Filing Number: 807033
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| Filing Accepted: 2/17/2025 |
| Last/Business Name
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MCMAHON
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First Name |
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PATRICK & MELISSA |
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| Street Address
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12428 BRADY PLACE BLVD |
| City, State Zip
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JACKSONVILLE,
FL
32223
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| Email Address
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TGREER@ITSABOUTJUSTICE.LAW |
| Complainant Type:
*
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Insured |
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| Last/Business Name* |
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MCMAHON |
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First Name |
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PATRICK & MELISSA |
| Policy # * |
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GH000002373609 |
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Claim #* |
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HO0524425438 |
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Attorney is Applicable
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| Last Name* |
GREER
First Name *
TAMARA
Initial
A
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| Street Address* |
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350 N. LAKE DESTINY RD. |
| City, State Zip* |
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MAITLAND
,
FLORIDA
32751
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| Email Address * |
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TGREER@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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MONARCH NATIONAL 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 15715 |
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| Name of individual responsible for violation (if any):*
MONARCH NATIONAL
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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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Non-renewal
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Claim Denial
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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)(3)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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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.
o Section I – Property Coverages
o Coverage A: Dwelling
o Coverage B: Other Structures
o Coverage C: Personal Property
o Coverage D: Loss of Use
***627.4133(2)(e)(1) Canceling or non-renewing an insured prior to the statutory time period of 90 days after substantial repairs have been made.***
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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 May 21, 2023, the Insured, Patrick and Melissa McMahon, suffered storm damage to their home located at 12428 Brady Pl Blvd, Jacksonville, FL 32223-5524. The storm caused damage to the roof.
- Prior to the loss, Monarch National Insurance Company (“Monarch”) had issued a policy of insurance (Policy No. GH000002373609) for the Insured’s property. Said policy was in full force and effect on date of loss and afforded coverage for damage caused by the storm event.
- Monarch was notified of the loss by the Insured and assigned claim number HO0524425438. During the course of Monarch’s investigation of the loss, the Insured made their property available for inspection, provided facts and information about the loss, and complied with Monarch’s adjustment of the claim. Despite fully cooperating with Monarch’s investigation, Monarch capriciously denied coverage for the Insured’s insurance claim even though there was clear evidence of storm damage to the covered property. Monarch came to its coverage determination by ignoring relevant facts and information provided by the insured that established the damages to the roof which were unquestionably the result of storm damage. Most concerning, Monarch and its representatives either underplayed or misrepresented is 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. For instance, Monarch denied coverage for the roof even though there was clear storm damage. Monarch denied coverage for these damages even though they are specifically afforded coverage by the policy’s ensuing loss provision.
- Unfortunately, Monarch’s underhanded tactics have continued. Monarch notified the Insured that their policy will be cancelled at the end of the policy term. Monarch knows that by not renewing the policy, the Insured is now left between the proverbial “rock and a hard place” because they cannot make repairs until Monarch tenders full payment owed under the policy. Furthermore, the Insured is unlikely to be able to obtain new insurance from a different carrier because they have an open and pending lawsuit and unrepaired damage to their home. Ironically, had Monarch properly adjusted the claim and timely issued payment, the Insured would have already made the necessary repairs to the damaged property. Monarch’s decision to not renew the policy while the Insured is fighting to obtain the benefits rightfully owed under the policy is indicative of just how far Monarch is willing to go to retaliate against those customers who challenge its coverage determinations.
- It is clear that Monarch has not acted honestly or fairly towards its Insured. Monarch 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 improperly underpay coverage for the Insured’s claim. It has become a general business practice of Monarch 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 Monarch to arbitrarily undervalue and underpay claims without conducting reasonable investigations and instead base its coverage determinations on evidence it knows to be inaccurate or incomplete.
- In order to cure this civil remedy notice, Monarch must immediately acknowledge in writing that the full amount of the damages to the roof are covered under the policy and that the Insured is entitled to a full roof replacement. Monarch must also immediately withdraw its notice of nonrenewal and reinstate coverage to the Insured until their insurance claim and lawsuit are resolved, and for up to 90 days after substantial repairs have been made as required under Fla. Stat 627.4133(e)(1). The written acknowledgement and renewal notice should be provided to the Insured’s counsel, Tamara A. Greer, Esq. at 350 N. Lake Destiny Road, Maitland, Florida 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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