Civil Remedy Notice of Insurer Violations
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Filing Number:     809254
Filing Accepted:  3/3/2025
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Complainant
Last/Business Name *  
NAPLES MARINER INC   First Name  
Street Address * 1295 GULF SHORE BLVD. S.
City, State Zip * NAPLES, FL 34102
Email Address * PBOURGET@COMCAST.NET
Complainant Type: * Insured
Insured
Last/Business Name*   PBOURGET@COMCAST.NET   First Name  
Policy # * AMC-35969-03 Claim #* 4197887
Attorney
Attorney is Applicable
Last Name* DUROCHER First Name * JOSHUA Initial
Street Address* 3310 WEST CYPRESS STREET SUITE 202
City, State Zip* TAMPA , FLORIDA 33607
Email Address * JD@THEKDLEGALGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN COASTAL INSURANCE COMPANY
NAIC Company Code 12968
 
Name of individual responsible for violation (if any):* ANY AND ALL ADJUSTERS, SUPERVISORS, MANAGEMENT, ATTORNEYS AND/OR INDIVIDUALS ASSOCIATED WITH THE CLAIM. CHUCK JEWELL, SHARON BLOW, GIL BARAN, RANDY CIARLONE, FACHON REED.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
* 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)(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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Section I Property Coverages of the appliable policy provides coverage for the reported claim. The Insured has complied with all policy conditions, and there are no exclusions that apply. The Insured believes the Policy language relevant to the violations include all applicable policy coverages, loss payment provisions, loss settlement provisions, valuation provisions and other terms and conditions of the subject policy. In particular, the Insured refers to the following policy language: Coverage A – Dwelling, Coverage B - Other Structures, Coverage C - Personal Property, Coverage D - Loss of Use, Additional Coverages, Law and Ordinance Coverage, and/or Additional Endorsements and Forms. The carrier has failed to issue insurance benefits to its Insured pursuant to the Loss Settlement, Loss Payment, and other Provisions in the applicable policy.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This complaint is made on behalf of Naples Mariner Inc (“Insured”). Naples Mariner Inc purchased their policy from American Coastal Insurance Company (“Carrier”), Policy No. AMC-35969-03 (the “Policy”), which provided coverage for the property located at 1295 Gulf Shore Blvd. S., Naples, FL 34102 (the “Property”). Naples Mariner Inc paid all premiums associated with the Policy. The Policy was in full force and effect at the relevant times herein. On or about September 28, 2022, the Property was damaged because of Hurricane Ian. The loss caused substantial damage to the Property, including, but not limited to, substantial damage to the Property’s roof, soffits, decorative tiles on the exterior buildings, fencing, fascia, lights, doors, and walkways. The Insured promptly notified American Coastal Insurance Company of the damages. The Carrier acknowledged the claim and assigned it Claim No. 4197887. Since then, the Carrier has simply refused to properly pay Naples Mariner Inc for their Hurricane Ian claim and has neglected and delayed the claim as long as possible to increase its profits to the detriment of its Insured. Specifically, following receipt of the claim, American Coastal Insurance Company retained an insurance industry-oriented adjuster, Chuck Jewell, who failed to complete a full and proper evaluation of the claimed damages. The Carrier’s inspection included a cursory visual only view of the damages. The insurance company’s representative was neither a licensed roofer nor an engineer, architect or other expert qualified to give an opinion as to the cause and origin of the damages. Based on this individual’s observations, the Carrier found the damage to the roof and interior fell below the deductible. Here, the roof was found to be repairable for just a few hundred dollars, which the Carrier’s position would later change following a more in-depth review. Later, the Insured retained a public adjuster, who reviewed the full extent of the damages. The public adjuster presented an estimate of damages for $1,147,971.10, which outlined all the damages caused by Hurricane Ian. After the insured provided the Carrier with an estimate of the true scope and pricing of the damages and submitted a sworn statement in proof of loss, the Carrier had an inspection completed by an engineer on May 26, 2023. The engineer opined that the roof had been damaged by the hurricane winds, but that the roof was repairable. The engineer report is extremely limited in the documented damage to the roof – at least when compared to the extensive damage found within the public adjuster’s estimate. It should also be noted that the roof itself was less than five years old, and the paint was all only a few years old as well. The engineer confirmed wind damages to the upper portions of the exterior paint. The evidence of exterior damages goes well beyond the decorative tiles and paint, as there are impact marks throughout the exterior. The engineer also found certain decorative damages to the exterior that he could not rule out as a wind related issue. It is clear from the engineer’s report that the initial inspection missed a great deal of damage that should have been blatantly obvious had a thorough review been completed. Yet still this engineer inspection missed the scope and severity of the damages. An updated coverage determination was issued on September 6, 2023, with an updated