Filing Number: 807029
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| Filing Accepted: 2/17/2025 |
| Last/Business Name
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| Street Address
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12000 ROMERO COURT |
| City, State Zip
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ORLANDO,
FL
32837
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| Email Address
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DBTECH69@YAHOO.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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NAGLE |
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First Name |
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GERRARD |
| Policy # * |
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7709HR000728 |
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Claim #* |
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079413-GQ |
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Attorney is Applicable
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| Last Name* |
WOOD
First Name *
ANGELA
Initial
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| Street Address* |
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350 N. LAKE DESTINY ROAD |
| City, State Zip* |
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MAITLAND
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FLORIDA
32751
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| Email Address * |
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AWOOD@ITSABOUTJUSTICE.LAW |
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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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NATIONWIDE MUTUAL 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 23787 |
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| Name of individual responsible for violation (if any):*
NA
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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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Cancellation
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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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| 624.155(1)(b)(3) |
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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.
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| 626.9541(1)(i)(2) |
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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.
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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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| 626.9541(1)(i)(3)(b) |
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Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
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| 626.9541(1)(i)(4) |
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Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
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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.
A certified copy of the policy is not in the possession of the Insureds, but has been requested from the insurance carrier. Based on information and belief, the following policy provisions are relevant to this civil remedy notice.
Section 1 – Coverage A – Perils Insured Against
Section 1- Conditions – Loss Settlement
Section 1 – Conditions - Loss Payment
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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.
On or about October 10, 2024, the Insured, Gerrard Nagle suffered damage to his home located at 12000 Romero Court, Orlando, FL 32837 as a result of Hurricane Milton.
Prior to the loss, Nationwide Property & Casualty Insurance Company (“Nationwide”), had issued a policy of insurance (Policy No.: 7709HR000728) for the Insured’s property. Said policy was in full force and effect on date of loss and afforded coverage for damage caused by a hurricane.
Nationwide was notified of the loss by the Insured and assigned claim number 079413-GQ. During the course of Nationwide’s investigation, the Insured made his property available for inspection, provided facts and information about the loss, and complied with Nationwide’s adjustment of the claim.
Despite fully cooperating with Nationwide’s investigation, Nationwide severely undervalued coverage for the Insured’s insurance claim even though there was clear evidence of significant hurricane damage to the Property. Nationwide came to its coverage determination by ignoring relevant facts and information provided by the Insured’s and his contractors that established the damages to the roof and exterior of the residence were unquestionably the result of Hurricane Milton and that his roof needed to be replaced.
Most concerning, Nationwide and its representatives either underplayed or misrepresented its own findings in order to avoid having to tender payment on a claim that it knows should be covered pursuant to the terms of the policy. Nationwide ignored relevant weather data, or didn’t disclose it, disregarded important evidence provided by the Insured, and overlooked basic facts and information that contradicted its findings that the damages were caused by factors other than a hurricane.
It is clear that Nationwide has not acted honestly or fairly towards it’s Insured. Nationwide and its representatives have failed to conduct a proper investigation of the loss, misrepresented the scope and cause of damages at the residence, and misapplied exclusions in the policy in order to undervalue the Insured’s claim. It has become a general business practice of Nationwide to not implement proper claims handling procedures, to hire consultants that routinely ignore or intentionally misidentify relevant evidence, and to not settle claims in good faith when under all circumstances it should have. As is the case here, it is a pattern and practice for Nationwide to undervalue and misapply exclusions without conducting reasonable investigations and instead base its coverage determinations on evidence it knows to be inaccurate or incomplete.
Worst of all, on September 12, 2024, Nationwide notified the Insured that the policy of insurance will be cancelled as of January 14, 2025. This is a violation of Florida law section 627.4133, Florida Statutes:
Upon a declaration of an emergency pursuant to s.252.36 and the filing of an order by the Commissioner of Insurance Regulation, an insurer may not cancel or non-renew a personal residential or commercial residential property insurance policy cover a dwelling or residential property located in this state which has been damage as a result of a hurricane or wind loss that is the subject tof the declaration of emergency for a period of 90 days after the dwelling or residential property has been repaired. A structure is deemed to be repaired when substantially completed and restored to the extent that it is insurable by another authorized insurer that is writing policies in this state
It is clear that Nationwide is acting in bad faith and essentially putting Mr. Nagle between a rock and a hard place; unable to make repairs due to Nationwide’s undervaluation of the claim and unable to obtain new coverage due to the damage caused by Hurricane Milton.
In order to cure this civil remedy notice, Nationwide must immediately acknowledge in writing that the damages claimed by the Insured were primarily caused by Hurricane Milton and that replacement of the roof and any other damages caused by Hurricane Milton are covered by the policy of insurance. Nationwide must also send notification that Mr. Nagle’s Policy will not be canceled and provide documentation the policy is being renewed. The written acknowledgement should be provided to the Insured’s counsel in writing at Angela A. Wood, at 350 N. Lake Destiny Road, Suite 300, Maitland, FL 32751.
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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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