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.

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

“We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss.”

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

Boca Royale Country Club LLC (hereinafter “Boca Royale”) is insured with a policy issued by Westchester Surplus Lines Insurance Company (hereinafter “Chubb”). The insured property or home is located at 1601 Englewood Rd, Englewood, FL 34223. In September of 2022, Hurricane Ian caused extensive wind damage to Boca Royale’s property. Boca Royale timely reported a claim for this damage to Chubb and fully cooperated with all requests for inspections. They provided all requested documentation, if any, and complied with all post loss policy conditions. An estimate for repair of all damages with respect to Boca Royale’s claim was prepared on their behalf for $1,954,972.53 was sent to Chubb. After reporting the claim, Chubb retained an unqualified and biased field adjuster who has a financial relationship with Chubb. Their field adjuster inspected Boca Royale’s property in an apparent effort to minimize Chubb’s losses instead of adjusting the claim in good faith in due regard for Boca Royale’s interests. Despite Chubb finding coverage for Boca Royale’s claim, Chubb significantly undervalued their claim at only $592,780. This low-ball evaluation has prevented Boca Royale from permanently repairing their property. As stated previously, an estimate for repair with respect to Boca Royale’s claim was prepared on their behalf for $1,954,972.53; well above the amount determined by Chubb. Based on these facts, it is clear Chubb significantly underpaid for Boca Royale claim in bad faith. It denied full coverage for the claim without conducting a reasonable investigation based upon the available information. It misrepresented pertinent policy provisions and facts, and did not act fairly and honestly with Boca Royale in due regard for their interests. Chubb also severely delayed the claim and failed to timely respond to communications. This has become a common business practice of Chubb. As of today, February 14th, 2025, the following is a timeline of what has occurred with this claim. We have interacted mainly with Michael Conley since the beginning of 2023 and have had numerous back and forth conversations both through email and by phone in order to settle this claim for Boca Royale. Mr. Conley has asked us to provide documents and invoices that we have previously and continually provided, however, they have not moved any closer to fairly settling this claim. As two policies were in place at the time of this loss, the other carrier, Lloyd’s of London, has paid out a total of $950,000. As stated previously, Chubb has only paid out $592,780 therefore Chubb still owes $357,220. Florida Statute § 624.02 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. Chubb has breached their duty by refusing to properly and timely adjust the loss. Chubb has more than enough information and is still refusing to accept full coverage for Boca Royale’s claim. The continued and repeated reckless claim delay of full coverage will result in a significant punitive damage award if a bad faith lawsuit is filed. Chubb can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for the claim and by paying Boca Royale based on their full estimate.

