Filing Number: 808186
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| Filing Accepted: 2/24/2025 |
| Last/Business Name
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RENAISSANCE CONDO ASSN
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First Name |
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AMY |
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| Street Address
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3401 WINKLER AVE |
| City, State Zip
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FORT MYERS,
FL
33916
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| Email Address
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BOGGS-PLEADINGS@BOGGSLAWGROUP.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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RENAISSANCE CONDO ASSN |
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First Name |
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AMY |
| Policy # * |
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HCP007506 |
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Claim #* |
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H127257 |
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Attorney is Applicable
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| Last Name* |
BOGGS
First Name *
AMY
Initial
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| Street Address* |
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4554 CENTRAL AVE, STE L |
| City, State Zip* |
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SAINT PETERSBURG
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FL
33711
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| Email Address * |
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BOGGS-PLEADINGS@BOGGSLAWGROUP.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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HERITAGE PROPERTY & CASUALTY 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 14407 |
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| Name of individual responsible for violation (if any):*
DAVE THURMAN
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| Type of Insurance
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Commercial 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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gross underevaluation of the loss
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Other
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failing to respond to proof of loss
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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)(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)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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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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| 626.9541(1)(i)(3)(e) |
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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.
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| 626.9541(1)(i)(3)(f) |
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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.
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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.
Loss payment provision of the policy which requires payment of covered losses. Loss payment provision which requires coverage for the cost of reasonable repairs to the property in the event of a covered loss.
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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.
The Renaissance (Fort Myers) Condominium is an upscale condominium community located in Fort Myers, Florida (the “Community”). The Community is comprised of seven (7) residential buildings, carports, a pool area and fencing. The Community is governed and maintained by the Renaissance (Fort Myers) Condominium Association, Inc. ( the “Association”). The Community was severely damaged as a result of Hurricane Ian which barreled through Fort Myers on September 28, 2022.
The Association was insured for wind damage with Heritage Property & Casualty Insurance Co. (“Heritage”) for the 4/24/22 to 4/24/2023 policy period (the “Policy”). The Policy includes coverage for the peril of windstorm and covers all of the buildings in the Community. The Association submits this Notice of Violation against Heritage because Heritage has failed and refused to pay the full benefits due under the Policy, has grossly undervalued the claim – paying only $29,519.15 for damage estimated to exceed $1.8 million – has misrepresented the coverage available under the Policy, and has failed to timely communicate with the Association. In sum, Heritage undervalued, delayed, and mis-handled this claim from the outset.
The Association timely reported the loss to Heritage and Heritage assigned claim number H127257 to the loss. Heritage took nearly a year before it accepted coverage on 8/22/23 and made a small payment of $29,515.15 for damage to the carports. Heritage closed the claim and refused to re-open the claim after the Association retained a public adjuster and submitted additional documentation of damages. Specifically, the Association through its adjuster has submitted a detailed damage analysis and photos establishing damage in the amount of $1,832,803.26 ACV/ $2,062,162.29 RCV and Heritage refused to tender payment beyond the initial payment of $29,515.15. The Association submitted a Sworn Statement in Proof of Loss to Heritage on September 24, 2024. Heritage still refused to tender additional payment. The Association is seeking damages as follows:
Aggregate Total Estimated Damage for Buildings 1-7 $1,755,264.72 ACV/ $1,975,976.81 RCV less Aggregate Deductible for Buildings 1-7 of $518,990.60; Plus Estimated Carport damage total $60,528.54 ACV/ $69,175.48 RCV, reduced to Limits ($41,027.00), less prior payment of $29,519.15; Plus Fence Damage Total $17,010.00 ACV/ $17,010.00 RCV, reduced to Limits ($9,411.00) = $1,257,192.87 ACV/ $1,477,905.06 RCV.
Heritage has refused On information and belief, Heritage has engaged in the following behaviors with such frequency that the conduct is a pattern and practice of Heritage: delay, improper adjustment of claims, under-valuation of claims, failure to communicate with insureds, failure to respond to the proofs of loss submitted by insureds, failure to tender undisputed amounts due in a timely manner, and failing to render a coverage determination within a reasonable time period following the loss. This Notice is sent to perfect the Association’s rights under Florida Statute section 624155. In order to cure the defects identified in this Civil Remedy Notice of Insurer Violation, Heritage must tender payment for damage to Buildings 1-7, the fences and the carports in an amount consistent with the insured’s scope of damage.
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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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