estimate. Just short of four months after the engineer inspection, the carrier finally conceded more damage was found that was not in the first estimate, but still found the damages were under the deductible. It then took over six months from then for the carrier to concede the roof replacement in writing, but only if the Insured were to execute a release in return. Since then, the offers remain insufficient to put the Insured in their pre-loss position, and still no updated estimate has been provided to show the roof replacement cost. Then, over a year after the updated coverage determination, a request for information was made for the first time. The Insured complied, but it was clear from this request – made over two years after the loss – that this was a mere delay tactic to prevent all payments. In Florida, the work of adjusting insurance claims engages the Public Trust. American Coastal Insurance Company has breached this duty by its improper adjustment of this claim. The actions by the Carrier and its adjuster(s) are contrary to the Loss Payment and Valuation provisions of the Policy. Carrier, through its adjuster and persons entrusted to investigate this loss, has failed to investigate this loss adequately and fairly. The Carrier has, based on the above facts to date, committed the following violations: 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 their interests; by 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; and by failing to adopt and implement standards for the proper investigation of claims. This is unconscionable and a gross violation of ethical standards by the Carrier and clear evidence of bad faith by the Carrier who should have evaluated and fairly provided coverage for the true cost of the damages associated with the loss. This failure to investigate and consider adverse information is evidence that Adjusters (listed) approach investigations in a manner that is prejudicial to its Insureds in violation of Florida Administrative code 69B-220.201(3)(c). American Coastal Insurance Company has a contractual obligation not to look the other way when confronted with facts revealing the possibility of coverage. The concept of insurance is that insurance is the insurer’s granting of timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the insured may mitigate damages and to put the Property back into the position it was in prior to the loss as quickly as possible. Here, American Coastal Insurance Company has breached this duty. As detailed above, American Coastal Insurance Company has refused or failed to cooperate or “Adjust the Loss” with the Insured during the claims adjustment process in compliance with the Policy’s “Loss Payment” provision. This is a breach of the Policy. American Coastal Insurance Company ’s handling and adjustment of this claim and the conduct of the adjusters, supervisors, management, and individuals associated with or retained by the carrier in this claim to date, evidence that it has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations set forth above. American Coastal Insurance Company has also failed and/or refused to thoroughly, accurately, and completely investigate and evaluate Naples Mariner Inc’s claim for damages, and has failed to provide sufficient explanation under the terms of the policy for the coverage position adopted, and has failed to provide their insured with documents which purportedly support the position taken. This notice is given to protect the right to pursue the civil remedy authorized by Florida Statute, including any and all bad faith/extra contractual, should the Carrier fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. The Insured also intends to seek punitive damages against the Carrier as it appears that their violations occur with such frequency as to evidence a general business practice, and the violations were willful, wanton, and malicious and were in reckless disregard for the rights of the Insured. While no specific “cure amount” is required for this Civil Remedy Notice to be valid, the Insured will consider the allegations contained herein “cured” if Carrier: (1) Immediately tenders an actual cash value payment listed within their public adjuster’s estimate less the deductible ($1,041,119.26), with no requirement for the Insured to sign a release. While the Insured is requesting that this be done to “cure” this Civil Remedy Notice, the Insured is willing to consider, and may accept, any reasonable counteroffer. Therefore, if Carrier disagrees with the requests, the Insured requests that Carrier make a counteroffer before the end of the “cure period” and provide supporting documentation for any such offer so that they may understand any discrepancies that could exist regarding the estimates.
Comments
User Id Date Added Comment
azesch@amcoastal.com 05-02-2025 The following constitutes American Coastal Insurance Company's ("AmCoastal") response to this Civil Remedy Notice of Insurer Violations ("CRN"). The CRN is not valid because it does not comply with applicable statutes, and AmCoastal denies the allegations in the CRN in their entirety. AmCoastal also rejects the defamatory allegations in the Notice. The Complainant/Insured and AmCoastal have reached a settlement agreement, including an agreement by the Complainant/Insured to release AmCoastal from all claims, including all claims relating to the CRN. Therefore, the allegations in the CRN have been cured.
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.

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DFS-10-363
Rev. 10/14/2008