Comments

User Id		Date Added		Comment
chad.pasternack@kennedyslaw.com		04-03-2025		Westchester Surplus Lines Insurance Company (“Westchester”) hereby responds the Civil Remedy Notice No. 806951 (“Notice”) filed by Boca Royale Country Club LLC (“Boca Royale”) in connection with claim number KY22K2910523 under policy number FSF16658583 001. Westchester objects to the Notice because it does not state with specificity the information required by Fla. Stat. Section 624.155(3)(b): (1) The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated; (2) The facts and circumstances giving rise to the violation; (3) The name of any individual involved in the violation; and (4) Reference to specific policy language that is relevant to the violation, if any. The Notice fails to comply with Section 624.155(3)(b), so the Notice is legally insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 879 (Fla. 4th DCA 2021). With respect to the alleged statutory violations, the Notice fails to describe the facts and circumstances giving rise to each violation. The Notice alleges Westchester violated Section 624.155(1)(b)(3), alleging Westchester failed to promptly settle claims, when the obligation to settle became reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portion of the insurance policy coverage. However, the Notice does not identify what different insurance coverages are at issue or how Westchester tried to influence settlements under the respective coverages. The Notice also alleges that Westchester violated Section 626.9541(1)(i)(3)(c), alleging Westchester failed to acknowledge and act promptly upon communications with respect to claims, but does not identify any specific communication Westchester failed to acknowledge or act promptly upon. The Notice also vaguely states that Westchester “misrepresented pertinent policy provisions and facts,” but does not identify any misrepresentation. With respect to the names of individuals involved in the violation, the Notice vaguely states that “[Westchester] retained an unqualified and biased field adjuster who has a financial relationship with [Westchester].” It is not clear who the Notice is referring to or what facts Boca Royale contends demonstrate lack of qualification or bias. For these reasons, the Notice is legally insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 879 (Fla. 4th DCA 2021). Notwithstanding that the Notice is legally insufficient, the facts and circumstances described in the Notice are inaccurate. Westchester issued to Boca Royale policy number FSF16658583 001, with policy period from July 17, 2022 to July 17, 2023 (“Policy”). The Policy provides certain insurance coverage for five separately-scheduling buildings located at 1601 Englewood Road, Englewood, FL 34223. The Policy has Building limits of Insurance of $1,800,000 (Bldg. 1), $200,000 (Bldg. 2), $122,000 (Bldg. 3), $100,000 (Bldg. 4), and $160,000 (Bldg. 5). The Policy also has a $5,000 limit for outdoor property. There is a 90% coinsurance requirement for each building. Boca Royale is also insured under an insurance policy issued by Certain Underwriters at Lloyd’s London (“Lloyd’s of London”). The Lloyd’s of London policy, certificate no. GRSP2052, provides certain insurance coverage for the same five buildings with the same limits of insurance. Therefore, under the Other Insurance provision in the Policy, Westchester will pay its proportional share, 50%, of covered loss or damage. Boca Royale reported a claim to Westchester for damage to the five buildings and outdoor property resulting from Hurricane Ian on September 28, 2022. Westchester promptly engaged independent adjusting firm Crawford Global Technical Services to assist with its investigation of the claim. Crawford assigned Angela Nixon as field adjuster. Ms. Nixon inspected the property on October 13, 2022. Prior to the inspection, Reform Restoration, LLC had completed some mitigation work at the property. Ms. Nixon observed wind damage to each of the five buildings. However, she also observed a visible flood line on the outside of the Accounting Office, Membership Office, and the Golf Pro Shop. Ms. Nixon was subsequently informed that Boca Royale had a renovation project in progress at the time of Hurricane Ian, but that the pre-loss work performed was limited to partial removal of the kitchen and partial removal of the bar top in the ballroom of the clubhouse. Westchester also engaged Nate Reichold, with J.S. Held, as a building consultant, and Trent VanAllen, P.E., to assist with determining the scope of storm-related damage. Stephens Engineering Consultants prepared a detailed analysis of the wind-related damage and J.S. Held prepared a detailed repair estimate for the wind-related damage to each of the buildings. J.S. Held also prepared a comprehensive analysis of the mitigation invoices from Reform Restoration. J.S. Held also assessed the valuation of each building, which reflects that the clubhouse was underinsured. The Policy require Boca Royale to insured the clubhouse to at least 90% value. However, the clubhouse has a replacement cost value of $2,136.056.00, but the limit for the clubhouse is only $1,800,000. On March 21, 2023, Westchester issued payment of $69,102.92 to Reform Restoration. Westchester concurrently issued payment of $426,538.42 to Boca Royale, based on a Replacement Cost of $1,410,062.35 (in total for the five buildings plus outdoor property), less depreciation of $368,918.10, less deductibles of $121,600.00, and less coinsurance penalty of $66,467.41 (payment at 93.63%). This payment reflects Westchester’s 50% share of the $853,076.84 net amount. On April 11, 2023, Westchester issued another payment of $3,610.52 to Reform Restoration. After completion of the repairs to each building, Boca Royale submitted invoices reflecting work performed for the purpose of releasing withheld depreciation. Based on the information provided, Westchester determined that Boca Royale is entitled to $332,483.16 in withheld depreciation, which was limited by $24,662.49 because the loss for Building 4 (Sales Office) exceeded the Building limit of $100,000. On January 14, 2025, Westchester issued payment of $166,241.58, representing Westchester’s 50% share of the withheld depreciation. Westchester concurrently provided Margi Furey with Shepherd Insurance a statement of loss explaining the payment. Westchester specifically denies each and every accusation of wrongful conduct made against it in the Notice. Should the Department require further evidence, elaboration, or clarification in the context of the Notice and this response, please do not hesitate to contact the undersigned.

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