Civil Remedy Notice of Insurer Violations
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Filing Number:     809146
Filing Accepted:  3/3/2025
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Complainant
Last/Business Name *  
GROTEKE   First Name   ALESSANDRA AND WALTER
Street Address * 1102 SOUTH BAYSHORE BLVD.
City, State Zip * SAFETY HARBOR, FL 34695
Email Address * LAGROTEKE@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GROTEKE   First Name   ALESSANDRA AND WALTER
Policy # * KIN-HO-FL-246085061 Claim #* HO-4377501
Attorney
Attorney is Applicable
Last Name* MARKER First Name * SHAUN Initial J
Street Address* ONE NORTH CLEMATIS STREET, SUITE 510
City, State Zip* WEST PALM BEACH , FL 33401
Email Address * SMARKER@MERLINLAWGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   KIN INTERINSURANCE NETWORK
NAIC Company Code 16603
 
Name of individual responsible for violation (if any):* OFFICERS, SUPERVISORS, AND OR MANAGEMENT OF KIN INTERINSURANCE NETWORK, AND ALL CLAIM REPRESENTATIVES, DESK ADJUSTERS, FIELD ADJUSTERS, LOSS CONSULTANTS, ENGINEERS, AND EXPERTS, SONYA PASTUCH, WILLIAM CHANG, HOLLY HARRIS, PHIL FREEMAN.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Claim Denial
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)(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)(2) 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.
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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Building coverage provisions; additional coverages; duties in event of loss policy provisions; all terms and conditions of Section I of the insurance policy; the insurance policy's definition section; the insurance policy's exclusion of coverage provisions; loss payment policy provision; loss settlement provision; the declarations page; we will adjust all losses with you.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the public trust. Kin Interinsurance Network has breached this duty by its handling of the Insureds’, Alessandra and Walter Groteke’s, Claim of Loss (Claim Number HO-4377501; D.O.L. 10/9/24). Kin Interinsurance Network has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insureds’ insurance claim for damages. On or about October 9, 2024, the Insureds submitted a claim to Kin Interinsurance Network for damages sustained as a result of Hurricane Milton. We have identified the following instances of bad faith conduct on the part of your company: • Purposefully minimizing the value of the claim by using biased estimating software/pricing and low-balling the cost of repairs. Specifically, estimations and repair costs have been purposefully devalued to the benefit of the insurance company despite knowledge that these costs are woefully deficient. • Implementing a claim handling process geared solely to the minimization of roof related damages. Specifically, taking a hardline stance on repairability in lieu of roof replacement regardless of evidence supporting the latter. This scheme is meant solely to benefit the carrier while hindering the insured from obtaining just compensation for the loss. • Failing to adopt and implement standards for the proper investigation of the claim; failing to conduct a proper investigation of all wind damage to the property, including all wind damage to the roof. • The Kin estimates purposefully minimizes the damages that resulted to the property as a result of wind from Hurricane Milton. This resulted in Kin’s failure to issue full payment to the insured for the damages to their property from Hurricane Ian, including but not limited to, the roof. • As a result of Kin’s failure to conduct a timely and complete roof inspection, payments have not been made to the Insureds. • Kins’s email to Counsel for Insureds on February 28, 2025 reflects that the “Claim Status Update is that the investigation is still in progress and a determination of coverage and any amount of loss has not been completed.” Accordingly, Kin Insurance has failed to timely investigate the claim and failed to timely provide a coverage determination. • Moreover, a Sworn Statement in Proof of Loss was submitted on or about November 9, 2024 to Kin Insurance, and Kin has failed to affirm or deny full or partial coverage of claims despite the submission of the Sworn Statement in Proof of Loss. • Kin has failed to account for and acknowledge all damage from wind of Hurricane Milton including but not limited to all tiles damaged from Hurricane Milton. • Refusing to pay for necessary repairs and attempting to coerce us into accepting a lower settlement amount by failing to properly consider all applicable statutes and building code requirements both at the state and local level. These actions on the part of your company are unacceptable, and are in violation of our insurance policy and the duty of good faith and fair dealing that Kin Interinsurance Network owes to its policyholders. Based on conduct to date, these practices occur with such frequency as to constitute a general claims handling process/business practice imbedded within the company’s management of Hurricane Milton claims. To date, notwithstanding the Insureds’ pleas otherwise, Kin Interinsurance Network has continued to refuse to acknowledge its obligation to tender all insurance proceed monies due and owing the Insureds or assist the Insureds in mitigation of the damages. The insurer has failed and refused to acknowledge coverage and restore the Insureds to their pre-loss condition. Kin Interinsurance Network has sufficient information upon which to evaluate the Insureds’ claim for damages, and certainly has been provided with an independent means by which to determine the amount of loss. The Insureds have otherwise fully complied with the insurer's requests for post-loss compliance. Kin Interinsurance Network has not properly paid all of the covered damages. These actions by Kin Interinsurance Network occur with such frequency to indicate a general business practice of the company. The Insureds have complied with the policy of insurance and Florida law, and Kin Interinsurance Network continues to wrongfully refuse to tender the insurance proceeds that are due and owing the Insureds. The concept of insurance is the granting of timely and prompt indemnity or security against a contingent loss. Florida statute section 624.02 defines "insurance" as a contract whereby one undertakes to indemnify another or pay a specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the Insureds may be put back into the position they were in prior to the loss as quickly as possible. Kin Interinsurance Network breached this duty. The Insureds were and still are forced to expend out of pocket monies to submit the insurance claim to force Kin Interinsurance Network to honor its obligations under the insurance policy to pay all the insurance proceeds due and owing them. Kin Interinsurance Network has clearly displayed bad faith in its handling, processing, and wrongful delay of this claim. The Insureds merely request that Kin Interinsurance Network "adjust the loss" with them in accordance with the policy of insurance for which Kin Interinsurance Network has accepted a premium, and in accordance with Florida law. Kin Interinsurance Network’s conduct has been reckless and unfair to its Insureds and has caused and continues to cause additional damages. We demand that Kin Interinsurance Network immediately take steps to rectify the situation and handle this claim in a fair and appropriate manner. This includes providing full and fair compensation for the damages incurred and for any additional costs and expenses incurred as a result of Kin Interinsurance Network's bad faith conduct, including but not limited to, fees and costs related to the retention of personnel/counsel required to challenge Kin Interinsurance Network’s improper handling of this claim. [As of this moment, the damages found and evaluated by the insured(s) value at minimum $291,787.04, and we request payment in that sum as a curative measure to the conduct described herein.]
Comments
User Id Date Added Comment
kristen.henderson@kin.com 05-01-2025 While Kin Interinsurance Network believes that the Civil Remedy Notice fails to comply with the requirements of Florida Statute §624.155 and Florida Case law, it has responded to the Notice in writing to Shaun Marker on May 1st, 2025.
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