Filing Number: 808868
|
| Filing Accepted: 2/28/2025 |
| Last/Business Name
*
|
|
|
AND ROOF TARP NOW, INC.
|
|
First Name |
|
ECOBUILD GROUP, INC. |
|
| Street Address
*
|
|
INSUREDS' PROPERTY: 5037 TOPROYAL LANE |
| City, State Zip
*
|
|
JACKSONVILLE,
FL
32277
|
| Email Address
*
|
|
INTAKE2@THEKRFIRM.COM |
| Complainant Type:
*
|
|
Third Party |
|
| Last/Business Name* |
|
VELICHKO |
|
First Name |
|
GEORGE AND LUBA |
| Policy # * |
|
BFL6508093-00 |
|
Claim #* |
|
CFL22579257 |
|
Attorney is Applicable
|
| Last Name* |
KADIR
First Name *
ALI
Initial
A.
|
| Street Address* |
|
986 DOUGLAS AVE, STE. 102 |
| City, State Zip* |
|
ALTAMONTE SPRINGS
,
FL
32714
|
| Email Address * |
|
INTAKE2@THEKRFIRM.COM |
|
|
| Insurer Type
*
|
|
Authorized Insurer
Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
PEOPLE'S TRUST INSURANCE COMPANY
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code 13125 |
|
|
| Name of individual responsible for violation (if any):*
AARON C. EDWORTHY (FORMERLY POWELL), ANDREW PARSONS, RAPID RESPONSE TEAM LLC, AND ALL PEOPLE’S TRUST CLAIMS ADJUSTERS, EMPLOYEES, REPRESENTATIVES, AGENTS, VENDORS, AND/OR ENGINEERS WHO HANDLED THE CLAIM.
|
| Type of Insurance
*
Residential Property & Casualty
|
|
|
| Reason for Notice
*
|
|
Claim Denial
|
|
Claim Delay
|
|
Unsatisfactory Settlement Offer
|
|
Unfair Trade Practice
|
|
Other
:
Misrepresentation
|
|
|
*
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)(2) |
|
Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
|
| 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)(b) |
|
Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
|
| 626.9541(1)(i)(3)(c) |
|
Failing to acknowledge and act promptly upon communications with respect to claims.
|
| 626.9541(1)(i)(3)(d) |
|
Denying claims without conducting reasonable investigations based upon available information.
|
| 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.
|
| 626.9541(1)(i)(3)(f) |
|
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.
|
| 626.9541(1)(i)(3)(g) |
|
Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
|
| 626.9541(1)(i)(3)(h) |
|
Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
|
| 626.9541(1)(i)(4) |
|
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).
|
|
*
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 insure for direct physical loss to the property covered caused by a peril listed below unless the loss is excluded in the Exclusions.
. . . .
2. Windstorm Or Hail.”
|
| |
*
Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
The Complainants, Ecobuild Group, Inc. and Roof Tarp Now, Inc. (“the Complainants”), are mitigation companies and assignees of the homeowners/insureds who provided tarp and emergency mitigation services to the Insureds’ property/home after a wind and rainstorm. However, the Complainants were wrongfully underpaid by the insureds’ insurance company for said services.
To be specific, the assignors, George and Luba Velichko (“the Insureds”), are homeowner insureds with an insurance policy issued by People’s Trust Insurance Company (“People’s Trust”) that insured property located at 5037 Toproyal Lane, Jacksonville, Florida 32277.
In December of 2020, the Insureds’ property sustained extensive damage caused by a wind and rainstorm for which People’s Trust admitted coverage under the subject insurance policy. The Complainants subsequently provided tarp and emergency mitigation services to the Insureds’ property. To date, all work has been completed. The Complainants submitted reasonably priced invoices totaling $11,839.96 with supporting documentation and photographs to People’s Trust for said services.
After reporting the claim, People’s Trust retained an unqualified and biased field adjuster who has a financial relationship with People’s Trust. This field adjuster inspected the Insureds’ home in an apparent effort to minimize People’s Trust’s losses instead of adjusting the claim in good faith.
However, despite admitting coverage for the insurance claim, People’s Trust significantly undervalued the coverage afforded by paying only $2,300.00 which is unreasonably low for the services provided.
Based on these facts, it is clear People’s Trust unreasonably denied full coverage and full payment for the Complainants’ services in bad faith through its extremely low and unreasonable undervaluation. Had People’s Trust conducted a reasonable investigation based upon the available information, it would have been evident that affording greater coverage and issuing a substantially higher payment is warranted. Instead, it failed to adopt and implement standards for proper claim investigation as well as misrepresented pertinent policy provisions/facts rather than act fairly and/or honestly with the Complainants in due regard for their interests. This has become a common business practice of People’s Trust.
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 and/or assignees of the insured(s) may mitigate damages and put the insured(s) back into the position they were in prior to the loss as quickly as possible. People’s Trust has breached this duty by refusing to properly and timely adjust the loss.
As a result, the Complainants had no choice but to retain the undersigned counsel to file a lawsuit against People’s Trust.
People’s Trust has more than enough information and is still refusing to pay the Complainants the outstanding amount due regarding its invoice. This continued and repeated reckless claim delay and denial of payment will result in a significant punitive damage award if a bad faith lawsuit is filed.
People’s Trust can cure the violations contained herein by paying the Complainants the outstanding amount of $9,539.96 for their invoices.
|
|
*
|
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
|